It is important that all of these specimens are analysed within 1 hour of being produced and kept close to body temperature (under a jumper etc).  This is to comply with WHO 2010 guidelines because motility decreases with time and the reference values are standardised to be taken within 1 hour of production. 

Patients should be made aware of this urgency otherwise a repeat may be necessary.

Please see the patient information leaflet for further information.

 

Appointments

Patients should first see their GP / Hospital Consultant who will issue a request form, instruction leaflet and pre weighed container.  All patients must book a time slot to bring in their sample.  This allows the laboratory to arrange workload and process the sample within the 1 hour timeframe.  Failure to book an appointment will mean that samples can not be analysed and will have to be repeated.

Telephone 01924 512088 to arrange to bring in a sample.  Appointments for both Post Vasectomy and Fertility testing are available variably between Monday-Friday 08:30-14:30.

• Please also bear in mind that without a completed request form the laboratory cannot process the test and the sample will be rejected.

• A correctly labelled container must be supplied to the patient.  Please ensure that the containers used are pre-weighed and toxicity tested (red stamp on lid) and avoid using addressograph labels on them as these add weight.

 

Private Room

There is a room available at Dewsbury Hospital for production of specimens if required.  This may be useful for patients who live a long way from Dewsbury Hospital and who would struggle to deliver their samples within an hour.  Please ask for the room when making the appointment. 

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Subfertility / Post-Reversal

At Mid Yorkshire Hospitals NHS trust we offer a basic semen analysis investigation to assess a male patient’s fertility and ability to reproduce. 

The procedure is done according to WHO 2010 (World Health Organisation) and ABA (Association of Biomedical Andrologists) recommendations.  Specimens need to be analysed within 1 hour of production because motility steadily decreases with time.  There is a room available for patients to produce a sample on-site for those who find this timescale too tight.

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The testing encompasses motility, morphology, concentration, volume, pH, total count and white blood cells.
Appearance, aggregation, agglutination and round cells are also assessed or commented on.  

 

A variation of these tests can be performed on patients who have had vasectomy reversals and those who require special clearance after undergoing a vasectomy.

 

The results we provide should contain the relevant information a clinician needs to be able to make a referral, if necessary, to a fertility centre, urology clinic or other specialist.  

 

If required, help with clinical interpretation of results can be sought from Yorkshire Fertility on:

General enquiries - 01422 261344

 

E: info@yorkshirefertility.co.uk
 

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Request forms

Request forms are either a modified histology/non-gynae. form with a red stamp or an ICE form:

The patient needs to complete the following information on the form:

• Time of specimen

• Date of specimen

• Was this a complete sample? Yes/No

• Length of abstinence 2-7 days? Yes/No 

• Signature in the box

It is important that the patient fills in these details otherwise results may be misleading.

 

Please note if we do not have the correct request form then we cannot carry the test out and the patient will have to return to their GP/ Consultant for a request form. 

 

Private room 

There is a room available at Dewsbury Hospital for production of specimens if required. This may be useful for patients who live a long way from Dewsbury Hospital and who would struggle to deliver their samples within an hour. Please mention that room is required when making an appointment. This is available at variable times between Monday - Friday, 8:30 am - 2.30pm.

 

Post Vasectomy

 

A single semen sample collected according to specific criteria is usually sufficient to confirm the success of a post-vasectomy operation.  The specimen should be sent a minimum of 12 weeks after the operation and after a minimum of 20 ejaculates.  The sample needs to be complete and following a length of abstinence of 2-7 days.  If any spermatozoa are still present the patient will be required to submit further specimens.

 

These initial specimens should be analysed within 1 to 4 hours according to the British Andrology Society.

 

Patients must contact the hospital on 01924 512088 to arrange a time slot for their sample to be analysed.  Patients will need to carefully read the instruction sheet before arranging their test.

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Occasionally, if non-motile spermatozoa persist, a 'special clearance' sample may be requested. Special Clearance samples should be treated as if they are an subfertility sample (see subfertility section).

 

Request forms
Request forms are a modified Histology/Non-gynae. form with a purple stamp or ICE form. 

The patient should complete the following details on the form:

• Time of specimen

• Date of specimen

• Was this a complete sample? Yes/No

• Length of Abstinence 2 – 7 days? Yes/No   

• Post vasectomy patients will also have to confirm that their sample has been taken after 12 weeks and that a minimum of 20 ejaculates have occurred.

It is important that the patient fills in these details otherwise results may be misleading.

Delivery of specimens
All post vasectomy samples are analysed at Dewsbury Hospital using an appointment system. Samples should be provided on site or delivered in person to Pathology Reception, Staincliffe Wing Dewsbury Hospital.  Samples will not be processed if the patient does not have an appointment.  Appointments are available variably Monday - Friday 8:30-14:30.

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Filling in Forms

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It is important that request forms are completed as fully as possible, with clinical details where necessary. Please note that if the form is not filled in correctly the specimen may be rejected or returned. Please check our user guide for minimum identifiers e.g. name, date of birth etc. we need before a sample is accepted.​

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Reference Values for Semen

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Reference values are derived from current recommendations from WHO (World Health Organisation) 2010 and ABA (Association of Biomedical Andrologists) 2016.

 

It may be interesting to note that the data used to compile this 95% confidence limit came from fertile men who had conceived within the last 12 months.  Patients below the lower limits therefore should not be considered infertile.

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Limitations / Uncertainty of Results

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There is an inherent error in all scientific measurements.  According to WHO 2010 if the lab counts 400 spermatozoa the standard error is 5%.  Other factors can also contribute to uncertainty.

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Results cannot be accurately determined if received in incorrect containers that have not been weighed or toxicity tested.  This will affect motility, volume and total count.

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If the patient has not provided a complete sample or adhered to the abstinence period then this will affect motility, morphology and concentration.

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Aggregation, agglutination, viscosity and extremely highly concentrated samples may skew results due to clumping and crowding. This will be mentioned in the report.

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Samples with low concentration are associated with a higher degree of sampling error.

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Round cells can be either immature germ cells or inflammatory cells, of which the latter can impair sperm motility and DNA integrity. The laboratory does not perform additional staining tests to further identify inflammatory cells but does report an increased amount of round cells (germ cells or white blood cells).

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There are many factors that can affect the outcome of a fertility test.  

 

Physical factors
• Sexual abstinence should be between 2 and 7 days (3 or 4 days is best).
• Some plastics are toxic to sperm so specimen containers must be obtained from Andrology as these have been tested for toxicity and proven to be suitable for use.
• Extremes of temperature can damage sperm so the sample should be kept as close to body temperature as possible whilst being transported to the laboratory.
• A condom and/or artificial lubrication must not be used for semen collection, as it will kill the sperm.
• Motility of sperm can decline over time so it is important that the semen sample is examined within an hour of it being produced. The specimen should be brought directly to Pathology by the patient within an hour of it being produced.
• The first part of the ejaculate contains the majority of sperm and so the whole of the specimen should be collected to ensure accurate assessment of sperm concentration. The semen sample must be obtained by masturbation (manual stimulation) and should be collected directly into the specimen container provided by the laboratory.
• Viscous specimens or specimens where there is sperm agglutination can affect semen analysis results

 

 

Potential iatrogenic causes of abnormal sperm function
• The quality of semen may be affected if any of the following drugs have been prescribed in the previous three months:
• Cytostatic agents
• Hormones and hormonally active drugs, e.g. androgens, antiandrogens,
• oestrogens, progestogens, glucocorticoids, anabolics,
• Psychotropic drugs (e.g. antiepileptics)
• Antiemetics
• Analgesics
• Antibiotics
• Antihypertensive drugs
• Excessive Fever

 

Reference: Andrology for the Clinician W.B Schill 2006

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Updated: 07/12/2023