DEPARTMENT OF CELLULAR PATHOLOGY GUIDELINES FOR USERS OF THE ANDROLOGY SERVICE MINDELSOHN WAY EDGBASTON BIRMINGHAM B15 2TG Page 1 of 7
CONTENTS 1. Andrology Service Contact Telephone Numbers 2. Andrology Department Opening Hours 3. Andrology Department Location 4. Andrology Service Details 5. Methods of Patient Referral 6. Specimen Production 7. Reporting of Results 8. Clinical Advice and Interpretation 9. Performance Limitations - Key Factors Page 2 of 7
1. ANDROLOGY SERVICE: CONTACT TELEPHONE NUMBERS Birmingham Women s NHS Foundation Trust (BWNHSFT) 0121 472 1377 Referral for Semen Analysis: Via BWNHSFT Patient Access Team (Booking Office) Direct Booking NHS Choose and Book Telephone: 0121 627 6845 Fax: 0121 627 2768 Technical and Reporting Enquiries: Andrology Laboratory Clinical Enquiries for Andrology: Clinical Lead Dr Sue Avery Head BMS: Tervinder Sokhi BMS Team Leaders Beverley McCracken Helen Greaves Pathology Services Manager: Linda Bentley 0121 627 2717 tervinder.sokhi@bwhct.nhs.uk 0121 627 2738 beverleymccracken@bwhct.nhs.uk helengreaves@bwhct.nhs.uk 0121 627 2722 linda.bentley@bwhct.nhs.uk 0121 627 2797 sue.avery@bwhct.nhs.uk Senior Clinical Embryologist Julian Allsopp 0121 607 4772 julian.allsopp@bwhct.nhs.uk Page 3 of 7
2. ANDROLOGY DEPARTMENT OPENING HOURS Monday - Friday 8.00 16.00. There is no out of hours service available 3. ANDROLOGY DEPARTMENT LOCATION The Andrology Department is located adjacent to the Birmingham Women s Fertility Centre (BWFC) on the second floor of the Birmingham Women s NHS Foundation Trust. Patients should report to the BWFC Reception from where they will be collected for their appointment by a member of the Andrology Department. 4. ANDROLOGY SERVICE DETAILS The Andrology Department is part of the Cellular Pathology Department, under the Genetics and Laboratories Directorate of Birmingham Women s NHS Foundation Trust. The Andrology Department provides a diagnostic semen analysis service for patients as a component of infertility investigation. Currently the department does not provide a post-vasectomy semen analysis service. All semen analysis investigations are undertaken on-site in the Andrology Department at Birmingham Women s NHS Foundation Trust and no samples are referred to other laboratories. The Andrology Laboratory Clinical Lead and deputy are both Clinical Scientists; laboratory management and test investigation is undertaken by Biomedical Scientists, with clerical support from Medical Laboratory Assistants who also greet the patients. The quality of the service is maintained by recognised effective internal quality control measures and participation in the UK NEQAS Andrology scheme. Members of staff undertake all appropriate Trust mandatory training and participate in continuing professional development schemes. 5. METHODS OF REFERRAL Couples who are experiencing difficulties in conceiving visit their GP who may refer them to the Birmingham Women s Fertility Centre for fertility investigations. The male partner is invited to book an appointment for diagnostic semen analysis, by telephoning BWFC Reception on 0121 627 2700. Males who are concerned about their potential fertility or require investigation following surgery, illness or prolonged medication, may be referred for diagnostic semen analysis at the Andrology Department. These referrals, by Consultants from other Hospital Trusts or by General Practitioners from local Primary Care Trusts, may be made by letter or fax (0121 627 2768) to the Patient Access Team (Booking Office) at Birmingham Women s NHS Foundation Trust. The patient is then sent a letter offering an appointment to attend the Andrology Department for diagnostic semen analysis. Page 4 of 7
There is also a direct NHS Choose and Book service for GP referrals. The GP should set up a referral then give the patient a website address, password and Unique Booking Reference (UBRN) serial number. The appointment can be booked either by the GP whilst the patient is in attendance, by the patient accessing the website or by the patient telephoning NHS Direct who will make the direct booking on his behalf. The referral letter must be attached electronically to the UBRN. Referral forms are available from the Andrology Department at the above address and on the Trust intranet. Alternatively a letter or fax can be used but must include the following information: Patient s full name, address and date of birth Name and address of referring clinician Name and address of General Practitioner Investigation required If the patient is Hepatitis B or HIV positive, this should be noted on the request form for laboratory information. Where retrograde ejaculation or anejaculation is known or suspected, this must be noted on the referral form and the patient provided with the appropriate information sheet, available on the Trust intranet. 6. SEMEN SAMPLE PRODUCTION Patients are requested to abstain from sexual activity for 3-5 days prior to seminal fluid analysis. On-site sample production Upon arrival at the BWFC reception, the patient is given his Andrology laboratory form and asked to check that all demographics are correct. There is also a section on the form, to be completed by the patient, relating to sample collection and clinical details. The patient is escorted to the procurement room in the Andrology Department where he is given a sample pot labelled with his name, date of birth and hospital registration number. The demographics on the sample pot are checked to ensure match with the laboratory form and the patient is then requested to provide a semen sample by masturbation. Off-site sample production If a patient experiences difficulty in producing a sample on-site, or is reluctant to do so, he can be offered the opportunity to provide a sample at home. This must be arranged to coincide with an appointment time agreed with the Andrology Department. The patient is given a sample pot or advised to obtain one from his GP surgery or pharmacist. A latex free, non-spermicidal condom ( male factor pak ) can also be provided by Andrology staff. If the semen sample is produced by the patient at home, it should be produced at a suitable time to enable delivery to the Andrology Department as close to the Page 5 of 7
appointment time as possible. This should be within 30 60 minutes after sample production. Prior to delivery, the patient must ensure that he has labelled the sample pot with his name, date of birth, date and time of sample production. He must ensure that the container is correctly sealed and that the sample is stored as close to body temperature as possible during transport to the Andrology Department. When the patient arrives at the BWFC Reception, a member of the Andrology Department staff will be called and will then check that the details are correctly recorded on the sample pot and assist with completion of the laboratory form. 7. REPORTING OF RESULTS Seminal fluid analysis reports will be issued to the referring clinician within 3-5 days of specimen receipt. All reports issued include current World Health Organisation reference ranges for semen parameters. Reports will also either include a statement confirming normal semen parameters or alternatively will detail appropriate interpretative comments relative to results outside the reference ranges. When transfer to the Telepath laboratory database set up for Andrology Semen Analysis Investigation is complete, the department will issue copy reports for GPs where the referring clinician is not a GP. If the patient does not want the report to be sent to his GP practice he must notify the Andrology staff at the time of his visit. PLEASE NOTE THAT VERBAL REPORTS WILL NOT BE ISSUED FOR SEMEN ANALYSIS RESULTS. 8. CLINICAL ADVICE AND INTERPRETATION Clinical advice and interpretation can be obtained from the Clinical Lead, Dr Sue Avery or Senior Embryologist, Mr. Julian Allsopp, via the contact details given in Section 1 above. 9. PERFORMANCE LIMITATIONS - KEY FACTORS Abstinence from sexual activity is recommended for 3-5 days prior to semen sample production for fertility investigation, to ensure optimum representative yield of spermatozoa in the semen sample. Semen samples produced at home should be kept as close to body temperature as possible and delivered to the laboratory within 30-60 minutes. All semen analysis should be commenced within 60 minutes of sample production to minimise sample deterioration. Page 6 of 7
Patients with retrograde ejaculation or an-ejaculation should follow the instructions given by the referring clinician and need to produce a post masturbatory urine sample for examination. 10. TIME LIMITATIONS FOR FURTHER TEST REQUESTS Routine repeat test: i.e. checking to see if the previous test was representative repeat after a two week time interval is adequate. After any intervention that is expected to impact on sperm production repeat after a time interval of 12 weeks or more is recommended as it will take at least twelve weeks for any intervention effect to show... Further information is available via: Birmingham Women s NHS Foundation Trust website: http://www.bwhct.nhs.uk/ Birmingham Women s Fertility Website: http://www.bhamivf.org.uk/ Page 7 of 7