Semen Analysis:
Patient
Information
Instructions
- Semen analyses are performed
Monday through Friday, 8:30 AM to 4:00 PM at Associates in Urology office
suite at the address below, and must scheduled in advance.
- Clean containers are
required for collection of semen and can be obtained from our office from
your private physician.
- The patient must abstain
from ejaculation for two to five days prior to collection of the sample. Longer
abstinence may impair the semen quality. The sample may be caught in the container
to give accurate results. Regular condoms cannot be used as they contain a
spermacide.
- Payment is due at the
time services are rendered.
- Patients will be asked
to fill out information (on the bottom half of this page) to hand in with
the specimen. In addition, the patient must label the specimen container
with his name.
- The specimen must
be kept at body temperature. Do not heat or refrigerate the sample.
If collected outside the office, the sample may be transported in a pocket
to keep it at body temperature.
- Copies of the analysis
are available upon request. Routinely, however, tests results require appointment
with Dr. Seaman for a detailed interpretation and treatment plan.
- Specimens must
arrive within 1 hour of being produced.
- Please note: your
office visit may be arranged the same day of semen analysis; however, as the
specimen remains in the incubator for 20 minutes prior to analysis, the results
will not be available until at least 50 minutes after the specimen is received.
- Please note: A semen
analysis is primarily a test of fertility. Therefore a fertility related diagnosis
and/or procedure code will be used if coverage is submitted to your insurance
company.
Patient Information
|
__________________________
Name
|
______________________
Date |
|
__________________________
Time of Collection
|
|
|
__________________________
Social Security Number
|
|
__________________________
Number of Day of Abstinence |
|
__________________________
Time Specimen Received
(to be filled in by receptionist) |
|
Eric K. Seaman,
MD Male Reproductive Medicine and Surgery, Associates in Urology
741 Northfield Avenue, Suite 206; W. Orange, NJ 07051 (973) 325-6100 Fax: (973)
325-1616