Post-Vasectomy Semen Tests

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There is an information booklet available for patients : Vasectomy Semen Analysis, which can be found in the patient library section of our website.

Post-Vasectomy Semen Analysis (PVSA) is the procedure used to establish the success of a vasectomy. Contraceptive precautions should be used until the clinician confirms that the semen sample is clear of sperm. Assessment of a single sample is acceptable to confirm vasectomy success if all recommendations and laboratory methodology are met and no sperm observed.

Special clearance can be given to the patient by the surgeon if the number of non-motile sperm seen in two assessed samples is <100 000/ml (a very occasional non-motile sperm seen in a deep cell chamber). It cannot be provided if any motile sperm are observed.

Requirements :

  • The first specimen for examination should be produced at a minimum interval of 12 weeks post-surgery and after producing at least 20 ejaculates (British Andrology Society guidelines 2016)
  • Abstinence should be between 2-7 days (3-4 days is best)
  • The sample must be obtained by masturbation (manual stimulation) and should be collected directly into the specimen container provided by the laboratory
  • The whole ejaculate must be collected into the sample container
  • The complete specimen is needed for this examination, so if any of the specimen is spilt, the laboratory must be informed and a repeat specimen may be required
  • A condom and/or artificial lubrication must not be used for semen collection, as it will kill the sperm
  • A  fresh sample is essential for this test and must be brought directly to the laboratory within four hours of it being passed at home
  • The specimen container and request form must be labelled with the patient’s full name, date of birth and the date and time the specimen was passed
  • If non-motile sperm are observed, further samples must be examined within 1 hour of production
  • Subsequent specimens produced at the referring doctor’s request should be brought directly to Andrology by the patient within 1 hour of being passed

Donor Sperm Banking

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Why are sperm donors needed?

Forty per cent of women of infertile couples are unable to conceive because of abnormality or absence of sperm in their partner’s ejaculate. Artificial insemination using donor semen is the only method of treatment available to these couples who wish to have a family. In many centres, the limiting factor is the availability of suitable donors and therefore most clinics are grateful for offers from men wishing to be semen donors.
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What are the donor requirements?

All potential semen donors who intend to begin the process of donation must first meet certain eligibility criteria as described in the UK guidelines for the medical and laboratory screening of sperm, egg and embryo donors (2008) and the HFEA 8th code of practice.

Some of the criteria are that the donor must:

  • Be aged between 18 and 41.
  • Be proven to be negative for infectious diseases including (but not limited to) HIV, HTLV, Hepatitis B and C and syphilis.
  • Be fit and healthy.
  • Have no known inheritable disorder or serious medical problems.

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How to start the process?

If you think that you meet the eligibility criteria to become a sperm donor, you can contact Andrology for further information by telephone (0161 276 6473) or email andrology.lab@mft.nhs.uk.

Due to previous experience with hoax calls it is important that we avoid giving information over the phone so information about becoming a sperm donor, screening tests and the donor questionnaire is either posted out or emailed to you.

When you have read the information, if you wish to proceed, complete the Sperm Donor Questionnaire and include a passport sized photograph on the form. Then return to Andrology by post at Andrology Laboratories, Department of Reproductive Medicine, Old Saint Mary’s Hospital, Oxford Road, Manchester, M13 9WL or email it to andrology.lab@mft.nhs.uk

When your completed questionnaire has been received by Andrology an appointment letter will be sent out to you.

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What happens at the first appointment?

On the day of your appointment, you will be asked to produce a semen specimen by masturbation into a container, which we will provide, using one of our private rooms. There are some pornographic magazines available in the rooms but we do not have any pornographic DVDs or internet access. You may bring your own material with you to the appointment if you wish.

Please abstain from intercourse or masturbation for between 2-7 days (3-4 days is best), prior to this appointment. This sample will be frozen and then thawed to see if it would be suitable for use in artificial insemination treatment.
Potential donors must be aware that after examination, a proportion of semen samples will fail to fulfil all the required criteria, but in the majority of cases this has no bearing on your potential fertility.

Blood and urine samples are also taken for preliminary screening tests.

Following these tests (the blood results can take up to 6 weeks) a doctor will look at your results and you will be sent either a counselling or a doctor’s appointment.

These results will determine if you meet our eligibility criteria to donate your sperm. These results will only be available at your doctor’s clinic appointment.

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Which tests will a donor have before he is accepted?

By law, all donors must have blood screening tests for HIV antibodies (AIDS), HTLV and Hepatitis B & C. Other blood screening tests include Syphilis, Cytomegalovirus and Cystic fibrosis. The donor’s blood group will be determined and there will be a chromosomal analysis. Donors are also screened for Gonorrhoea and Chlamydia.
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Contacting your GP regarding sperm donation

Your agreement to contacting your GP for clarification of any specific details in your medical history may be sought.
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How many visits will I have to make to the hospital?

If you were accepted as a donor you would be required to attend the Andrology laboratory for about ten/fifteen appointments, usually at weekly intervals. Please be aware that these appointments are morning appointments, Monday to Friday.

You will need to return to the Department of Reproductive Medicine for blood tests six months after you have completed the course of sperm donation.

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DNA profiling

For donors that produce their samples offsite, DNA profiling will be used to ensure that each sample received is from the intended donor and has not been contaminated or tampered with en-route to the laboratory at Saint Mary’s Hospital.

A blood sample for this test will be taken during the donor’s first appointment and a small amount of semen from the sample produced onsite for the test freeze/thaw will also be retained for this purpose.

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Information you must disclose

You must inform the laboratory if you are taking any medicines or tablets, or have had any injections whilst you are attending the Sperm Bank, or within the previous 6 weeks leading up to your first appointment. You must inform us of any illnesses or any lifestyle changes whilst you are attending the Sperm Bank.
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Future commitments

In accordance with the Human Fertilisation and Embryology Authority Guidelines, all semen samples must be cryopreserved for at least 180 days to enable a follow up blood screening tests to be performed on the donor’s behalf and for the donor to be re-examined to exclude the development of any possible sexually transmitted disease, at the completion of banking.
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Expenses

Since April 2012 the HFEA have allowed sperm donors to be compensated by £35 per clinic visit.
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How is the semen stored?

Semen samples are stored in small, sealed bottles (ampoules) in liquid Nitrogen vapour. These ampoules are carefully labelled with your donor code, date of birth and date of freezing. A second member of staff verifies the details. Freezing needs to take place as soon as possible after the sample is produced. By law the samples can be kept up to 10 years from the date they were frozen.
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HFEA

The HFEA – Human Fertilisation and Embryology Authority – is the body that regulates fertility treatment in the UK. All semen donors have to be registered with the HFEA. Donors can stipulate how many families they are willing to create, up to a maximum of 10 families.
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Legal and Financial Situation Re Guardianship

You have no legal or financial obligations to any child created from your donation. The people who receive the donation will be the legal guardians of any child that is born.
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When can any offspring contact the HFEA?

When the child reaches 18 they can contact the HFEA for:

  • The donor’s full names (and any former names)
  • The donor’s date of birth and the town or district where they were born
  • The donor’s last known postal address (or their address recorded at the time of registration)
  • The donor’s NHS number
  • The donor will be informed by the HFEA that enquiries have been made about them

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Will the donor be held responsible if a child born from donation is disabled in any way?

No. However, it is your responsibility to inform us of any genetic or inheritable diseases which present themselves in your immediate family. Failure to do so is an offence and it is the right of any child resulting from this to sue the clinic for damages. The court might require the HFEA to disclose the donor’s identity under the Congenital Disabilities (Civil Liabilities) Act of 1976.
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What information will the recipient be given about the donor?

All information will be non-identifying. An attempt will be made to match donor and recipients physical characteristics.
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What information will the donor be given about the recipient?

No information is given about the recipient. You may however ask whether your sperm has produced pregnancies and how many pregnancies.

Support

If you have any questions before, during or after your donation you can contact our staff who will be happy to discuss them with you.

Sperm donation email address :  andrology.lab@mft.nhs.uk
Counsellors : Anne Curley or Bev Loftus (0161) 276 6800
Andrology Laboratory : (0161) 276 6473

Confidentiality of patient information

Manchester University NHS Foundation Trust (referred to as MFT or the Trust) collects, holds and processes personal data about many individuals, including information about its employees, patients, suppliers, clients and stakeholders.

The Department of Reproductive Medicine conforms to the Trust policy on Handling Person Identifiable Information (policy ON4-3438).

We, as a Trust, take our duty to protect your personal information and confidentiality very seriously and we are committed to taking all reasonable measures to ensure the confidentiality and security of personal data for which we are responsible, whatever format and medium it is held in.

Every employee, agency worker, volunteer, third party contractor and supplier is responsible for ensuring that they handle information with care and respect. It is their responsibility to protect this information from those who are not authorised to use it or view it. They must ensure that whilst in their care, and when transporting information to somebody else, they have done everything possible to protect this information and comply with the Data Protection Act, The Caldicott Principles and the Confidentiality: NHS Code of Practice.

The Trust information charter can be found on Staffnet (the Trust’s intranet) and the Department of Reproductive Medicine notes that :

  • We only ask for information that we need to allow interpretation of results
  • We protect the information and ensure only those staff who need to see the information can access it
  • We share the information only when we need to for patient care. For example, sending the information to another laboratory for testing
  • We don’t store information for any longer than is absolutely necessary

Complaints, Concerns & Compliments Procedure

Manchester University NHS Foundation Trust (referred to as MFT or the Trust) welcomes feedback from patients and the public about services we provide. The Department of Reproductive Medicine conforms to the Trust policy on Complaints, Concerns and Compliments (policy ON5-2482).

The Trust is committed to delivering the very best high quality healthcare services and is proud to serve patients and service users from widely diverse communities covering local, regional, national and international locations.

It is recognised that at times things can go wrong. When complaints are raised the Trust has a responsibility to acknowledge the concern or complaint, put things right as quickly as possible, learn lessons and prevent recurrence by identifying and implementing service improvements.

In most circumstances the quickest, most effective way of resolving a concern is to deal with the issue locally. Complaints or concerns can be directed to the laboratory manager or any Andrology representative, in person, by email : andrology.lab@mft.nhs.uk, or by telephone : (0161) 276 6473.

If the issue cannot be resolved locally you can direct your complaint to the Patient Advice and Liaison Service (PALS).

Sperm Banking Information for Patients

Sperm storage is provided as a free service to NHS patients where fertility might be impaired by a medical condition, or as a side effect of treatment. Some forms of chemotherapy, radiotherapy and surgical therapy can lead to infertility that may be temporary or permanent. This is known as ‘premature infertility’. A charge for this service is made to fee paying patients.

Before any of these therapies are carried out, it is possible to store sperm using a freezing process known as “cryopreservation”. These samples can be used (after thawing) to overcome possible sterility caused by the above treatments using procedures such as Artificial Insemination, In Vitro Fertilisation (IVF) or Intracytoplasmic Sperm Injection (ICSI).

The Andrology Laboratory in the Department of Reproductive Medicine provides a service of long term semen storage for premature infertility for up to 55 years. This service is regulated and licensed by the UK statutory body, the Human Fertilisation and Embryology Authority.

Your clinician will refer you for long term sperm storage when they have confirmed the possibility of premature infertility. They will have arranged viral screening blood tests before referring you to Andrology. These need to be negative for :

  • Hepatitis B and Hepatitis C
  • Human Immunodeficiency Virus (HIV)
  • Human T-cell lymphotropic virus (HTLV)

Appointments

Appointments are usually made quickly (often the next working day). This gives you the best chance to store as much of your sperm as possible, before your treatment starts. There is an information booklet for patients : Long Term Sperm Storage, which can be found in the patient library section of our website. You can bring someone to accompany you to the appointment but you will be seen alone if you prefer.

Location of Andrology

You will need to ask for the Andrology Laboratory in the Department of Reproductive Medicine. We are in the Old Saint Mary’s Hospital building on the corner of Oxford Road and Hathersage Road. Directions, travel options and car parking (on Hathersage Road) can be found on the Getting Here page located on the Saint Mary’s Hospital home page. If you are using a Sat Nav then enter the post code M13 0JH.

HFEA consent forms

There are statutory (legal) regulations regarding the freezing and storing of sperm. The Human Fertilisation & Embryology Authority (HFEA) requires the patient’s consent in writing prior to sperm storage. The patient will need to consider :

  • How long his sperm should be stored for
  • If he wishes to name a partner to be able to use his sperm in assisted conception
  • What will happen to his sperm if he died or became mentally incapacitated
  • What will happen to his sperm if it is not used

The patient is free to withdraw or vary the terms of his consent at any time, unless the sperm has already been used. You will need to attend Andrology to complete the legal HFEA consent forms before sperm banking is undertaken. There is an information booklet for patients : Consent Giving, which can be found in the patient library section on the home page of our website.

Semen sample production

On the day of your appointment you will be asked to produce a semen sample, in one of our private rooms, by masturbation. 2-7 days abstinence from sexual activity is preferable for sperm storage. There are some pornographic magazines available in the rooms but we do not have any pornographic DVDs or internet access. You may bring your own material with you to the appointment if you wish.

Examination of semen sample

Your semen sample will be examined for the presence of motile sperm. Freezing takes place as soon as possible after the sample is passed, so it is better if the sample is produced on the premises. It will then be stored in ampoules (small sealed bottles), in liquid nitrogen vapour. The ampoules are labelled with your full name, date of birth, reference number and the date of storage. You will be informed of the quality of the sample and the number of ampoules stored. You can wait for this information if you wish (it will take approximately 20-30 minutes). Depending on when your treatment starts you can store more samples if you wish.

Semen analysis check after completion of treatment

You may wish to check whether your treatment has affected your fertility. Some men recover their fertility after treatment, and if you want a sperm count at any time after banking, please telephone (0161) 276 6473 for an appointment. Please allow six months to elapse from completion of your chemotherapy/radiotherapy.

Change in circumstances

It is important to keep us informed of any change in your circumstances e.g. change of address, change of partner. This is in case we have to notify you of any changes in regulations. We will contact you every 10 years to decide if you need to keep your samples in long term storage. If your premature infertility diagnosis remains, you can continue to store your samples for up to 55 years. We will try to contact you 5 and 2 years before the end of the statutory storage period. If we have no contact from you, your samples will be destroyed when they reach the end of their statutory storage period.

Queries

If you need any more information about the service, you can phone us on (0161) 276 6473.

Sperm Banking Information for under 16s

The DVD ‘Whack to the Future’ from the Teenage Cancer Trust is designed specifically for under 16’s. It entails a cartoon story encompassing the reasons and implications of storing sperm. It is advisable to watch the DVD prior to consultation with Andrology, so that you have a deeper understanding of what the process entails and why it is recommended. (www.teenagecancertrust.org).