Post vasectomy report forms 2026

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  1. Click ‘Get Form’ to open the post vasectomy report form in the editor.
  2. Begin by entering your NHS number and laboratory number at the top of the form. Ensure you attach your label with your details.
  3. Fill in your personal information, including surname, forename, date of birth, address, and the date and time of your vasectomy.
  4. Indicate whether you produced the sample on-site at the fertility lab by selecting 'Yes' or 'No'.
  5. Complete the section regarding days since last ejaculation and confirm if you collected the entire sample by checking 'Yes' or 'No'.
  6. Tick the appropriate box for which sample collection this is (1st, 2nd, or 3rd) and sign to confirm all details are correct.
  7. Review the patient checklist to ensure all requirements are met before submission.

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A post-vasectomy analysis checks to see whether your contains . Expected results show no or very few nonmoving . Abnormal results show moving or high numbers of nonmoving .
to collect your sample into the sterile container. Do not use a or spermicide. After you collect the sample, you must keep the sample warm (body temperature) until you drop it off at the lab. You can do this by carrying the sample in hand or against the body.
The results of your samples will be sent to the doctor who performed the operation. They will contact you with your results. If you have any questions, please contact the clinic where your vasectomy was performed.
Grade 4: Fast and forward progression where move in a straight direction. Grade 3: move forward but at a slower speed and/or in a curved direction. Grade 2: move slowly and in a poorly defined direction. Grade 1: move but fail to progress forward.
The first sample should be submitted a minimum of 12 weeks after vasectomy and after 20 ejaculations. If are present a second sample will need to be examined within 1 hour of production.