Request a semen analysis

Please complete this form if you have been requested by your GP to get your semen tested. This may of been via your partners consultation or your own. A semen analysis is where a sample of semen (sperm and associated fluid) is analysed to check the quality and quantity of the sperm. The results are usually available within a week.

If the results are not normal, the test should be repeated to ensure it was accurate. This will normally be performed after approximately 3 months.

Your GP can refer you to a specialist in male infertility at your local hospital or fertility clinic if any problems are found.

Semen analysis is done at University Hospital Coventry & Warwickshire (UHCW). 

What is the process?

Step 1: Complete the form below

Step 2: Our GPs will confirm your request and send the form to you electronically via text

Step 3: Print the form out and follow the instructions in the text message to arrange your appointment

Please note if you do not have access to a printer then select this option below and you can collect the form from reception. You will be texted once it is ready for collection.

Your sperm count can be significantly improved through a number of lifestyle changes. Please see some links below which you might find helpful.

Lifestyle Clinic

Help Stopping Smoking

Help Reducing Alcohol Consumption

Join our fitness club to get more active

Step 1 of 2

Date of Birth  Required
Why are you requesting the test?  RequiredMost couples who are trying for a baby and having regular sex without any contraception don’t need to seek medical advice until they have been trying for one - two years.
Please select from the options below which relate to you (select as many as apply)  Required
Current fertility status  Required
Smoking is a well known factor to reduce sperm quantity and quality. For help on quitting smoking please see the link above the form.
Alcohol consumption is associated with increased numbers of morphologically (structurally) abnormal sperm
Please state in Kg (Kilos) or Stone & lbs. Increased weight has been shown to cause marked reductions in fertility. If you are eager for further advice on this please click on the fitter futures link above.
Do you have access to a printer?  RequiredIf you do not have access to a printer we will print the form for you and let you know once it is ready for collection via text.
Declaration  Required

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