Several studies suggest decreased fertility potential in patients with a history of testicular torsion. However, in the current study in couples in which the male had a history of testicular torsion the pregnancy rate and the interval to pregnancy were within the accepted range of the general population.

INTRODUCTION AND OBJECTIVES: Many couples seeking permanent contraception choose vasectomy, yet little is known about the number performed per year or trends over time in the United States (US). Survey studies, both directly to providers and through the National Survey of Family Growth, have been used to estimate vasectomy rates. These are limited by the lack of provider information and small sample sizes. Our goal is to more accurately assess vasectomy rates in the US and determine temporal and regional patterns using a large, national insurance claims database.METHODS: The Truven Health Marketscanâ database contains information from adjudicated and paid insurance claims filed for privately insured individuals with employment based insurance. Claims data on patient age, vasectomy rate, and location in the US from 2007-2013 was evaluated. We included men aged 18-64 and grouped them in the following groups: 18-24, 25-34, 35-44, 45-54, and 55-64. In order to be included in the data analysis there must have been a claim in the Marketscanâ database in the past year.RESULTS: Over the time period 577,404 men were counseled for vasectomy and 453,369 (79%) underwent the procedure. The rate by region during the time period is: North Central (0.66%), West (0.61%), South (0.50%) and Northeast (0.41%). The most common vasectomy rates are in the 25-34 year olds and 35-44 year olds with 0.98% and 1.30% respectively. Over this time period there is a decrease in vasectomy rate in all age groups and in all locations of the country (p<0.001) as seen in Table 1. Using this data and the most recent US Census data, an estimated 513,594 vasectomies were performed in the US in 2012.CONCLUSIONS: An estimated 513,594 vasectomies are performed in the US. From 2007-2013 there was a decrease in the rate of vasectomy in all age groups and in all locations of the country. Vasectomies are more commonly performed in the North Central and West region of the US and in men aged 35-44.