The leaflet is detailed below, or you can download the 'Blood-borne Viruses (HIV, Hepatitis B, Hepatitis C)' leaflet in PDF.

Blood-borne Viruses (HIV, Hepatitis B, Hepatitis C)

Patients wishing to have fertility treatment require viral screening as part of their investigations. Viral status affects how your eggs, sperm and/or embryos are processed and stored in the laboratory. Viral screening is in place to ensure that the risk of passing blood-borne viruses on to others is as low as possible. Viral screening protects our patients and their eggs, sperm, and embryos, in addition to protecting our staff. Patients who are seeking treatment with donated gametes or embryos can request information about the donor’s screening status (e.g., viral, genetic). Patients can also request information on the sensitivity and suitability of any tests. It is important to note that screened gamete providers can still be a carrier of genetic disease or infection.

Each patient and partner (if applicable) who will be having eggs, sperm and/or embryos stored will require the following investigations, Human Immunodeficiency Virus (HIV) and Hepatitis B and C. You will be required to sign a consent form which gives the staff permission to take the blood sample and send this for testing.

Please do ask a member of staff if you have any questions, alternatively more information regarding these viruses can be found at:

• HIV aware: hivaware.org.uk
• National Aids Trust: nat.org.uk
• Terrence Higgins Trust: tht.org.uk
• Averting AIDS and HIV (AVERT): avert.org
• NICE Guidelines Hepatitis B: Hepatitis B | Health topics A to Z | CKS | NICE
• https://www.nice.org.uk/guidance/cg165/documents/hepatitis-b-scope2
• British Liver trust: Hepatitis B - Hepatitis B - British Liver Trust
• NHS (2018) Hepatitis C https://www.nhs.uk/conditions/hepatitis-c/
• Hepatitis C: Hepatitis C - Hepatitis C - British Liver Trust
• Home | British Association for Sexual Health and HIV (bashh.org)

General questions

How can infection with blood-borne viruses be prevented?

The main ways to prevent infection with blood-borne viruses is to avoid activities that put you at risk, such as sharing needles and having sex without a condom. Vaccination for hepatitis B if you are at high risk (e.g., health care/laboratory worker) is recommended.

What happens if my test is positive?

If your test is positive, you will be contacted without delay by the medical team at The Fertility Hewitt Centre and referred to another hospital for specialist care, which will include counselling and if required possible treatment. As each hospital has their own process you will be guided accordingly by the specialist team you are referred to.

Will I be able to undergo treatment without being tested?

If you wish for us to freeze and store any “spare” embryos created during your treatment cycle, then you must be tested prior to treatment. The Human Fertilisation & Embryology Authority (HFEA) is our governing body that upholds fertility law. The HFEA requires any patient and partner (where applicable) to be screened before you are starting treatment to ensure the storage requirements for your eggs, sperm and embryos are possible.

If there is a new diagnosis, there will be a delay in the start of any treatment to ensure safety of all patients and staff and to discuss on an individual basis any changes there may be to your treatment process.

Document Code: P-INFO-GEN-18	Version No: 13	Document Title: HIV & Hep Screening
Date of issue: 15.02.2024	Date of review: 15.02.2027	Owner: J Mutch	Author: S Wood

 

 

The leaflet is detailed below, or you can download the 'Zika Virus & Ebola' Virus leaflet in PDF.

What is Zika virus?

Zika virus infection is caused by a virus that is transmitted by a mosquito.

What are the symptoms of the Zika virus?

After an infected mosquito bites a human, the first symptoms of Zika can develop in 3 to 12 days but it can be shorter or longer in some people. Most people infected with Zika virus has no symptoms. For those with symptoms, Zika virus tends to cause a mild, short-lived (2 to 7 days) illness. Signs and symptoms suggestive of Zika virus infection may include a combination of the following:

• rash
• itching or pruritus
• fever
• headache
• arthralgia (pain in the joints) or arthritis
• myalgia (generalised muscle pain)
• conjunctivitis (inflammation in the eye)
• lower back pain
• retro-orbital pain (pain behind the eye)

Testing

The only correct diagnosis is through laboratory blood testing, which can be arranged via your GP.

Fertility Treatment

Due to the nature of the virus it is strongly advised people do not try to conceive around the time of travel to a zika affected region or country. It is recommended that women avoid unprotected sex and starting a pregnancy while travelling in an area with Zika virus. You should also avoid unprotected sex and starting a pregnancy for 8 weeks (if a woman) or 3 months (if a man) after you return home.

More information on the Zika virus can be found at

Zika virus - NHS (www.nhs.uk)

Zika virus (ZIKV): clinical and travel guidance - GOV.UK (www.gov.uk)

If you have any further questions, please speak with a member of the team

What is Ebola virus?

Ebola virus disease (EVD) is a rare but severe infection in humans. It is caused by the Ebola virus, a filovirus.

 What are the symptoms of Ebola infection?

The time interval from infection with the virus to onset of symptoms is 2 to 21 days. First symptoms are the sudden onset of fever, fatigue, muscle pain, headache and sore throat. Other symptoms include:

• weakness
• diarrhoea
• vomiting
• abdominal pain

Testing

The only correct diagnosis is through laboratory blood testing, which can be arranged via your GP.

Fertility Treatment

Due to the nature of the virus it is strongly advised people do not try to conceive around the time of travel to a zika affected region or country. It is recommended that women avoid unprotected sex and starting a pregnancy while travelling in an area with Zika virus. You should also avoid unprotected sex and starting a pregnancy for 8 weeks (if a woman) or 3 months (if a man) after you return home. Semen can remain infectious for at least three months after recovery.

More information can be found at:

Ebola virus disease - NHS (www.nhs.uk)

Ebola: overview, history, origins and transmission - GOV.UK (www.gov.uk)

 

Document Code: P-INFO-GEN-51	Version No: 5	Document Title: Zika Virus & Ebola
Date of issue: 15.02.2024	Date of review: 15.02.2027	Owner: J Doyle	Author: S Wood

 

 

 

 

 

 

 

 

 

 

Catheter Test

The leaflet is detailed below, or you can download the 'Catheter Test' leaflet in PDF.

What is a catheter test?

The catheter test is a common procedure. It gives your doctor the opportunity to perfect the technique needed to do your actual embryo transfer in cases where it is suspected to be difficult.

Why is a catheter test done?

Having a catheter test is a lot like having an embryo transfer. During embryo transfer we use a very soft catheter which contains your embryo and is performed as gently as possible. A difficult embryo transfer has been associated with lower pregnancy success rates. In cases where we think that difficulty might be anticipated during the actual embryo transfer in view of your medical history we may recommend you to have a catheter test beforehand.

What does the catheter test involve?

The catheter test is usually done before starting the IVF cycle. You will probably be told to come that day with a full bladder. This is because your full bladder pushes the uterus into a position which makes the procedure easier. A speculum will be used to help your clinical practitioner visualise the neck of your womb (cervix), more like having a smear test, and place the catheter into and through the cervix into your uterus.

You may feel cramping or a sharp but tolerable pain when the catheter is placed. Some women only feel slight discomfort like during a smear, and nothing more.

What is the aim of the procedure?

The aim of the procedure is to choose the best catheter to use with your anatomy. This test checks to see whether there are any reasons why the catheter may not enter the cervix smoothly. This test helps to find the best path from your cervix into your uterus which may vary according to the position of the uterus.

Why do I need a catheter test?

If you had any previous surgeries to your cervix, uterine abnormalities, cervical fibroids, or any other factor that can make the passage through your cervix into the uterine cavity difficult.

Do I need anaesthetic?

No, the procedure is performed whilst you are awake. The procedure should be as gentle as possible and painless similar to embryo transfer. However, you may experience some discomfort especially if the passage through the cervix is difficult which may lead your doctor to offer you a further procedure.

Are there any risks?

It is generally considered a very safe procedure. There is a very rare chance of developing an infection. If you develop a high temperature within a few days of the procedure, experience severe cramping, unusual bleeding (not just spotting), offensive vaginal discharge, or you are concerned at any time, please contact the Hewitt Fertility Centre for further advice. There is also a small chance that the procedure gets abandoned due to difficult entry, hence a subsequent procedure would then be required at a later date.

How much does it cost?

Currently if your treatment is funded by the NHS, you may be eligible to have the procedure performed without cost. If you are paying for your treatment an additional cost will be incurred.

 

Document Code: P-INFO-GEN-61	Version No: 3	Document Title: Cather Test PIL
Date of issue: 09.02.2023	Date of review: 09.02.2026	Owner: A, Chiara	Author: A. Chiara

Diagnostic Semen Analysis (Leighton)

The leaflet is detailed below, or you can download the 'Diagnostic Semen Analysis (Leighton)' leaflet in PDF.

What is semen analysis?

Semen analysis is the gold-standard test performed to assess the fertility potential of a male. Several important parameters are measured which include semen volume, sperm concentration, sperm motility and sperm shape. All parameters are compared to reference ranges set by the World Health Organisation (WHO).

The total number of spermatozoa per ejaculate, sperm concentration and the extent of progressive sperm motility are related to pregnancy rates. Motility assessment is usually performed using computer-aided sperm analysis (CASA).

How do I get an appointment?

You will need to be referred to us by a clinician. Once we have received your referral, we will send you out a pack to the address provided to us. This pack will contain instructions, a production form, sample pot and appointment information. These instructions must be read in advance of attempting to produce your sample.

If you cannot make the appointment, we have sent you please contact Ward 25 reception team on 01270 612212 in advance to reschedule. We are unable to accept any samples without an appointment.

How can I produce the sample?

Samples should be collected by masturbation. Do not produce your sample using lubricants, condoms or through the withdrawal method. If you are unable to ejaculate by masturbation, special condoms for use at home may be provided in exceptional circumstances. However, the entire ejaculate will not be available for examination, and the specimen is likely to be contaminated by contact with the skin of the penis and to some extent also vaginal fluid and cells on the outside of the condom.

How do I collect the sample?                                              

• In order to obtain an optimum sample you are required to abstain from any sexual activity (masturbation or intercourse) before your appointment. Please ejaculate 4 days before your appointment and then again 2 days before your appointment. Do not ejaculate again until you are producing your sample for analysis.
• Produce your sample by masturbation into the non-toxic sterile pot provided in your pack. Your pot must be labelled with your name, DOB and hospital identification number.
• Please do not attempt to produce your sample into any other type of specimen pot.
• Please ensure you attempt to collect all of the semen produced.
• Once the sample has been collected please ensure the lid is screwed on tightly and place the pot inside the sealable bag provided.
• Ensure you bring the fully completed request form with you to the hospital. We cannot accept your sample until this has been completed correctly.
• The pot must not be exposed to extremes of temperature either before or after sample production. If you are concerned about this, please speak to a member of staff.

Where can I produce the sample?

You may produce your sample at home if you can deliver it to the laboratory at your allotted appointment time preferably within 30 minutes after collection and at least no longer than 50 minutes after collection. Whilst travelling from home it is important you keep the sample close to the body under clothes during transportation (for example, in a pocket) as sperm are sensitive to extremes of temperature. If preferable, your partner may deliver your sample and completed production form.

If you cannot deliver your sample to the laboratory within 50 minutes of ejaculation or would rather produce your sample on site, we have rooms available for use.

Where do I need to go?

The Andrology laboratory is located within Ward 25 at Mid Cheshire Hospitals NHS Foundation Trust, Leighton hospital (CW1 4QJ). From the Maternity and Women’s services entrance, proceed down the corridor and take the stairs/lift on the left hand side to the 2nd floor. Please report to reception upon arrival.

How do I get my results?

Your results will be sent back to your referring clinician approximately 14 days after your semen analysis. Unfortunately, these results cannot be given to you by our laboratory staff.

Repeat tests

If you cannot produce your sample or have an incomplete collection you will be asked to repeat the test after a further 2 days abstinence. If one or more of your sperm parameters are reported below the lower fifth percentile (WHO 2021) your clinician may request you repeat the test. This is to ensure your results are representative of a typical ejaculate.

What if I have a poor result?

Discovering you have a poor result may come as a shock and leave you feeling anxious. We have counsellors and patient support groups available at our Liverpool and Knutsford centres

if you would like to discuss your feelings relating to this diagnosis (https://www.thehewittfertilitycentre.org.uk/support-and-advice/)

You should always bear in mind that advances in fertility treatment mean that you may still be able to conceive. You can discuss your options and next steps with your clinician.

Research and waste

The portion of your sample that is left over after diagnostic semen analysis is disposed of by incineration. It will not be stored for treatment purposes. In some cases, it may be used by us for training or research.

Queries

Please feel free to contact the Hewitt Andrology service on 0151 702 4214 if you require any further information about this test. PLEASE CONTACT THE WARD 25 RECEPTION TEAM DIRECTLY IF YOU WISH TO CHANGE YOUR DATE/TIME OF APPOINTMENT.

Quality

The Lewis-Jones Andrology department at the Hewitt Fertility Centre has provided a dedicated Andrology service for over 10 years. We were the first Andrology laboratory to be accredited for quality and competence by the UK Accreditation Scheme (UKAS). Our laboratory is also enrolled in the UK National External Quality Assurance Scheme (UK NEQAS) which helps to ensure clinical laboratory test results are accurate, reliable and comparable wherever they are produced.

 

Document Tide: SCI-AND-FORM-168	Version No: 4
Document Title: Diagnostic semen analysis patient information leaflet (Leighton)
Date of issue: 30.03.2023	Date of review:  30.03.2025
Owner: R Lunt	Author: O Sandys

Diagnostic Semen Analysis

The leaflet is detailed below, or you can download the 'Diagnostic Semen Analysis' leaflet in PDF.

What is semen analysis?

 Semen analysis is the gold-standard test performed to assess the fertility potential of a male. Several important parameters are measured which include semen volume, sperm concentration, sperm motility and sperm shape. All parameters are compared to reference ranges set by the World Health Organisation (WHO).

The total number of spermatozoa per ejaculate, sperm concentration and the extent of progressive sperm motility are related to pregnancy rates. Motility assessment is usually performed using computer-aided sperm analysis (CASA).

How do I get an appointment?

 Once you have been referred to us by a clinician you will be able to book in for your appointment online using the NHS e-Referral service. After you have booked in, we will send you out a pack to the address provided to us. This pack will contain instructions, a production form and sample pot. These instructions must be read in advance of your appointment.

If you have any questions, please contact the laboratory on 0151 702 4214.

We are unable to accept any samples without an appointment.

How can I produce the sample?

 Samples should be collected by masturbation. Do not produce your sample using lubricants, condoms or through the withdrawal method. If you are unable to ejaculate by masturbation, special condoms for use at home may be provided in exceptional circumstances. However, the entire ejaculate will not be available for examination, and the specimen is likely to be contaminated by contact with the skin of the penis and to some extent also vaginal fluid and cells on the outside of the condom.

How do I collect the sample?

• In order to obtain an optimum sample you are required to abstain from any sexual activity (masturbation or intercourse) before your appointment. Please ejaculate 4 days before your appointment and then again 2 days before your appointment. Do not ejaculate again until you are producing your sample for analysis.
• Produce your sample by masturbation into the non-toxic sterile pot provided in your pack. Your pot must be labelled with your name, DOB and hospital identification number.
• Please do not attempt to produce your sample into any other type of specimen pot.
• Please ensure you attempt to collect all of the semen produced.
• Once the sample has been collected please ensure the lid is screwed on tightly and place the pot inside the sealable bag provided.
• Ensure you bring the fully completed request form with you to the hospital. We cannot accept your sample until this has been completed correctly.
• The pot must not be exposed to extremes of temperature either before or after sample production. If you are concerned about this, please speak to a member of staff.

Where can I produce the sample?

 You may produce your sample at home if you can deliver it to the laboratory at your allotted appointment time preferably within 30 minutes after collection and at least no longer than 50 minutes after collection. Whilst travelling from home it is important you keep the sample close to the body under clothes during transportation (for example, in a pocket) as sperm are sensitive to extremes of temperature. If preferable, your partner may deliver your sample and completed production form.

If you cannot deliver your sample to the laboratory within 50 minutes of ejaculation or would rather produce your sample on site, we have private production rooms available for use.

Where do I need to go?

 Your chosen appointment location will be listed in your semen analysis pack.

Liverpool – The Lewis-Jones Andrology Department at the Liverpool Women’s Hospital (L8 7SS) is situated on the second floor. Please follow signs for the Hewitt Fertility Centre and our waiting room is situated next door.

Knutsford – The Andrology laboratory is situated on the ground floor of The Hewitt Fertility Centre, Knutsford (WA16 8ZR). Upon arrival please report to reception and a member of staff will be able to assist you.

Ormskirk – The Seminology laboratory is located within the Gynaecology and Maternity department at Ormskirk District General Hospital (L39 2AZ). From the main entrance of the hospital please continue two thirds of the way up through the main corridor and turn right.

How do I get my results?

 Your results will be sent back to your referring clinician approximately 14 days after your semen analysis. Unfortunately, these results cannot be given to you by our laboratory staff.

Repeat tests

 If you cannot produce your sample or have an incomplete collection you will be asked to repeat the test after a further 2 days abstinence. If one or more of your sperm parameters are reported below the lower fifth percentile (WHO 2021) your clinician may request you repeat the test. This is to ensure your results are representative of a typical ejaculate.

What if I have a poor result?

 Discovering you have a poor result may come as a shock and leave you feeling anxious. We have counsellors and patient support groups available at our Liverpool and Knutsford centres if you would like to discuss your feelings relating to this diagnosis.

(https://www.thehewittfertilitycentre.org.uk/support-and-advice/) You should always bear in mind that advances in fertility treatment mean that you may still be able to conceive. You can discuss your options and next steps with your clinician.

Research and waste

The portion of your sample that is left over after diagnostic semen analysis is disposed of by incineration. It will not be stored for treatment purposes. In some cases, it may be used by us for training or research.

Queries

Please feel free to contact the laboratory on 0151 702 4214 if you require any further information about this test.

Quality

 The Lewis-Jones Andrology department at the Hewitt Fertility Centre has provided a dedicated Andrology service for over 10 years. We were the first Andrology laboratory to be accredited for quality and competence by the UK Accreditation Scheme (UKAS). Our laboratory is also enrolled in the UK National External Quality Assurance Scheme (UK NEQAS) which helps to ensure clinical laboratory test results are accurate, reliable and comparable wherever they are produced.

Document Code: SCI-AND-FORM-113	Version No: 7
Document Title: Diagnostic semen analysis patient information leaflet (all sites)
Date of issue: 19.04.2024	Date of review:  19.04.2027
Owner: R Lunt	Author: O Sandys

 

Post-vasectomy Semen Analysis

The leaflet is detailed below, or you can download the 'Post Vasectomy Semen Analysis ' leaflet in PDF.

Why do I need a post-vasectomy semen analysis?

Approximately 12 weeks after your operation you are required to produce a semen sample to confirm whether your vasectomy has been successful. During the analysis we will not only check for the presence of sperm but also whether any sperm seen are motile and have fertilisation potential.

Some sperm can remain in the vas deferens in the months following your procedure. It is important that you have ejaculated (via masturbation or with contraception) over 20 times before your post-vasectomy semen analysis to help clear out any sperm that have remained.

How do I get an appointment?

 Once you have been referred to us by a clinician you will be able to book in for your appointment online using the NHS e-Referral service. After you have booked in, we will send you out a pack to the address provided to us. This pack will contain instructions, a production form and sample pot. These instructions must be read in advance of your appointment.

If you have any questions, please contact the laboratory on 0151 702 4214.

We are unable to accept any samples without an appointment.

How can I produce the sample?

 Samples should be collected by masturbation. Do not produce your sample using lubricants, condoms or through the withdrawal method. If you are unable to ejaculate by masturbation, special condoms for use at home may be provided in exceptional circumstances. However, the entire ejaculate will not be available for examination, and the specimen is likely to be contaminated by contact with the skin of the penis and to some extent also vaginal fluid and cells on the outside of the condom.

How do I collect the sample?

• In order to obtain an optimum sample you are required to abstain from any sexual activity (masturbation or intercourse) before your appointment. Please ejaculate 4 days before your appointment and then again 2 days before your appointment. Do not ejaculate again until you are producing your sample for analysis.
• Produce your sample by masturbation into the non-toxic sterile pot provided in your pack. Your pot must be labelled with your name, DOB and hospital identification number.
• Please do not attempt to produce your sample into any other type of specimen pot.
• Please ensure you attempt to collect all of the semen produced.
• Once the sample has been collected please ensure the lid is screwed on tightly and place the pot inside the sealable bag provided.
• Ensure you bring the fully completed request form with you to the hospital. We cannot accept your sample until this has been completed correctly.
• The pot must not be exposed to extremes of temperature either before or after sample production. If you are concerned about this, please speak to a member of staff.

 Where can I produce the sample?

 You may produce your sample at home if you can deliver it to the laboratory at your allotted appointment time preferably within 30 minutes after collection and at least no longer than 50 minutes after collection. Whilst travelling from home it is important you keep the sample close to the body under clothes during transportation (for example, in a pocket) as sperm are sensitive to extremes of temperature. If preferable, your partner may deliver your sample and completed production form.

If you cannot deliver your sample to the laboratory within 50 minutes of ejaculation or would rather produce your sample on site, we have private production rooms available for use.

Where do I need to go?

 Your chosen appointment location will be listed in your semen analysis pack.

Liverpool – The Lewis-Jones Andrology Department at the Liverpool Women’s Hospital (L8 7SS) is situated on the second floor. Please follow signs for the Hewitt Fertility Centre and our waiting room is situated next door.

Knutsford – The Andrology laboratory is situated on the ground floor of The Hewitt Fertility Centre, Knutsford (WA16 8ZR). Upon arrival, please report to reception and a member of staff will be able to assist you.

Ormskirk – The Seminology laboratory is located within the Gynaecology and Maternity department at Ormskirk District General Hospital (L39 2AZ). From the main entrance of the hospital please continue two thirds of the way up through the main corridor and turn right.

How do I get my results?

 Your results will be sent back to your referring clinician approximately 14 days after your post-vasectomy semen analysis. You should continue to use an alternative method of contraception until you have received confirmation of the success of your vasectomy, also known as clearance.

Repeat tests

 If you have not ejaculated 20 times or it has not been 12 weeks since the operation you may be asked to repeat the test at a later date. You may also be asked to repeat the test if there are any sperm seen in your sample.

The presence of sperm doesn’t necessarily mean your vasectomy has been unsuccessful since some sperm may remain in the vas deferens for a while after the operation. If invited, it is important that you attend your repeat test as it will help to confirm whether all residual sperm have been cleared out of the vas deferens or if the procedure has in fact failed. It is important to know that clearance is only given to patients when the clinician can be sure that they could not achieve a pregnancy. Failure to attend your post-vasectomy semen analysis could result in an unplanned pregnancy.

Research and waste

The portion of your sample that is left over after post-vasectomy semen analysis is

disposed of by incineration. In some cases, it may be used by us for training or research.

Queries

 Please feel free to contact the laboratory on 0151 702 4214 if you require any  further information about this test.

 Quality

 The Lewis-Jones Andrology department at the Hewitt Fertility Centre has provided a dedicated Andrology service for over 10 years. We were the first Andrology laboratory to be accredited for quality and competence by the UK Accreditation Scheme (UKAS). Our laboratory is also enrolled in the UK National External Quality Assurance Scheme (UK NEQAS) which helps to ensure clinical laboratory test results are accurate, reliable and comparable wherever they are produced.

Document Code: SCI-AND-FORM-112	Version No: 8
Document Title: Post vasectomy patient information leaflet (all sites)
Date of issue: 19.04.2024	Date of review: 19.04.2027
Owner: R Lunt	Author: O Sandys

This leaflet can be made available in different formats on request. If you would like to make any suggestions or comments about the content of this leaflet, then please contact the Patient Experience Team on 0151 702 4353 or by email at pals@lwh.nhs.uk

Post-vasectomy Semen Analysis (Leighton)

The leaflet is detailed below, or you can download the 'Post-vasectomy Semen Analysis (Leighton)' leaflet in PDF.

Why do I need a post-vasectomy semen analysis?

Approximately 12 weeks after your operation you are required to produce a semen sample to confirm whether your vasectomy has been successful. During the analysis we will not only check for the presence of sperm but also whether any sperm seen are motile and have fertilisation potential.

Some sperm can remain in the vas deferens in the months following your procedure. It is important that you have ejaculated (via masturbation or with contraception) over 20 times before your post-vasectomy semen analysis to help clear out any sperm that have remained.

How do I get an appointment?

You will need to be referred to us by a clinician. Once we have received your referral we will send you out a pack to the address provided to us. This pack will contain instructions, a production form, sample pot and appointment information. These instructions must be read in advance of attempting to produce your sample.

If you cannot make the appointment we have sent you please contact Ward 25 reception team on 01270 612212 in advance to reschedule. We are unable to accept any samples without an appointment. Please note we are only able to offer appointments on Thursdays. Please feel free to contact the reception team to find out the dates that these sessions are being held.

How can I produce the sample?

Samples should be collected by masturbation. Do not produce your sample using lubrication, condoms or through the withdrawal method.

If you are unable to masturbate, special non-toxic condoms designed specifically for the collection of semen samples are available for use at home. Please ask in advance of your appointment if this is something you require.

How do I collect the sample?

• In order to obtain an optimum sample you are required to abstain from any sexual activity (masturbation or intercourse) before your appointment. Please ejaculate 4 days before your appointment and then again 2 days before your appointment. Do not ejaculate again until you are producing your sample for analysis.
• Produce your sample by masturbation into the non-toxic sterile pot provided in your pack. Your pot must be labelled with your name, DOB and hospital identification number.
• Please do not attempt to produce your sample into any other type of specimen pot.
• Please ensure you attempt to collect all of the semen produced.
• Once the sample has been collected please ensure the lid is screwed on tightly and place the pot inside the sealable bag provided.
• Ensure you bring the fully completed request form with you to the hospital. We cannot accept your sample until this has been completed correctly.
• The pot must not be exposed to extremes of temperature either before or after sample production. If you are concerned about this, please speak to a member of staff.

Where can I produce the sample?

You may produce your sample at home if you can deliver it to the laboratory at your allotted appointment time preferably within 30 minutes after collection and at least no longer than 50 minutes after collection. Whilst travelling from home it is important you keep the sample close to the body under clothes during transportation (for example, in a pocket) as sperm are sensitive to extremes of temperature. If preferable, your partner may deliver your sample and completed production form.

If you cannot deliver your sample to the laboratory within 50 minutes of ejaculation or would rather produce your sample on site, we have production rooms available for use.

Where do I need to go?

The Andrology laboratory is located within Ward 25 at Mid Cheshire Hospitals NHS Foundation Trust, Leighton hospital (CW1 4QJ). From the Maternity and Women’s services entrance, proceed down the corridor and take the stairs/lift on the left hand side to the 2nd floor. Please report to reception upon arrival.

How do I get my results?

Your results will be sent back to your referring clinician approximately 14 days after your post-vasectomy semen analysis. You should continue to use an alternative method of contraception until you have received confirmation of the success of your vasectomy, also known as clearance.

Repeat tests

If you have not ejaculated 20 times or it has not been 12 weeks since the operation you may be asked to repeat the test at a later date. You may also be asked to repeat the test if there are any sperm seen in your sample.

The presence of sperm doesn’t necessarily mean your vasectomy has been unsuccessful since some sperm may remain in the vas deferens for a while after the operation. If invited, it is important that you attend your repeat test as it will help to confirm whether all residual sperm have been cleared out of the vas deferens or if the procedure has in fact failed. It is important to know that clearance is only given to patients when the clinician can be sure that they could not achieve a pregnancy. Failure to attend your post-vasectomy semen analysis could result in an unplanned pregnancy.

Queries

Please feel free to contact the Hewitt Andrology service on 0151 702 4214 if you require any further information about this test. PLEASE CONTACT THE WARD 25 RECEPTION TEAM DIRECTLY IF YOU WISH TO CHANGE YOUR DATE/TIME OF APPOINTMENT.

Quality

The Lewis-Jones Andrology department at the Hewitt Fertility Centre has provided a dedicated Andrology service for over 10 years. We were the first Andrology laboratory to be accredited for quality and competence by the UK Accreditation Scheme (UKAS). Our laboratory is also enrolled in the UK National External Quality Assurance Scheme (UK NEQAS) which helps to ensure clinical laboratory test results are accurate, reliable and comparable wherever they are produced.

 

Document Code: SCI-AND-FORM-150	Version No: 3
Document Title: Post vasectomy patient information leaflet (Leighton)
Date of issue: 30.03.2023	Date of review: 30.03.2025
Owner: R Lunt	Author: O Sandys

HYCOSY 

The leaflet is detailed below, or you can download the 'HYCOSY' leaflet in PDF. 

Hysterosalpingo Contrast Sonography

What is HYCOSY?

A Hycosy is a test using ultrasound and a special fluid called Sonovue to examine the uterus and fallopian tubes.

Why do we perform HYCOSY?

We use this test as an infertility investigation. If either the cavity of the uterus, or the tubes are damaged it can prevent conception taking place.  It is not possible to see the tubes with normal x-rays or ultrasound, so a specialist examination such as this is needed.

What does the examination entail?

The examination is performed in the ultrasound room.  You will be asked to empty your bladder and the procedure will be explained by the practitioner.

You will be asked to lie on the bed and a cover will be draped over your lower body.  A transvaginal ultrasound examination will then be performed.  This entails a thin ultrasound probe being introduced into the vagina.  This is a routine gynaecological examination, and should not hurt.  This allows us to visualise the uterus and ovaries prior to the Hycosy.

If this is satisfactory, the examination will then progress to Hycosy.

A speculum will be put into the vagina; this allows us to see the entrance to the womb (cervix).  A small catheter will then be passed into the uterus.  A tiny balloon which is attached to the catheter will be inflated to keep the catheter in place during the examination.

The speculum is then removed and a small amount of fluid is injected into the cavity under ultrasound control.  The fluid shows up as a “bright white” on ultrasound and we can trace its course outlining the cavity of the womb and tubes if there is no blockage.

You may feel some discomfort similar to period pain. A recent audit performed at the Hewitt fertility Centre showed that 35% of the women have mild discomfort and 8-10 % of them have mild-severe pain during the procedure; immediately after the procedure, the same women refer no pain or discomfort in 55 % of the cases. Only less than 2% of them still report mild pain after the procedure. Usually this pain or discomfort is helped by the use of usual painkillers such as Paracetamol.  If you are worried about the discomfort you may take your usual painkiller half an hour before the examination.

How long does the test take?

 The procedure takes about half an hour.

What happens after the examination?

You may wish to bring a panty liner to wear as the fluid used is sticky.  You may not feel able to return to work immediately after the examination.  If possible you should be accompanied by a partner or friend on your homeward journey, and you should not drive for an hour or so afterwards. Most women feel completely well after the procedure and can return to their normal activities shortly after. The examination will be reported by the practitioner and will be discussed in full at your next clinic visit.

What are the side-effects/risks?

Like any other intrauterine procedure, the HyCoSy is associated with a small risk of infection. Antibiotic cover is not routinely offered, but please do not hesitate to contact your GP or the hospital in case you experience offensive vaginal discharges, abdominal pain, fever or sign of infection. You could experience some pain as discussed before and some mild vaginal bleeding.

Booking your appointment

The test cannot be performed if you are bleeding or there is a chance that you are pregnant.  You must use barrier methods of contraception during the cycle of the hycosy appointment, and we will ask you to sign a disclaimer that you are not pregnant.

Smears and screening swabs should have been performed prior to this procedure and the results must be available to view.

Should you have any queries regarding your appointment or procedure please contact the Hewitt Fertility Centre on 0151 702 4123 – option 1.

 

Document Code: MED-FORM-2	Version No: 7
Document Title: Hycosy Patient Information
Date of issue: 02.11.2022	Date of review: 02.11.2024
Owner: R Russell	Author: C Achilli

 

Sperm DNA Damage Testing

The leaflet is detailed below, or you can download the 'Sperm DNA Damage Testing' leaflet in PDF.

What is sperm DNA damage?

Half of the information to make a human is delivered by the sperm to the egg. Sperm production takes place inside the testicles and takes approximately two months to complete. During this time, there is a possibility that the sperm DNA can become damaged. The exact cause of sperm DNA damage is unknown but may be related to lifestyle and genetic factors.

What evidence is available for sperm DNA fragmentation?

A number of studies have indicated that high sperm DNA damage can be associated with infertility issues including disrupted embryo development, poor IVF fertilisation rates and higher rates of pregnancy loss after IVF/ICSI¹. However, two systematic reviews on sperm DNA damage testing have been completed which resulted in conflicting opinions on the use of the sperm DNA damage test^2,3. Unfortunately, the evidence available on sperm DNA damage is limited and there is currently no large clinical study available to justify regular use of this test. 

What is the sperm DNA fragmentation test?

A test called the COMET assay is used to detect sperm DNA damage. This test involves chemically breaking down the sperm sample to release the DNA and testing it. The COMET assay enables the DNA damage to be measured by examining the number of DNA breaks in the sample.

How is this test performed?

A semen sample is needed to perform the DNA test. The results of the DNA test aim to indicate the fertility potential of the sperm in the semen sample.

When will my results be available?

The sperm DNA damage test will take less than a day to process in the andrology laboratory. The sample is then frozen and sent away for further testing. The results can take up to six weeks to be processed.

Is sperm DNA damage testing for me?

The genetic integrity of the sperm is essential for normal embryo development. A high level of DNA fragmentation in sperm cells may represent a cause of male infertility that conventional examinations do not test for.

Your doctor or embryologist may recommend you have the sperm DNA damage test if failed fertilisation has occurred and there is no known cause for this outcome. This test offers a possible further explanation for un-explained infertility. The results of a sperm DNA damage test may impact slightly on the management of your treatment but may identify why you are struggling to get pregnant.

How much does the test cost?

Please see our fee schedule or speak to a member of our team to discuss sperm DNA damage test costs.

Costs and funding | The Hewitt Fertility Centre

The Human Fertilisation and Embryology Authority (HFEA) and the test:

Sperm DNA damage testing is an additional investigation that can be added to your treatment. Sperm DNA damage is viewed as an ‘add-on’ treatment. For more information on treatment add-ons please refer to the HFEA website:

Treatment add-ons with limited evidence | HFEA

Please discuss the current HFEA traffic-light status of sperm DNA damage testing with your fertility specialist.

How to book the test?

If you are a Liverpool patient please call our funding team on: 0151 702 4301/4481.

If you are a Knutsford patient please call 01565 653287

 

Document Code: P-INFO-GEN-62	Version No: 6	Document Title: Sperm DNA Damage Testing
Date of issue:21/02/2023	Date of review:21/02/2026	Owner: R Gregoire	Author: R Howard