Reduced Postvasectomy Semen Analysis Testing With the Implementation of Special Clearance Parameters.

OBJECTIVE: To determine the applicability of postvasectomy special clearance parameters (<100,000 nonmotile sperm/mL on semen analysis) suggested by the American Urological Association and to define the associated cost savings with avoidance of further testing. MATERIALS AND METHODS: We retrospectively reviewed the cohort of men undergoing vasectomy from December 2009 to August 2012 at a single institution. Patient demographics and postvasectomy semen analysis (PVSA) results were collected for clearance parameter comparisons. RESULTS: During the study period, 230 patients underwent vasectomy with a mean ± SD age of 36.4 ± 6.5 years. Among the cohort, 83.5% were married and 95.2% had one or more children. The initial PVSA was completed by 111 (48.3%) patients at a mean of 17.8 weeks (range 4-45) following vasectomy. Sperm was identified on initial PVSA in 40 patients (36.0%); 1 patient was found to have motile sperm. Of 39 patients, 38 (97.4%) with nonmotile sperm on PVSA could be cleared to cease other contraceptives based on the most recent clearance guidelines. For those completing an initial PVSA, postvasectomy clearance increased from 64.0% to 98.2% representing a potential cost savings of $2356 in repeat semen testing. CONCLUSION: Postvasectomy contraceptive clearance can be greatly increased when rare nonmotile sperm parameters are included although postvasectomy semen testing compliance remains poor.

Do CASA systems satisfy consumers demands? A critical analysis.

Boar studs are often offered new technologies including several CASA (computer-assisted semen analysis) systems. However, independent information to assist their purchase decisions is not available. The systems accuracy and repeatability variation because of different factors can be evaluated through duplicate testing of semen samples and comparison of the results according to WHO standards for humans. This primary analysis and a thorough economic cost benefit evaluation will help to decide whether the purchase of a CASA system will be profitable for a boar stud. Our experience of implementing several CASA systems in the cooperative Dutch Artificial Insemination (AI) centres is used as a base for this discussion.

A novel cost-effective approach to post-vasectomy semen analysis.

OBJECTIVE: • To examine compliance, clearance rates and cost-effectiveness of a novel approach to managing men following vasectomy based on the testing of sperm viability. PATIENTS AND METHODS: • Between January 2003 and March 2005, 832 men undergoing vasectomy were followed prospectively for a minimum of 12 months. • Post-vasectomy semen analysis (PVSA) was carried out at 16 weeks with repeat at 20 weeks only if sperm were detected on initial PVSA i.e. a single clear PVSA on simple microscopy was deemed sufficient for declaring vasectomy successful. • In men with persistent non-motile sperm (PNMS) in the second specimen, comprehensive analysis of number and viability of sperm using a fluorescent probe was carried out on a fresh semen specimen taken in accordance with British Andrology Society (BAS) guidelines. RESULTS: • Overall compliance with the PVSA protocol was 81.3% (95% CI 78.5 to 83.8). No sperm were seen in 540 (78.8%) and 70 (10.3%) at the initial and 2(nd) PVSA respectively. • Persistent spermatozoa at 20 weeks were present in 66 (9.8%, 7.8 to 12.2) cases with 58 (8.6%, 6.7 to 11.0) having PNMS and 8 (1.2%, 0.6 to 2.3) having motile sperm. • Fluorescent viability testing in 53 of the 58 with PNMS showed viable sperm in 2 (3.8%, 1.0 to 12.8). The failure rate of vasectomy defined by PVSA (8 with motile sperm on 2(nd) PVSA and 2 with viable non-motile sperm on fluorescent testing) was 1.2% (0.7 to 2.2). • Average cost per vasectomy of PVSA using this protocol was £10.77 (US$ 16.67) compared with a minimum likely average cost using BAS guidelines of £18.10 (US$ 28). CONCLUSION: • Demonstrating absence of sperm on simple light microscopy in a single specimen of semen at 16 or 20 weeks post-vasectomy and reserving comprehensive testing of sperm viability for only the higher risk group with PNMS improves compliance and represents a cost-effective strategy for declaring surgical success. This reduces the costs of PVSA by least 40% compared with adherence with BAS guidelines without compromising success in determining outcome after vasectomy.

Genetic evaluation of breeding strategies for improvement of dairy cattle in Kenya.

A deterministic approach was used to compare breeding strategies utilizing local and imported semen for improvement of dairy cattle in Kenya. The local selection programs considered were a closed progeny testing scheme (CPT) and a young bull system progeny of local bulls (PLB). The continuous semen importation (CSI) and young bull system progeny of imported bulls (PIB) were the strategies based on imports. The breeding strategies were compared on the basis of selection response. The effect of genetic correlation (r(g)) and initial differences in genetic merit between the two populations was also examined. The CSI and PIB strategies ranked above CPT by, correspondingly, 35.1% and 25.0% when the r(g) between Kenya and the USA was assumed to be one. At a r(g) of 0.58, imports from countries which are 1.50 standard deviation (SD) above the local population were superior to CPT but equal to PLB. This means that if CSI is to be used at a r(g) of 0.58, then only semen from countries which are >1.50 SD should be imported. At a r(g) of 0.70 and with an initial genetic difference of 1.25 SD, the economic responses in CSI and PLB were equal. This indicates that semen importation is only justified when genotype-environment interaction is >0.70. It is concluded that wholesale importation of semen as a means of achieving sustainable genetic progress in Kenya is a less optimal solution and there is the need for an effective local selection program.