Post-vasectomy semen analysis

Post-vasectomy semen analysis (PVSA) is a critical test to establish the absence of sperm in your semen following a vasectomy surgery. The analysis will assess whether sperm are present in the provided semen sample and evaluate their motility, if any sperm are detected, to confirm the success of the procedure.

Typically, the analysis is performed approximately 12 weeks post-surgery, and it is recommended to ejaculate a minimum of 20 times before the test to help clear any remaining sperm from the vas deferens.

At Homerton Fertility Centre, we follow the 2016 Post-Vasectomy Semen Analysis Guidelines (Hancock et al., 2016), set by the Association of Biomedical Andrologists, the British Andrology Society, and the British Association of Urological Surgeons. We use the recommended large volume fixed-depth slide method for analysis.

Your semen sample will be examined microscopically, assessing and recording several key parameters, including:

• volume - the amount of ejaculate produced in millilitres
• viscosity - how thick or thin the semen is
• sperm Concentration - the number of sperm, if present in the ejaculate
• sperm Motility - if sperm are present, their movement will be assessed and graded according to WHO 2021 (6th Edition) motility criteria
• sample centrifugation - reported only for samples that do not meet the requirements for large volume fixed-depth slide analysis.

After your GP referral, the Homerton administration team will contact you within 48 hours once the referral has been accepted to schedule an appointment to drop off your semen sample.

You must only use the sterile container provided by Homerton Fertility Centre. You can collect the sample collection kit from the Homerton Fertility Centre reception, Monday to Friday, 08:00am-4:00pm at least 10 days before your appointment; samples in other containers will not be accepted and analysed.

• It is required that the test be done at least 12 weeks post-surgery, and that you ejaculate a minimum 20 times prior to help clear any remaining sperm from the vas deferens.
• You must abstain from ejaculation for two days prior to your appointment. Frequent ejaculation is encouraged leading up to the appointment, but a maximum of two days abstinence is required for an accurate analysis.
• Collect the sample by masturbation into the sterile sample container provided by the Homerton Fertility centre only. The container remains sterile until opened so avoid touching the inside.
• Please wash and dry your hands and genitals thoroughly before providing the sample and write your name and date of birth on the sample container- samples with improper/incomplete labelling will not be analysed.
• Ensure the entire sample is collected, especially the initial fraction which contains the most motile sperm. Do not attempt to recover any spillage, but please report it on the collection form. Replace the lid firmly immediately after collecting the sample.
• Do not use lubricant, water, hand creams, or condoms when collecting the sample. Special condoms may be provided by the Homerton Fertility centre for a £20 charge if required and by prior arrangement.

You may produce your sample at home (off-site) or onsite (Homerton Fertility Centre).

·         If producing onsite (Homerton Fertility Centre), the sample must always be kept upright and placed in inner pocket of the provided zip-lock specimen bag before being placed in the pass-through vault.

·         If producing off-site (home), the sample must be brought to the Homerton Fertility centre at your allocated appointment time and within 40 minutes from the time of production. During transportation the sample container should not be exposed to extreme temperatures, keep the sample upright and close to the body under your clothes.

·         Do not produce your sample in a public area e.g. public toilets, car parks or anywhere else in the hospital as this is illegal (Sexual Offences Act 2003) and could result in prosecution.

After successfully collecting your sample, please drop it off in the drop box, along with the completed sample delivery form, at your scheduled appointment time. The Andrology team requires the form to process and record your results. The drop box is located on the right-hand side of the Homerton Fertility Centre reception.

Location

Homerton Fertility Centre
First Floor
Homerton University Hospital
Homerton Row
London E9 6SR

Open, Monday to Friday – 8am to 4pm. We are not open on Saturdays, Sundays, or public holidays.

Please be aware that if you arrive more than 10 minutes late, your appointment will be cancelled. In such cases, the laboratory reserves the right to discharge you back to your GP, and a new appointment will need to be scheduled.

It is collected in a container not issued by Homerton Fertility.

The entire sample has leaked during transit.

It is collected in an unlabelled or incorrectly labelled container and not accompanied by a completed and signed form.

It is not produced on the same day as the scheduled appointment.

The time between sample production and analysis does not allow for accurate analysis (above 40mins).

It is submitted without a corresponding patient appointment.

It is dropped off outside the allocated appointment time and day.

It is dropped off by an unauthorised representative and the semen analysis form has not been signed by the patient.

Your post vasectomy semen analysis result will be sent to your referring clinician or GP within 10 working days. It is recommended to keep using an alternative form of contraception until you receive a positive confirmation of your post vasectomy analysis, also known as clearance.

Clearance is defined as One ‘azoospermic’ semen sample (a sample with no sperm in the ejaculate) that was produced according to our defined sample production criteria and fulfils the 2016 PSVA guidelines.

Unfortunately, the andrology staff are unable to provide this result to you directly. Please do not call the Andrology Laboratory for results, as they will not be given over the phone.

Your GP or clinician may recommend a repeat test scheduled anew in the following 4 weeks under the following circumstances:

• if it has been less than 12 weeks since your vasectomy and/or you have not ejaculated at least 20 times prior to the test
• if non-motile sperm are detected in your semen sample
• if motile sperm are present in the sample. 

If persistent non-motile sperm is still found, special clearance may only be granted after the assessment of two follow-up samples, in line with recommended guidelines and testing methods. These tests are scheduled at least four weeks apart. Attending your repeat test is essential to confirm whether residual sperm have been cleared or if the vasectomy has failed.

After the PSVA is completed, any remaining portion of your sample is discarded and not kept for treatment. Occasionally, it may be utilized for quality control, training, or research activities but only if you have consented to this.

After your diagnostic semen analysis is complete, any remaining portion of your sample will be safely disposed of in accordance with the Trust’s waste management policy and will not be kept for treatment purposes.

If you have provided written consent on the Instructions for Semen Analysis form, your sample may be used on the day of collection for staff training in procedures such as preparation of sperm for intrauterine insemination (IUI), in vitro fertilization (IVF), or simulation of the intracytoplasmic sperm injection (ICSI) process. It may also be used to train staff in freezing and warming sperm samples; however, the samples will not be cryostored. Additionally, samples may be used for semen analysis training or quality control purposes.

Your sample will never be used for patient treatment and will be safely disposed of on the day of collection.

If you have any questions about the use of your sample for training or quality control, please ask to speak with a member of the laboratory team before leaving your sample for diagnostic semen analysis.