Post vasectomy semen analysis

Firstly, you need to ensure that your doctor has provided you with a completed semen analysis referral form clearly indicating a request for a post vasectomy semen analysis. We recommend that all samples should be produced on site in our private sample production rooms in Ipswich and Cambridge. Where this is not practicable, samples can be produced at home if you live within 30 minutes of either of the laboratories. If you decide to attend our satellite in Peterborough, samples must be produced at home before attending the appointment (no production rooms are available on-site).

We will provide you with a suitable sterile container upon arrival or you can collect your container 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, you need to ensure that your sample is produced no earlier than 12 weeks post vasectomy and 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. If you do not meet these criteria when you attend for your sample, we will need to repeat your test.

Finally, you need to telephone the Andrology Service on 01223 349010 (option 2) and arrange your appointment to produce your sample for analysis.

Please note there may be a wait of up to four weeks before we are able to offer you an appointment, but we will do our utmost to accommodate you as soon as possible.

In order to get the best sample from you, we require you to abstain from any sexual activity (including masturbation) for between 2 days (48 hours) and up to 5 days prior to your appointment date.

In both Cambridge and Ipswich, we have quiet and discrete rooms available for you in which you can produce your sample. In Peterborough, we do not have a production room, this means you will need to produce your sample at home.

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 20 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. 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 (Cambridge and Ipswich) in one of our dedicated sample rooms or at home (Peterborough). At your allocated appointment time a member of our laboratory team will greet you from the waiting area and check your referral form is completed correctly. We will then show you to the private sample room in which you can produce your sample and will provide you with an appropriately labelled sample container (or collect the sample from you if you produced the sample at home). 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 and the date on which your vasectomy was performed
• Abstain from any sexual activity for between 2 days (48 hours) and up to 5 days prior to your appointment
• 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. Check that the label on the sample pot has your name, date of birth, NHS number and address. Immediately transport the sample to the laboratory keeping it close to the body, for example in a jacket pocket during transportation
• If producing on site, masturbate and collect the sample into the container making sure you tightly cap it. Check that the label on the sample pot has your name, date of birth, NHS number and address
  • In Cambridge, place the sample in the hatch to the laboratory (along with your completed referral form and any other relevant document). Close the hatch and press the switch to let the lab team know your sample is ready for collection.
  • In Ipswich, place the sample in the provided sample tray and leave as instructed in the sample room with your completed referral form and any other relevant document. Press the ‘doorbell’ and leave; the lab team will collect your sample from the production room.
• 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 other documents have been provided to you, please make sure these have been completed as well. If any of this information is missing we will not be able to accept the sample, so it is very important that you take the time to check documents are 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 you and your referring doctor. Despite the fact we are aiming to find no sperm in your sample post vasectomy it is still essential we have a complete sample to work with as it is possible sperm may be present in the part of the sample which was missed, particularly if this was the first part. Be honest when completing the sample form, it is much better to repeat the test and be sure than get an inaccurate result.

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.

Our production rooms (in Cambridge and in Ipswich) have been designed to be comfortable and private and a video system is available to you should you wish to use it. In Cambridge, a hatch system links each room directly to the laboratory to allow easy delivery of your sample. In Ipswich a ‘doorbell’ system is in use to inform the lab when your sample is ready. Further site-specific instructions will be given to you by our team before you produce the sample at your chosen location.

Please note that masturbation is the only recommended method for collecting the sample ‘cleanly’ for analysis. The withdrawal method 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.

In the instance that for personal reasons you cannot produce a sample via masturbation, please inform a member of staff. In these circumstances, we can provide a kit which includes a non-spermicidal condom. This is a special condom, non-toxic for sperm, which you can use to produce a sample via sexual intercourse in the comfort of your home. After you have obtained the sample, place the semen from the condom into the provided container making sure you tightly cap it and place it in the self-sealing bag provided. Immediately transport the sample to the laboratory keeping it close to the body for example in a jacket pocket during transportation.

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

Current best practice for post vasectomy semen analysis (PVSA) has recently been updated. We are now able to clear patients on the basis of a single sample where the sample production criteria are stringently adhered to. We will assess your sample using a procedure called ‘large volume assessment’ to determine the presence or absence of sperm and carry out the following routine tests as part of your semen analysis:

• 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 patients 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 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 any motile sperm in your sample we cannot grant you clearance as just a single motile sperm could fertilise an egg.

After the analysis, your remaining sample will be safely disposed of as Clinical Waste and destroyed following the Trust’s waste management policy. This process complies with the statutory national waste strategies and directives and meets legislative requirements.

If you have given us your written consent, your remaining sample might be used for training purposes and/or for quality control tests and will be safely disposed of immediately after.

A written report will be sent to your referring doctor. We aim to release the final report within 10 working days of the analysis being performed. Occasionally we might experience some delays, in such cases, you will be informed as to when you should expect your results. For reasons of confidentiality we will 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 with no sperm in the ejaculate, produced according to our defined sample production criteria: at least 12 weeks and 20 ejaculations post vasectomy

If your sample meets these criteria, you will be granted clearance to stop using other forms of contraception. If sperm are identified in your sample, you will be asked to repeat the test 8-12 weeks later and should book another appointment accordingly.

Persistent non moving (immotile) sperm can remain in semen 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 100,000 immotile sperm remains following the analysis of 2 semen samples produced at least 4 weeks apart.

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

The laboratory team at Cambridge IVF have a combined experience of over 40 years in performing the range of tests which in combination provide a complete and accurate semen analysis. All tests are performed in accordance with the guidance set out by the World Health Organisation (WHO) and the Association of Reproductive and Clinical Scientists (ARCS). The laboratory subscribes to the National External Quality Assurance Scheme (UKNEQAS) for Reproductive Science and our service (Cambridge and Ipswich) is accredited by the United Kingdom Accreditation Service (UKAS) to ISO 15189.