Update 17.11.2022:  Andrology Laboratory Service at UHB

We are pleased to announce that from the 30^th May 2022, the Andrology Department at Good Hope Hospital begun working in accordance with the World Health Organisation (WHO) 6^th Edition for the examination of semen (diagnostic semen analysis). This included a change to some of the lower reference limits (volume, concentration, motility and vitality), differentiation of round cells and amendments to result interpretation where appropriate.  This examination procedure has not been accredited to the ISO standard (15189:2012), although this is being worked towards at present.  To assure users of the quality of results, we would like to state that the following safeguards are in place;

• Internal Quality Control (IQC) of volume, pH, motility, concentration, morphology (including TZI) and vitality 
• External Quality Assurance (EQA) participation for motility, concentration and morphology
• Interlaboratory Comparison scheme  (ILC) participation for vitality and PVSA
• Participation in the Cellular Pathology audit schedule and Quality Management System (QMS) under Cellular Pathology 
• Ongoing training and competence of staff undertaking Andrology activities
• Follow Pathology/Cellular Pathology procedures and policies for management of materials, reagents, consumables and equipment

Please do not hesitate to contact us if you have any questions or concerns on 0121 424 9717 or Emma Whitehouse on 0121 424 9717 (This email address is being protected from spambots. You need JavaScript enabled to view it.).  The Quality Leads can also be contacted on the Emails below:

• This email address is being protected from spambots. You need JavaScript enabled to view it.
• This email address is being protected from spambots. You need JavaScript enabled to view it. 

The User Handbook can be accessed here (update sin progress):  Andrology User Handbook

The Andrology Laboratory at University Hospitals Birmingham (UHB) is a partially UKAS Accredited Service (ISO15189:2012), currently operating from a single site located on the 1st Floor of the Sheldon Unit at Good Hope Hospital.

The laboratory's priority is to provide a comprehensive semen analysis service for Consultants, Urologists and General Practitioners from the Birmingham and Solihull area. This includes semen analysis  (Diagnostic Semen Analysis), post-operative analysis of semen following a vasectomy operation (Post Vasectomy Semen Analysis) and retrograde analysis of urine.

The laboratory operates on a clinic based service and has a maximum capacity of 2500 appointments available per annum.  This covers the annual workload of routine diagnostic semen analysis, post-vasectomy samples and retrograde ejaculation analysis. Routinely patients will be given an appointment to attend the Andrology Department for on-site sample production in a designated private clinic room, however in exceptional circumstances samples may be produced off site if then able to be delivered to the laboratory within an appropriate time interval. 

The UHB Andrology Laboratory has fully trained scientists who are highly proficient in performing quality diagnostic semen analysis in line with World Health Organisation (2021) and the 2016 Laboratory Guidelines for post vasectomy semen analysis. The laboratory regularly performs internal quality control, participates in the UK National External Quality Assurance scheme for Andrology (UKNEQAS) and liaises with other accredited laboratories for comparison of tests not covered within the UKNEQAS scope.

A laboratory referral can be made via:

• Paper copy referral forms sent to Appointment Centre via post/e-mail (internal consultants/health care professionals)
• Electronic Referral Service (e-RS) with an attached referral form

 A copy of the referral form can be obtained by;

Contacting the laboratory directly on 0121 424 9717

Or by downloading from here Andrology Referral Form

Or by GP’s accessing the word version at: https://hgs.uhb.nhs.uk/gps/

Off-site production can be arranged by the patient by telephoning the laboratory on 0121 424 9717 or by e-mailing This email address is being protected from spambots. You need JavaScript enabled to view it. (if you e-mail you are accepting that the connection is not secure and potentially not confidential – laboratory staff will minimise data transmission but cannot guarantee security).  Please note that retrograde urine production cannot be undertaken off-site.  This must be on-site at Good Hope Hospital.

Turnaround Time: 7-10 days (electronic reporting may be more rapid). Paper copies currently sent. This is due to validation of reports by a second scientist.

Anti-sperm antibodies (ASAB) are not tested at this laboratory. Agglutination is described if noted.

Please see user handbook for additional information including contact details.

Accreditation information can be found at:

https://search.ukas.com/#/tabbed/search?q=andrology

Post-vasectomy Semen Analysis (PVSA)

The laboratory undertakes examination procedures in line with the following guidelines:  2016 PVSA Guidelines.  This will give clinicians information regarding clearance criteria. 

Results are avialble to Hospital clinicians via the two portals:

• PICS/Clinical Portal - QEHB
• Concerto/ICE/Clinical Portal - HGS

GP's can access patient results through their own electronic result systems, although paper copy reports are sent out following result authorisation.

Key details of the service:

• Operates Monday to Friday 08:00am to 16:00pm
• Undertakes diagnostic semen analysis, post vasectomy analysis and retrograde examination (urine)
• Appointment based with on-site room for sample production
• 7-10 day turnaround time (electronic and paper copy reporting)
• Patients are booked within 7 weeks from referral, unless clinically indicated or by patient choice

Andrology Changes to Service or Notifications

World Health Organisation (WHO) Examination and Processing of Human Semen 2021 Guidelines

The WHO released the sixth edition of semen analysis guidelines in July 2021.  The Laboratory will be implemented these changes on 30.05.2022.  This includes a new set of lower reference limits and enhancements to user advice and guidance.   There will be CCG notification when this goes live.  If you require any further information please contact Emma Whitehouse  (This email address is being protected from spambots. You need JavaScript enabled to view it.).  

Updated 10.05.2022

Changes to Post-vasectomy semen analysis from 1st September 2019

Queen Elizabeth Hospital will no longer analyse semen samples for vasectomy success confirmation from the 1st September 2019.  A referral form must be completed and sent to the appointment centre for the patient to be given an appointment to attend at Good Hope Hospital.  All samples received into Pathology at Queen Elizabeth following this date will be rejected.  Please contact the laboratory if you require any further information. 

Retrograde Examination Procedure

Retrograde analysis is available at Good Hope Hospital.  This will assess numbers of sperm and motility (if present).  Morphology is not assessed as part of this examination.  The test was assessed by UKAS for accreditation to ISO15189:2012 on 21/01/2020 and is now included as an accredited test. 

If you require any further information, please contact Emma Whitehouse - Andrology Lead Scientist on 0121 424 9717 or Email This email address is being protected from spambots. You need JavaScript enabled to view it.

Liver function

Protein, Albumin, Bilirubin, ALT, ALP with GGT automatically reflex tested if ALP > 200

Renal/Electrolytes

Sodium, Potassium, Urea, Creatinine

Cardiac

Troponin I

Lipid

Cholesterol, Triglyceride

Bone

Calcium, Phosphate, ALP, TP, Alb

The clinical service is consultant-led and available on a 24-hour basis to hospital clinicians and GPs.

For the clinical interpretation or advice of any haematology test results please contact the on-call SpR or Consultant via switchboard - 0 from an internal telephone or 0121 424 2000 if phoning from outside of the Trust.

Please click on the link for the following guidance

GP Investigation and Referral Pathways for Leucocytes, Platelets and Polycythaemia

Investigation and Referral Pathways for Anaemia in Primary Care

Investigation of Paroxysmal Nocturnal Haemoglobinurea

Diagnostic algorithm for investigation of possible Gaucher’s disease in adults

Criteria for Referral to Haematology

Criteria for telephoning critical haematology results

Specific IgE ("RAST")

Measurement of IgE to specified allergens can help to confirm allergies suspected on clinical grounds.  Results must be interpreted in the context of a detailed clinical history, and neither positive or negative results are diagnostic in isolation.  The allergens to be tested must be specified on the request.  This test is not suitable for broad "allergy screening" in the absence of a history suggestive of an allergic reaction.

Skin Prick Testing

In many cases skin prick testing provides a safe and simple alternative to specific IgE measurement, but this does require referral.

Referrals are accepted for the investigation and management of patients who have suffered anaphylaxis and patients with the the following allergic conditions:

Urticaria/Angio-oedema

Clear allergic precipitants can be identified in only a small proportion of cases.  Patients may respond well to regular treatment with antihistamines.

Food Allergy

Skin-prick testing for a range of food allergens is available.  "Screening" is not appropriate, and diet and symptom diaries often help to identify suspected foods for testing.  Patients with life-threatening reactions benefit from detailed advice and individualised management plans.

Allergic Rhinitis and Asthma

Skin prick testing can help to identify significant aeroallergens in these patients, which may held in planning medical management.  Pollen desensitisation may be offered under certain circumstances: patients will only be considered if adequate medical therapy has failed, and certain other suitability criteria are fulfilled. 

Bee/Wasp Venom Allergy

Assessment of patients who have suffered severe reactions to bee or wasp stings is offered.  In some cases desensitisation immunotherapy is indicated to prevent anaphylaxis in individuals at particular risk.

Antibiotic and Anaesthetic Allergies

Suspected antibiotic allergy (especially to penicillin) is common, and can usually be circumvented by the choice of an alternative antibiotic.  In exceptional circumstances allergy testing may be appropriate.  It is often important to exclude or identify allergy to local and general anaesthetic agents, so that future routine or emergency treatment can be given safely.  A detailed history of the suspected anaesthetic reaction and the anaesthetic agents used are vital to successful assessment. Testing of serum tryptase levels immediately after an anaphylactic episode often aids diagnosis (see Laboratory Services).

Glucose Tolerance Tests

Appointments can be made via Diabetes Centre on 0121 424 0234.  A service is available at Solihull - for information contact Laboratory Reception at Solihull on 0121 424 5531 / 0121 424 5526.

Blood tests to help in the investigations of these conditions are listed below and a guide to their use may be found in Test Profiles.

Connective Tissue Disease

This covers a wide range of relatively rare conditions including systemic lupus erythematosus (SLE), scleroderma, polymyositis and Sjorgren's syndrome.  Rheumatoid arthritis is common, and may present initially with similar features.  However, the early involvement of other organs (e.g. skin, kidneys, eyes, Raynaud's) may suggest an alternative diagnosis.

Vasculitis

Includes a heterogeneous group of diseases, characterised by inflammation and necrosis of blood vessel walls.  Presenting features may include fever, weight loss, fatigue, multi-system involvement (skin, nasal bleeding/crusting, arthralgia, myalgia, neuropathy), with raised inflammatory markers and abnormal urinalysis.  As with connective tissue disease, rapid diagnosis and treatment is essential to prevent organ damage and death. Serological markers such as ANCA may be helpful, but are not diagnositc and their absence does not exclude vasculitis.  Biopsy evidence of vasculitis is always preferable to confirm the clinical suspicion.

Clinical advice regarding the management of these conditions may be obtained from the department Medical Staff, or from the relevant clinical specialty (e.g. renal, medicine, rheumatology).  Patients may be referred to Immunology or to Rheumatology for assessment.

Advice for Medical Practitioners

Advice regarding the investigation, treatment or referral of all patients with possible connective tissue disease and vasculitis is available from the medical staff.  Advice out of normal working hours can be obtained from the on-call rheumatology, renal or medical teams (depending on the patient's particular problem).

Only the fluid types below and specific analyses tabled are now allowable in Telepath and ICE. Where a fluid type or analysis is not allowable in Telepath please book as miscellaneous and then contact the Duty Biochemist before analysis is performed.

All fluids must be centrifuged and then analysed only if free from particles.

The basic approach to clinical problems is suggested.

The medical staff of the department are happy to advise with the investigation of any problems.