Guidelines for semen analysis and Post Vasectomy Analysis

Please follow these guidelines when you want to do a semen analysis for fertility reasons or if you had a vasectomy.

If you had a vasectomy, wait at least 8 weeks after the operation before you do the test.

  1. You are allowed to produce the specimen at home. A sterile container is needed for semen collection and can be collected from any Lancet Lab close to you. Ask for a “urine container”.
  2. Not all the labs have facilities to produce the specimen on site. Please confirm with the lab where you are going to submit the specimen.
  3. Before you can do this test, you must abstain for at least 3 days (in other words no sexual intercourse or masturbation for at least 3 days) but not longer than 7 days.
  4. The specimen must be produced by means of masturbation only, directly into the sterile container. The whole ejaculate must be collected.
  5. No sex should be involved during specimen collection.
  6. No condoms or lubricants are allowed due to its toxic effect on the sperm.
  7. Do not contaminate the specimen with any soap, water etc.
  8. Close the lid tightly after collection to prevent leakage. Do not wrap the container in anything.
  9. The specimen must be kept body temperature (in the trousers’ pocket) till it is submitted to the lab.
  10. If you produce the specimen at home, it must reach the lab within 1 ½ hours of being produced.

The cost is R1200 for a semen analysis(*SPERM) and R250 for a post-vasectomy analysis test (*POST)  and it needs to be paid when the specimen is submitted – no medical aids.

 

Please note that these tests are done on appointment only. Specimens could be submitted at the following labs:

In Gauteng, please phone 012-664-8596 during office hours to make an appointment:

  • Jhb: Lancet Corner, Corner of Stanley & Menton rd, Richmond, Auckland Park   Mon – Fri between 7:00 – 8:00 am (Please submit atPatient  Reception” in  Menton rd.)
  • Flora Clinic, 14 ave, Roodepoort.  Thursdays only between 7:00 – 8:30 am   (Lancet Lab on Lower Ground Floor, use Main Entrance)
  • Glynwood Hospital, Corner of Harrison & Princess st, Benoni.  Wednesdays only between 7:00 – 8:30 am (Lancet Lab on Ground floor in the hospital)
  • Morningside Mediclinic, Rivonia rd, Morningside Tuesdays only between 7:00 – 8:30 am  (Lancet Lab is situated at  Rochester Place, Block A, ground floor – next to Morningside Mediclinic)
  • Centurion:  Unitas Hospital, Lifestyle Management Park (next to the hospital), Unit 4, 2nd floor, Room 212. Mon-Fri  between 8:00 – 10:00 am
  • Pretoria:  Louis Pasteur Hospital, 8th floor, room 835. Mon-Fri between 7:00 – 9:00 am

 

 In Cape Town,  please phone 021 673 1700 during office hours to make an appointment:

  • Lancet laboratories @Library Square, 3rd floor, Wilderness road, Claremont.

 

Specimens could also be submitted at the following labs. Appointments could be made by phoning the given contact numbers below:

Durban & KZN:       031-308-6558/29/00

Rustenburg:            014-597-8510

Nelspruit:                013-752-8407

Polokwane:             015-294-0406

Tzaneen:                  015-307-4849

Potchefstroom:      018-293-8260

 

Cost of the test

 

The cost is R1200 for a semen analysis(*SPERM) and R250 for a post-vasectomy analysis test (*POST)  and it needs to be paid when the specimen is submitted – no medical aids.

 

Moving semen analysis into the future

 

According to a study published by the World Health Organisation (WHO) in 2012, one in every four couples in developing countries are affected by infertility. Semen analysis of freshly ejaculated sperm remains an essential diagnostic tool in the initial investigation of male infertility. A routine semen analysis is sometimes referred to as a sperm count but, in fact, a proper semen analysis includes much more than just a sperm count. The semen specimen is analysed for volume, viscosity, pH, colour, as well as sperm concentration, motility and morphology. The test is ideally performed following the guidelines set by the WHO methods that haven’t changed much over the past couple of decades.

Diagnostically, a routine semen analysis provides some indication of testicular and genital tract function, but prognostically, a routine semen analysis is unable to either accurately gauge fertility potential or predict reproductive outcome. There are two fundamental approaches to understanding the clinical use of a semen analysis:

  1. As a means of assessing a mans reproductive health, and
  2. Whether a mans ejaculate contains enough potentially functional sperm to effectively colonise his partners reproductive tract and reach the site of fertilisation in the Fallopian tubes.

Specifically with regards to the latter, sperm kinematics (characteristics that describe sperm movement, as opposed to the proportion of motile cells) has become the focus of many studies in order to establish real clinical value for semen analysis. Its value is greatly enhanced by adding sperm functional tests such as cervical mucus penetration, hyperactivation and DNA fragmentation.

  • Sperm cervical mucus penetration
    This test measures the ability of sperm in the semen to pass through cervical mucus or equivalent substance, and is equivalent to the historic Kremer test performed years ago. Studies have shown that at least 5 million sperm in the ejaculate should be able to pass through cervical mucus.
  • Hyperactivation
    Hyperactivation is a functional change in the sperm movement pattern which usually occurs during the capacitation process one of the important physiological events sperm have to undergo in order to achieve fertilisation. Sperm must be able to go into a whiplash-like motility pattern to help them penetrate the zona pellucida. If this test shows poor results, there is a chance that the sperm may not be able to fertilise an egg on their own, and intracytoplasmic sperm injection (ICSI) may be the best choice. Hyperactivation has been shown to be one of a combination of sperm function tests which can be used to predict successful fertilisation in vitro. The cut-off point for potential fertility is 20{c7b83ef3f28a5a4d1b92af1005aa96857b6821a19c5bf7bda4f75f8b16806b7f} hyperactivated sperm.
  • DNA fragmentation
    DNA fragmentation is associated with poor embryo development, low implantation rates and high miscarriage rates. Studies have shown that the outcomes of both in vitro fertilisation (IVF) and ICSI were adversely affected when high numbers of sperm with DNA fragmentation were used. Therefore the assessment of DNA fragmentation has been advocated as a predictor of assisted reproductive treatment (ART) success.
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