Development of a patient decision aid on post-vasectomy semen analysis for vasectomized men

Abstract

Introduction: Clinical practice guidelines recommend that vasectomized men submit a semen sample for post-vasectomy semen analysis (PVSA) after the procedure. However, about one-third of men do not comply with this recommendation. Complying with PVSA appears to be a "difficult" decision according to the Ottawa Decision Support Framework. We created a Patient Decision Aid (PtDA) to help men decide whether to do a PVSA and assessed its acceptability and perceived utility.

Methods: A multidisciplinary committee developed the PtDA, applying international standards through an iterative process. Content was based on literature on the determinants of compliance with PVSA and vasectomy effectiveness statistics retrieved from Vasectomie Québec, the largest vasectomy clinic in Canada. We conducted two 11-item surveys of men vasectomized in five vasectomy clinics located in the Province of Quebec, Canada to assess the PtDA acceptability and perceived utility.

Results: The PtDA includes a description of the PVSA, vasectomy success/failure probabilities, reasons reported for doing a PVSA or not, and resources to help with decision-making. In both surveys (n=28 and 78), participants found the tool to be acceptable overall. More than 90% found it easy to understand and helpful for evaluating the advantages and disadvantages of options and deciding which option to choose. More than 95% of men reported that the language and statistics were easy to understand.

Conclusion: Vasectomized men considered the PtDA on PVSA as acceptable and useful for deciding whether to do a PVSA.

Keywords: Outil d’aide à la décision; Patient decision aid; Patient-centered care; Reproductive health care; Santé reproductive; Semen analysis; Soins centrés sur le patient; Spermogramme post-vasectomie; Vasectomie; Vasectomy.