OVERALL: It’s a toss-up, and that’s good news.
In comparing the Legacy at-home post-vasectomy semen analysis and the Fellow Vasectomy Test, I’d call them comparable, with Legacy slightly cheaper. Legacy is $145 and Fellow is $149. Both are CLIA-certified, both ship free both ways, both check for the thing that matters (is there any sperm left?), and both will send results to your urologist.
The real differences are speed and setting. Legacy posts results within 24 to 48 hours of the sample reaching the lab. Fellow says most people get results in 7 to 10 business days. On the other side, Fellow has built its whole business around clinics: 4,000+ practices hand out Fellow boxes, there’s a published study showing 82% of patients actually complete the test, and if your result comes back positive they send a retest kit for free.
So: ordering it yourself and want the answer this week? Legacy. Your urologist already handed you a Fellow kit? Use it, you’re fine.
QUICK FACTS (Oct 2026):
- Legacy’s post-vasectomy test is $145. Fellow’s is $149. Both include shipping both ways.
- Legacy returns results within 24 to 48 hours of lab receipt. Fellow quotes 7 to 10 business days.
- Legacy reports volume, concentration and motility with double manual verification of zero sperm. Fellow checks for the presence of any sperm, living or dead.
- Both labs are CLIA-certified. Legacy’s lab also holds a New York State CLEP permit; Fellow holds a NYS permit specifically for post-vasectomy testing.
- Fellow sends a free retest kit if sperm are found. Legacy recommends a standard semen analysis for retesting.
- Both are HSA/FSA eligible. Legacy is also in-network with Aetna, Cigna, Emblem and UnitedHealthcare for semen analysis depending on your state.
LEGACY VS. FELLOW POST-VASECTOMY TEST: SIDE BY SIDE
| Legacy | Fellow | |
|---|---|---|
| Price | $145 | $149 |
| Shipping | Free overnight both ways, insulated “vault” | Free both ways, pre-paid mailer |
| What it checks | Volume, sperm concentration, motility; double manual verification of azoospermia | Presence of any sperm, living or dead |
| Results turnaround | 24 to 48 hours from lab receipt | 7 to 10 business days for most people |
| How results arrive | Client dashboard; can go to your provider | Secure emailed link; copy to your provider on request |
| Retest if sperm found | Order another test (standard semen analysis recommended) | Free replacement kit until zero sperm |
| When to test | 8 to 12 weeks after the procedure, per your doctor | 12 weeks and at least 35 ejaculations, per AUA guidance |
| Reminders | Not advertised | Email reminder when it’s time to test |
| Lab | Own lab, CLIA 31D2285605, NYS CLEP PFI 6002 | Own lab, CLIA 05D2177822, COLA 31245, NYS permit for PVSA |
| Published PVSA data | Legacy’s general kit validation | J Urol 2024 study: 82% compliance with mail-in PVSA |
| Clinic network | Clinician program; US military partnerships | 4,000+ clinical partners |
| Payment | HSA/FSA eligible; insurance in-network for semen analysis in some states | HSA/FSA eligible |
| Reviews | 4.9/5 on Google (all products) | 4.6/5 across 15,000+ reviews (all products) |
Sources: Legacy post-vasectomy semen analysis, Fellow Vasectomy Test, Fellow J Urol 2024 compliance study announcement. Prices checked October 24, 2026.
IS LEGACY OR FELLOW CHEAPER FOR A POST-VASECTOMY TEST?
Legacy, by four dollars. Legacy’s post-vasectomy semen analysis is $145 and Fellow’s Vasectomy Test is $149. Both include shipping to you and back to the lab, so there’s nothing hiding in the checkout.
If you’re the kind of person who’ll need a second test (more on that below), Fellow’s free retest kit can flip the math. Legacy would have you buy another test.
Both take HSA/FSA. Legacy also lists in-network coverage with Aetna, Cigna, Emblem and UnitedHealthcare for semen analysis in some states, so it’s worth a look at their insurance checker before you pay cash.
HOW FAST DO POST-VASECTOMY TEST RESULTS COME BACK?
This is the biggest gap between the two. Legacy posts results to your dashboard within 24 to 48 hours of the sample arriving at the lab. Fellow says most people get results in 7 to 10 business days.
I don’t think the lab work is slower at Fellow. Their standard semen analysis comes back in 1 to 2 business days. The vasectomy test is a cheaper, batched product aimed at clinics, and the turnaround reflects that. If you’re waiting to stop using other birth control, a week and a half feels long. If your urologist is the one reading the result anyway, it matters less.
WHAT DOES EACH TEST ACTUALLY CHECK?
Fellow’s Vasectomy Test does one job: it looks for the presence of any sperm, living or dead. That’s exactly what the American Urological Association guidance calls for, and if none are found you can stop using other contraception.
Legacy’s version reports semen volume, sperm concentration and motility, and runs a “double manual verification” when the count is zero, meaning two people confirm the azoospermia under a microscope. You get a bit more information, which is useful if there IS sperm left and you want to know how much.
For a yes/no on whether your vasectomy worked, both answer the question. Legacy gives you a slightly fuller picture.
WHAT IF SPERM ARE STILL FOUND?
It happens. Some men take longer than 12 weeks to clear, and a small number of vasectomies fail outright (Legacy puts it at 1 or 2 in 1,000).
Fellow handles this best: if your result is positive, or your doctor wants two clear results, they send another kit at no charge until you hit zero. Legacy recommends following up with its standard semen analysis, which you’d pay for.
WHEN SHOULD YOU TEST AFTER A VASECTOMY?
Both companies say the same thing in slightly different words: wait about 12 weeks and clear out your system first. Fellow quotes the AUA figure of at least 35 ejaculations in that window. Legacy says 8 to 12 weeks, ejaculate often starting a week after the procedure, and stop 2 to 5 days before you test. Follow your doctor’s instructions over either website.
One nice touch from Fellow: register the kit on the day of your vasectomy and they’ll email you when it’s time to test. Several reviewers mention this as the reason they actually got it done.
WHICH ONE DO CLINICS USE?
Fellow. More than 4,000 practices hand out Fellow kits, and a 2024 study in the Journal of Urology found 82% of patients completed their mail-in post-vasectomy test, far above the usual rate when men have to show up at a lab. That’s the strongest thing either company can say about post-vasectomy testing specifically, and it’s Fellow’s.
Legacy’s clinic program exists and the company is the preferred provider for several US military groups, but its post-vasectomy test is more of a direct-to-consumer product.
Hope this is helpful!!!!
FAQ: LEGACY VS. FELLOW POST-VASECTOMY TESTING
Which is better, Legacy or Fellow for a post-vasectomy test?
They’re comparable. Legacy is $4 cheaper ($145 vs $149) and returns results in 24 to 48 hours against Fellow’s 7 to 10 business days. Fellow sends a free retest if sperm are found, emails you when it’s time to test, and is the kit most urology clinics hand out. Pick Legacy for speed if you’re buying it yourself; use Fellow if your clinic gave it to you.
How much does an at-home post-vasectomy test cost?
$145 at Legacy and $149 at Fellow as of October 2026, both with shipping included. In-clinic post-vasectomy semen analysis is typically $150 or more before any lab fees.
How long do post-vasectomy test results take?
Legacy posts results within 24 to 48 hours of the lab receiving your sample. Fellow says most people receive results in 7 to 10 business days.
When should I do a post-vasectomy semen analysis?
About 12 weeks after the procedure, after clearing your system. The American Urological Association suggests at least 35 ejaculations in that window. Keep using other contraception until a test shows zero sperm.
What if my post-vasectomy test still shows sperm?
Keep using contraception and retest. Fellow sends a free replacement kit until you reach zero. With Legacy you’d order another test; they recommend the standard semen analysis.
Are at-home post-vasectomy tests accurate?
Both Legacy and Fellow analyze samples in their own CLIA-certified labs. Fellow’s post-vasectomy test is validated by its published mail-in semen analysis study, and a 2024 Journal of Urology paper found 82% of patients completed mail-in PVSA. Legacy adds a double manual verification whenever a sample reads zero sperm.
