HNY Policy and Pathway Repository - Humber

All Andrology sample drop offs for fertility and post vasectomy checks are carried out on an appointment basis only i.e. no patient sample drop in service.  Please ask patients to use our online booking tool, found at www.hulleastridingfertility.co.uk/bookings  - the link is also on the patient information on the request card. If patients attend the Unit without a prior booked appointment, unfortunately we will not be able to process their sample. If patients need to produce a sample using our onsite facilities, then patients can book online selecting the ‘produce on site’ option or call the Fertility Unit directly where one of our staff will be more than happy to help.

Definition

A specialist ISO15189 accredited laboratory, closely associated with Hull & East Riding Fertility for continuity of care, offering preliminary investigations for male subfertility problems and post-vasectomy semen analysis. Upon request we carry out more specialist infertility tests including tests for anti-sperm antibodies and vitality.

Fertility preservation for oncology, armed forces and transgender. Testicular failure or surgical health patients.

Exclude Red Flag Symptoms

• Conception not achieved when the female partner is of reproductive age and has had greater than one year of unprotected vaginal intercourse
• Female partner aged 36 years or over
• Known clinical cause of infertility
• History of predisposing factors for infertility

Primary care options would be expectant management if attempting to conceive for less than 12 months or commence investigations as per NICE Guidelines 156 - Fertility problems assessment and treatment

The Hull Andrology Unit Website (associated with Hull & East Riding Fertility)

Patient support group and information                                             

Patients can access a private service for a comprehensive fertility assessment to provide individuals with an indication of their current fertility and the likelihood of conception in the future, further information is available from Hull & East Riding Fertility website

Refer for semen evaluation when his partner is of reproductive age and has not conceived after one year of unprotected vaginal intercourse, in the absence of any known course of infertility. An earlier referral for semen evaluation should be offered when his partner is aged 36 years or over and/or there is a known clinical cause of infertility and/or a history of predisposing factors for infertility.

If your patient meets these criteria complete an Andrology request card with three patient identifiers, referring GP and Practice, any relevant clinical information and authorising signature. 

Do Not Refer

Referrals are only accepted to deduce the presence or absence of spermatozoa and the associated motility and morphology of the spermatozoa. Do not refer for specialist seminal fluid investigations such as haematospermia or culture and sensitivity testing.

Known viral positive patients should not be referred and are not accepted for semen analysis.  

Please provide the patient with a completed Andrology request card, patient information (attached to the request card), sample bag and correct fully labelled sample pot (containers distributed by HUTH Pathology stores specifically for Andrology). The patient will book an appointment online to attend the Andrology Unit at Book an Andrology Appointment - Hull & East Riding Fertility. He will attend the Unit with the sample within one hour of production (infertility analysis/vasectomy final clearance) and within four hours of production (post vasectomy analysis). Results with the interpretive comments will be returned electronically via patient centre/labcentre within 5-7 working days. Some GPs will also receive paper copies of results. 

Opening times are Monday, Wednesday and Friday 8:30 to 14:00 (excluding bank holiday and Christmas closure). Samples for infertility and post-vasectomy testing are to be produced offsite and delivered to the Andrology unit according to the online appointment booked by the patient, within one hour (infertility/vasectomy final clearance) or four hours (post-vasectomy) of production. A limited service is provided to patients wishing to produce their samples on site - this can be booked via Book an Appointment - Hull & East Riding Fertility. An abstinence period of 48 hours to 7 days is recommended and the complete sample is required for accurate evaluation.

The appropriate referral card must be used and all information completed including three patient identifiers, a GP name, Surgery and authorising signature and/or practice stamp. Please note that it is not possible to report results to Locum GPs - please only name a GP permanently registered at that surgery. 

To obtain correct sample pots those that have been toxicity tested for semen evaluation), please contact hospital stores on 01482 674715

Hull and ERY Andrology Unit Guide - for full and further information

Semen analysis form on ARDENS

Useful Websites

Hull & East Riding Fertility

NICE Pathways relating to Fertility

NICE Guidance 156 - Fertility problems and treatment

WHO - Laboratory manual for the examination of processing of Human Semen

How to refer your patient for IVF treatment

Hull and East Riding Fertility treats both funded and private patients; the referral process differs. Funded patients are referred to the NHS Subfertility Clinic at Hull Royal Infirmary. In order for the patients to be seen, the GP must attach appropriate results to the referral, including a semen evaluation and female investigations. Patients are reviewed and further investigated followed by a plan for treatment at Hull & East Riding Fertility.

For the treatment of private patients, GPs are required to send a referral for treatment directly to Hull and East Riding Fertility. On receipt of this Hull and East Riding Fertility will communicate further with the patient to organise treatment.