Arranging post-vasectomy checks
The first test should be requested at least 12 weeks after the vasectomy operation. The sample should be brought directly to Andrology by the patient or their representative and examined within four hours of production. If sperm are seen in the first sample then subsequent samples must be examined within one hour of production (Association of Biomedical Andrologists, the British Andrology Society and the British Association of Urological Surgeons guidelines 2016). If the patient lives more than one hour travel from the Andrology department they will be required to produce their subsequent samples on site.
GP surgeries that use ICE requesting can request post-vasectomy semen analysis on the ICE system.
For surgeries that already have post-vasectomy semen analysis packs
Request sample on ICE as a ‘collect later’ sample and attach a label onto the pot and form in the pack. The information leaflet in the post-vasectomy semen analysis packs tells the patient when and how to produce the sample. The first sample must be delivered by the patient or their representative directly to the Andrology laboratory within four hours of being produced.
For subsequent samples (of if surgery has no packs)
Request ‘I want to collect sample later’ and print out a postponed summary. This summary should be emailed to firstname.lastname@example.org and we will then send the patient an appointment.
If you have any questions, please email email@example.com.
Arranging a post-vasectomy check without an ICE request
Complete the semen analysis request card from the post-vasectomy pack. Ensure that the patient name, date of birth, full postal address, referring GP, referring GP practice & NHS number are recorded on the form. The information leaflet in the post-vasectomy semen analysis packs tells the patient when and how to produce the sample. The first sample must be delivered by the patient or their representative directly to the Andrology laboratory within four hours of being produced. Subsequent samples must be delivered to the Andrology department within one hour of production.
For subsequent samples without ICE requests (or if surgery has no packs)
Email a request to firstname.lastname@example.org with the patient name, date of birth, full postal address, referring GP, referring GP practice & NHS number. An appointment will then be sent to the patient by post. Alternatively the patient/partner may bring the completed request form directly to Andrology reception to make an appointment. The Andrology reception is open 8.30 am – 4.00 pm weekdays.
Please note that appointments cannot be given to patients over the telephone without a request card having been received in Andrology.
Post-vasectomy specimens to be brought from home
Patients must be able to deliver their first semen sample to Andrology within 4 hours (within one hour for subsequent samples) of it being produced at home. Where patients wish to pass specimens at home and this is acceptable to the clinician, then a completed request card together with a container and instructions (available in packs from Andrology) can be given to the patient. The sample should be kept at body temperature whilst being transported to the laboratory, for example by carrying it in an inside pocket. Excessive cold or heat can damage the sperm. The patient must bring the specimen directly to the Andrology reception in the Department of Reproductive Medicine, Old Saint Mary’s Hospital on Oxford Road, Manchester, M13 9WL (if using Sat Nav enter post code M13 0JH), on weekdays between the hours of 8.30 am – 3.00 pm, within 1 hour of producing the specimen.
Sample acceptance policy
It is desirable that samples are labelled with four unique identifiers but mandatory that samples are labelled with at least three unique identifiers which are as follows :
- Date of birth
- Hospital number
- NHS number
The request form data MUST match the above information on the sample. Where the sample is repeatable/ reproducible, no analysis will be performed and the sample will be discarded. A repeat sample will be requested. Andrology will accept no responsibility for analysed samples which initially failed to meet the acceptance criteria and will issue a disclaimer on such reports. A lack of patient or sample information may result in the laboratory not conducting the analysis / examination.
Examples could include :
- No dates and times of sampling
- Location for report delivery not given
Request forms SHOULD also contain :
- The patient’s location/destination for the report (or a location code)
- Tests required
- Name of Consultant or GP
- Name of the requester and contact number (bleep or extension)
- Date and time of sample collection
- Type of sample
- All relevant clinical information
- Patient address for GP requests
Some plastics are toxic to sperm and can affect sperm motility. Andrology provide specimen containers that have passed toxicity testing and are suitable for semen specimens.
Semen analysis (post-vasectomy)
1 working day from receipt of specimen.
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 for post-vasectomy checks :
- The first specimen for examination should be produced at a minimum interval of 12 weeks post-surgery and after producing at least 20 ejaculates (Association of Biomedical Andologists, the British Andrology Society and the British Association of Urological Surgeons 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.