What are the recommended follow-up procedures to confirm the success of a vasectomy?

To confirm the success of a vasectomy, the recommended follow-up procedure is to perform a post-vasectomy semen analysis (PVSA) to ensure azoospermia or the presence of only non-motile sperm, indicating effective sterilisation NICE CG156. Typically, the first semen sample should be collected around 12 weeks after the procedure or after 20 ejaculations, whichever comes first, to allow sufficient time for any remaining sperm to clear from the reproductive tract NICE CG156. If motile sperm are detected, further samples are advised at intervals until azoospermia or only non-motile sperm are confirmed, or until it is clear that the procedure has failed NICE CG156. Recent literature emphasises the critical role of PVSA in confirming vasectomy success and highlights that the presence of rare non-motile sperm may still be considered a successful outcome, reducing unnecessary repeat procedures Khalafalla et al. 2024. This integrated approach ensures that patients receive clear guidance on when to discontinue alternative contraception safely and confirms the effectiveness of the vasectomy NICE CG156; Khalafalla et al. 2024.