Semen analysis

Firstly, you need to ensure that your doctor has provided you with two completed semen analysis referral forms both indicating a request for a post vasectomy semen analysis. You can either produce your samples at Cambridge IVF or, if you live within 30 minutes travel time of Cambridge IVF you have the option to produce the sample at home. We will provide you with a suitable sterile container on both occasions when you arrive or you can collect your containers from Cambridge IVF prior to your appointment if you wish to produce at home. We will only accept samples produced into our own containers as we know these are fit for purpose and will not compromise the quality of the sample.

Secondly, your sample should be produced no sooner than 12 weeks post vasectomy and that your second samples is produced no earlier than 20 weeks post vasectomy. Before you produce the first sample you must ensure that you have ejaculated no less than 20 times following your vasectomy. These measures are in place to ensure that we are as likely as possible to be able to give you clearance post vasectomy with as little inconvenience to you as possible.

Finally, you need to telephone the Andrology Service on 01223 349017 and arrange two appointment times to produce your samples for analysis. The first appointment should be no less than 16 weeks following your vasectomy procedure; the second sample should be four to six weeks thereafter.

Please note it is likely there will be a wait of two to four weeks before we are able to offer you an appointment.

In order to get the best sample from you we require you to abstain from any sexual activity (including masturbation) for between two and five days (but in no case more than seven days) prior to your appointment date.

At Cambridge IVF we have quiet and discrete rooms available for you in which you can produce your sample.

Appointments are available for semen analysis between the hours of 09:00 and 15:00 Monday to Friday (excl. Bank Holidays)

Cambridge IVF does not operate a sample ‘drop in service’ as semen analysis is a time critical test and specimens must be produced and analysed at appropriate and pre arranged times. If you arrive more than 30 minutes after your allocated appointment time or do not have your referral form with you, we will be unable to perform your test and you may have to re-book the appointment. You should therefore give yourself plenty of time to arrive, especially if travelling by car. We do have ample free parking onsite but the roads surrounding Cambridge can sometimes be unexpectedly congested. If you cannot keep your appointment time for any reason please call and we will re-book your appointment for the next mutually convenient time and date.

Samples are either produced on site at Cambridge IVF in one of our dedicated sample rooms or at home in certain cases. Although our rooms are well proportioned we suggest that you produce your sample on your own; we do not recommend your partner accompanies you into the room although they are very welcome to wait for you in our waiting area.

• Firstly ensure that you have booked an appointment time
• Ensure that you have been provided with a completed semen analysis request form from your doctor and they have indicated the test required is a post vasectomy semen analysis. Your form should have your name, date of birth, NHS number, partner’s name, partner’s date of birth and the date on which your vasectomy was performed
• Abstain from any sexual activity for two to five days but for no more than seven
• At your allocated appointment time a member of our laboratory team will greet you from the waiting area, check your referral form is completed correctly and provide you with an appropriately labelled sample container (or collect the sample from you if you produced the sample at home). If you are producing the sample at Cambridge IVF, we will show you to the private sample room in which you can produce your sample
• If you are producing at home please bring along photo ID such as a driving license or passport so we can confirm your identity otherwise we cannot accept your sample for analysis
• Thoroughly wash, rinse and dry your penis, testicles and hands before you produce the sample
• If producing the sample at home; masturbate and collect the sample into the container making sure you tightly cap it and place it in the self sealing bag provided. Immediately transport the sample to Cambridge IVF keeping it close to the body for example in a jacket pocket during transportation
• If producing at Cambridge IVF, masturbate and collect the sample into the container making sure you tightly cap it and place it in the hatch to the laboratory (along with your completed referral form). Close the hatch and press the switch to let the lab team know your sample is ready for collection
• Complete the bottom part of the referral form; we need this information to ensure we get as much accurate information from your semen analysis as possible. If any of this information is missing we will not be able to accept the sample so it’s very important that you take the time to check it’s completed correctly
• Inform us if any of the sample is missed during production. Most of the sperm in the ejaculate are contained in the first part. If you do miss some of the sample we may ask you to repeat the test to ensure an accurate result can be provided to your referring doctor

Our production rooms have been designed to be comfortable and private and a video system is available to you should you wish to use it. A hatch system links each room directly to the laboratory to allow easy delivery of your sample. Further instructions will be given to you by our team before you produce the sample.

Please note that masturbation is the only recommended method for collecting the sample ‘cleanly’ for analysis. The withdrawal method (vaginal, oral or anal) is not recommended as it is likely that some of the sample will be lost and may in any case be contaminated. The first part of the ejaculate contains most of the sperm so this is particularly important.

Ordinary condoms cannot be used as these contain a spermicide which will kill any sperm in the ejaculate.

If you have any problems producing your sample, please give us a call, we will happily arrange another appointment for you.

We examine the sample under the microscope to determine if any sperm are present in the sample and carry out the following tests:

Sperm volume

We record the actual volume in millilitres of the semen sample you provided. We do not expect you to fill the container; an average ejaculate will be around 2.5 ml but some men will produce more or less semen.

Sperm concentration (sperm count)

Reported as millions per millilitre of semen. We use a microscope to identify if sperm are present in a droplet of your sample and if any are, we count the number of sperm in the sample using a special counting chamber and report this finding to your doctor.

Sperm motility

If sperm are present in the sample, the sperm are grouped into four groups with the strongest swimmers (grade ‘a’) being the most fertile. If there are motile sperm in your sample we cannot grant you clearance as just a single motile sperm could fertilise an egg.

Sample centrifugation

If no sperm are seen from the droplet of sperm examined we load the whole sample into a test tube and spin it in a machine called a centrifuge which causes any cells in the sample (including sperm) to form a concentrated ‘pellet’ in the bottom of the tube. This can then be harvested and examined under the microsope to confirm whether or not there are sperm present in your sample.

A written report will be sent to your referring doctor approximately three working days after the test was performed. Try not to become too anxious if your GP is unable to answer all of your questions, it may be that they need to contact Cambridge IVF for more information or advice. For reasons of confidentiality we never give out results over the telephone so please understand the good reasons why any such request will be politely declined.

Clearance post vasectomy is defined as follows:

• One sample where there are no sperm in the ejaculate (azoospermia) as long as acceptance criteria have been met (samples with no sperm in the ejaculate)
• One sample with <100,000 immotile sperm cells, followed by an azoospermic sample

If your samples fall into these criteria following analysis you will be granted clearance to stop using other forms of contraception.

Persistent non moving (immotile) sperm can remain in men for several reasons and your doctor will explain what they believe is the reason for this to you. ‘Special clearance’ can be granted by your doctor in such cases where a concentration of less than 10,000 immotile sperm remains 28 weeks following vasectomy.

Cambridge IVF cannot be held accountable where clearance has been granted in such circumstances and a patient then goes on to form a pregnancy.