Post-Vasectomy Semen Analysis

The post-vasectomy semen analysis (PVSA) is the only way to confirm a vasectomy worked. Until it comes back clear, you are not sterile.

What this test measures

A PVSA checks a semen sample for sperm. The lab looks at a fresh sample under the microscope and, if needed, centrifuges it to look for rare sperm. The goal is azoospermia (no sperm) or only rare, non-motile sperm.

The American Urological Association recommends testing about 12 weeks after the procedure and after at least 20 ejaculations — that clears sperm still stored downstream of the vasectomy site. Testing earlier often gives a false positive and just means testing again.

Parameters reported

How to prepare

  • Wait about 12 weeks and 20 or more ejaculations after your vasectomy. Testing sooner usually shows leftover sperm and you'll be asked to retest.
  • Abstain 2–7 days before the sample so there is enough volume to examine.
  • Do not use lubricants, saliva, or spermicide condoms during collection.
  • Collect the whole sample. If the lab allows at-home collection, deliver it within 60 minutes at body temperature — confirm when you book.
  • Bring your Hera lab order and a photo ID.

What happens at the lab

  • Check in at the lab's front desk and hand over your Hera order. The lab may ask you to register as a patient — this takes a few minutes.
  • You'll be given a sterile cup and a private room. Wash your hands, collect by masturbation, and note the exact time of collection on the label.
  • Hand the sample back to staff. Analysis starts within an hour, so there's nothing else for you to do on site.

Getting your results

Most labs report within a few business days. The report will state either no sperm seen, rare non-motile sperm, or a count with motility.

No sperm, or rare non-motile sperm (under 100,000/mL), is considered a successful vasectomy per AUA guidance and you can stop using backup contraception.

If motile sperm are present, keep using contraception and repeat the test in 4–6 weeks. Persistent motile sperm after 6 months may mean the vasectomy failed — your urologist will advise.

Test codes: CPT and diagnosis

A post-vasectomy check is billed under its own CPT code, separate from the fertility semen analysis. If your urologist gave you an order, or the lab asks which test you need, these are the codes.

CPT codes (what the lab runs)

Code What it covers
89321On a Hera order Presence and motility of sperm — the standard post-vasectomy semen analysis (PVSA).
89320 Complete semen analysis — some labs run the full analysis instead of the limited PVSA.

Diagnosis codes physicians commonly use (ICD-10)

Code What it covers
Z30.8On a Hera order Encounter for other contraceptive management — the post-vasectomy sperm count check.
Z98.52 Vasectomy status — records that the vasectomy has been done.

Ask for 89321 by name if a lab offers only the full analysis — it costs more and reports parameters you don't need after a vasectomy. Many health plans cover the post-vasectomy check as part of the procedure; the cash prices on Hera are for patients paying the lab directly.

Full CPT code guide →

Common questions

When should I do a post-vasectomy semen analysis?

About 12 weeks after the procedure and after at least 20 ejaculations, per the American Urological Association. Both matter: time lets the tract heal, and ejaculations flush out sperm still stored beyond the cut.

Do I need my urologist to order the post-vasectomy test?

No. Labs require a physician requisition, and Hera provides one signed by an independent physician. You can share the result with the urologist who did your vasectomy or keep it for your own records.

What result means the vasectomy worked?

Azoospermia (no sperm seen) or rare non-motile sperm — fewer than 100,000 non-moving sperm per mL. Either result means you can stop using other contraception.

What if sperm are still present?

Motile sperm at 12 weeks usually means you need more time and more ejaculations — repeat the test in 4–6 weeks. Motile sperm that persist past 6 months suggest recanalization and your urologist may recommend repeating the vasectomy.

What is the CPT code for a post-vasectomy semen analysis?

CPT 89321 — sperm presence and motility only. It is a different, cheaper test than the full fertility semen analysis (89320). The diagnosis codes usually paired with it are Z30.8 (contraceptive management) and Z98.52 (vasectomy status).

Where to get it

Lab networks with listed locations that run this test through Hera.

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