We try to see patients as quickly as possible and, in an ever-changing world, short notice appointments sometimes become available due to postponements and schedule changes. See below: 
Bridge Opening HoursInvestigations of Male Infertility
Semen analysis
Production of semen samples
Semen samples should be produced by masturbation at Bridge so that the analysis can take place immediately after production. However, if you feel you are unable to produce a sample on-site, please speak to one of our laboratory staff to discuss alternative arrangements.
Please make sure that you do not ejaculate for 3 days prior to producing a semen sample for analysis. This is important as it will ensure that the sample you produce on the day is at its optimum in terms of numbers and quality.
Results
The results of your semen analysis will be available within seven working days and will be discussed with you by your consultant. We do not give results out over the telephone, although you may request a written report.
Appointments
Appointments are required and can be arranged and booked via Admissions on 020 7089 1449. You will be required to complete a Registration Form which we will send with your appointment letter.
The Analysis
The following will be assessed during the semen analysis: the number of sperm present within the ejaculate (the sperm count); the number of sperm that are moving (the motility); the number of sperm that are normally formed (the morphology); whether or not there are anti-sperm antibodies present; the ability of sperm to survive over a 24 hour period and whether or not there is any infection present within the sample.
What is a 'normal' semen analysis result?
A normal semen analysis will show the following: a semen volume of between 2 and 3mls; a sperm count of at least 20 million sperm per ml; at least 45% of the sperm will be motile; at least 30% of the sperm will be normally formed and less than 10% of the sperm will be affected by antisperm antibodies.
The degree of variance from these accepted normal values will be assessed and the implications explained by your consultant during a follow-up consultation.
Some men with infertility problems are told that it is not possible to find any sperm in the ejaculate following routine semen analysis. This condition is called azoospermia. If these men wish to father a child using their own sperm it is then usually necessary to undergo a surgical procedure to try and extract sperm directly from the epididymis or from the testis. (PESA or TESE)
However, this surgery may not always be necessary. In some cases men who have been told that they have azoospermia do in fact produce some sperm that can be found in the ejaculate. The sperm is produced in very minute quantities and as a result can be missed during a routine semen analysis. Using advanced analysis techniques it may be possible for the embryologist to recover a few sperm from the ejaculate, which can then be cryopreserved and stored. This is carried out on several occasions and it may be possible to store enough sperm to be used in a treatment cycle. If sperm is collected using this method there will not be sufficient sperm to be able to fertilise eggs in the normal way and Intra-cytoplasmic sperm injection (ICSI) will always be required.
This technique is called Rapid Centrifugal Analysis (RCA). Firstly, the man will need to give several ejaculates for analysis over a period of weeks. Each of these ejaculates is then prepared by spinning in a centrifuge at very high speed. This concentrates all the cells in the sample, including any sperm cells, into a very small volume. It may then be possible for the embryologist to identify a few sperm using a very powerful microscope. If any sperm are seen then the ejaculate will be cryopreserved for future use.
Not all men who undergo this procedure will be successful. However, we expect that about 25% of men will be able to collect enough sperm to be able to use in an ICSI cycle.
If these sperm are used during ICSI then around 65% of the eggs can be expected to fertilise following the injection of a single sperm. Pregnancy rates following IVF/ICSI are currently 45% per embryo transfer.
For any further information, please contact Admissions on 020 7089 1449.
Hormone Assessment of the Male
In cases of azoospermia, blood analysis of hormones (FSH, LH and testosterone) will be taken. This will tell us if there is a blockage or if there is no sperm production within the testis. In the first instance, sperm can be retrieved through PESA or surgery might correct the problem. In the second instance, and in 50% of the cases, Testicular Sperm Extraction (TESE) will retrieve enough sperm to fertilize the egg. Exceptionally, if the levels of testosterone are too low, hormone replacement therapy will be advised.
Testicular Biopsy involves taking one or several small samples of the testes - either for analysis, or for the recovery of sperm in the most severe cases of azoospermia, for immediate test or cryo preservation for use later.