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Additional Specimen Types
Collection Instructions for Semen Analysis
The following information explains the requirements for basic and postvasectomy semen analysis. Please review the collection instructions below. Then copy and complete the form below with the patient. A separate copy can be obtained from LabCorp.
Patient Instructions for Semen Collection
The specimen must be delivered to the laboratory quickly, so the technologists can begin testing within one hour after the specimen is produced. This is essential for all basic fertility evaluations. (For postvasectomy check-ups, the most meaningful results are obtained within this time frame, but useful laboratory information can still be provided for three days after specimen collection—in this case only.)
In order to make sure that a fully qualified technologist will be available to perform the necessary tests on the patient's specimen, the patient must call the laboratory at the number provided by your doctor and set up an appointment. Note that a period of abstinence of two to seven days is to be observed before the specimen is collected. This includes ejaculation by any means.
If you opt for off-site collection, then you must deliver the specimen to the laboratory within one hour of collection. Temperature extremes during transit must be avoided (that is, less than 70°F or greater than 100°F). Patients can most conveniently avoid temperature extremes by carrying the container close to their person, preferably inside a shirt or pocket, especially during cold weather.
The specimen must be produced by masturbation. No lubricant of any kind may be used.
The entire ejaculate must be collected in a clean screw-cap container, preferably one provided by the laboratory, to make certain that there is no residue of possible spermicidal materials (soap or detergent, for example) in or on the interior surface of the container. Because most condoms contain spermicidal chemicals, their use for this purpose is to be avoided. (Note: If your doctor is also ordering a semen culture, you will have to use a container that is sterile. You should verify this with the doctor's office.)
Write your name, date, and time of collection on the specimen container.
Complete the information on the form below, place the form and specimen container in the bag, and give it to the employee in the reception area along with your doctor's written test order form.
Semen Analysis Specimen Information
Special Specimen Handling Requirements
Chain of Custody Procedures and Guidelines
Chain of custody is the term that refers to the process of providing documentation of specimen identification and handling from the time of collection to the completion of laboratory testing.
It is often appropriate to demonstrate that
- No adulteration or tampering has taken place.
- The names of all personnel who handled the specimen are documented.
- No unauthorized access to the specimen was possible.
- The specimen was handled in a secure manner.
- The specimen tested was provided by the individual whose information is printed on the specimen bottle label.
In order to use chain of custody handling, specimens must be submitted with chain of custody request forms. To order chain of custody handling, contact your local LabCorp facility.
Successful cytogenetics studies depend on specimen sterility and cellular viability. Considerations for submitting blood, bone marrow, tissue, and amniotic fluid are provided as follows.
Blood, Bone Marrow, Tissue. If submitting blood, bone marrow, or tissue for cytogenetics testing, follow these guidelines.
1. Submit blood or bone marrow in sterile sodium heparin (green) tubes. Lithium heparin tubes (green) inhibit cell growth. Use a small pediatric tube for aspirates less than 4 mL in volume. This will help avoid heparin toxicity of the sample.
2. Submit fetal tissue, skin, or other biopsies in LabCorp transport medium, Hanks' Balanced Salt Solution, or Ringer's lactate. Do not expose specimen to formalin or other fixatives.
3. Only refrigerate specimens when sterility is questioned.
Amniotic Fluid. When submitting amniotic fluid for cytogenetics testing, please follow the guidelines presented.
1. Submit specimens in sterile plastic tubes. Do not transport amniotic fluid in a syringe due to risk of loss of specimen if plunger is depressed.
2. Maintain at ambient temperature. Do not freeze or refrigerate.
3. Do not use the following containers for amniotic fluid:
a. Glass tubes with rubber stoppers. Rubber is toxic to amniocytes.
b. Wide-mouth urine containers that are prone to leak and become contaminated.
4. When preparing to transport cytogenetics specimens, please follow these guidelines.
a. Transport immediately so specimens will reach the laboratory within 24 to 48 hours—or as indicated elsewhere in this Directory.
b. To facilitate turnaround time and communication between the laboratory and physicians, complete the chromosome analysis history and order form with all the information required and staple the appropriate test request form to it. The following items are especially important:
- Name and telephone number of the attending physician, which allows us to call abnormal results. (Written reports follow at the regularly scheduled times.)
- Clinical data, to help interpret ambiguous karyotypes or determine the need for additional studies (eg, specialized banding techniques, extra chromosome counts).
- Be sure that both the sample submitted and the test requested are correctly indicated.
- Please note that you have the option to order a quantitative alpha-fetoprotein test on the same specimen for an additional charge. The minimal gestational age for amniotic fluid α-fetoprotein is 12 weeks.
Instructions for Collection and Submission of Paternity Specimens
To maintain chain of custody for any paternity collection, the proper collection kit must be obtained by calling the paternity evaluation department in Burlington, NC, at 800-742-3944. The kit contains specific collection instructions.
- Individuals presenting for collection who are residents of the State of New York must not be collected without clearance from the DNA Identification Testing Division in Burlington, NC. This is necessary in order to comply with various New York regulations.
- LabCorp requires that the individuals tested provide two forms of positive identification (instant photographs taken on site, and a government-issued identification card (typically a driver's license) prior to the actual collection of specimens.
- One LabCorp client authorization/chain of custody form must be submitted with each case. If there is more than one child or more than one alleged father involved in a specific case, an additional form should accompany the additional specimens.
- If parties in the same case are collected on different days or at different locations, in order to put the case together, each of the separate forms accompanying the specimens must list the names of the other parties whose specimens are not being included with the original submission in the space provided on the form.
- If any of the individuals being tested has received a transfusion within the previous 90 days, or has ever had a stem cell (bone marrow, cord blood, etc) transplant, indicate this in the space provided on the client authorization form.
- Buccal swabs (see kit) are the specimens of choice. Call the paternity department at 800-742-3944 (option 3) to obtain the buccal swab collection kit (containing instructions for the use of a buccal swab). If blood is collected, use the following (It is recommended that specimens from children be drawn first using only pediatric tubes.)
- Children: One pediatric lavender-top (EDTA) tube
- Adults: One adult lavender-top (EDTA) tube
- Do not prelabel buccal swabs or tubes. Samples shall be labeled immediately after collection and before proceeding to collect a specimen from another individual.
- The name used to label the sample of an individual and the name of the individual as it appears on the client authorization form must agree. In addition, each sample should be labeled with the draw date and phlebotomist's initials. The person collected should check the sample for correct name information and also sign on the buccal envelope (or initial the tube) indicating this was done. Collected swabs are to be allowed to to air-dry for one minute before placement in foam pockets.
- The blood specimens are to be placed in foam pockets. The foam pocket should then be placed in a specimen bag with an absorbent sheet and sealed. The client authorization form, court order, prepayment, and any pertinent documents are to be placed in the outside pocket of the specimen bag. Next, place the sealed specimen bag containing foam and paperwork in the cardboard box. Close the box by inserting tabs and place one “HLA DO NOT OPEN” label on the open end of the box. The person who packaged the specimens must initial this HLA label so that his or her initials overlap both the label and the box.
- If one kit will not accommodate all the specimens, use two kits, but make sure to tape the two kits together securely.
- Buccal swab samples are placed in the envelopes provided with the buccal swab kit. Follow the buccal swab collection and packaging instructions on the buccal swab packaging. Forward to LabCorp via the courier or Federal Express, as appropriate. Contact paternity customer service (800-742-3944) for assistance if forwarding via the US Postal Service is being considered.
- The chain of custody area on the client authorization form must be signed and dated.
- Do not freeze or expose specimens to excessive heat.
- Specimens must be kept in the custody of the collector until they are turned over to a LabCorp branch or the express delivery system.
- Specimens must be transported to arrive in the laboratory within 24 to 48 hours of specimen collection. The address of the laboratory is:
Note: If for any reason blood specimens are inadequate for evaluation, LabCorp reserves the right to request additional specimens.
If there are any questions regarding the above information or any paternity testing issues, please call the paternity customer service representatives at 800-742-3944, option 3.
Note: Please examine specimen collection and transportation supplies to be sure they do not include expired containers.
Specimen Rejection / Inability to Perform Testing
This Directory notes Storage Instructions for each test and specimen type. These are based on ideal circumstances, where necessary resources are available, intended to assist in maintaining the specimens in optimal condition, and should be considered recommendations.
In contrast, Causes for Rejection notes the limits of acceptability for the specimen, in order to obtain reliable results, and should be viewed as requirements. These are based on particular considerations of each test.
In addition to the specific Causes for Rejection noted for each test, testing will not be performed on specimens received under the following circumstances:
- Expired collection device
- Inappropriate collection device/specimen type
- Unlabeled specimens (unless clarified)
- Mislabeled specimens (patient ID not corresponding to test order) (unless clarified)
- Leaking/broken specimen container
- Gross bacterial contamination of specimen
- Quantity of specimen not sufficient for test
- Specimen subjected to extensive delay or extreme temperatures
Should testing not be possible due to any of these causes for rejection, you will be advised on the patient report of which tests were affected, and the reason the test could not be performed.
Hazardous Substance Information
LabCorp provides specimen collection containers that may contain the following hazardous chemicals:
- Acetic acid (30%) solution
- Boric acid tablet
- Citrate buffered acetone solution
- Ethyl alcohol (ethanol) solution
- Ethyl alcohol and polyethylene glycol solution
- Formalin (formaldehyde) − 10% neutral buffered formalin solution
- Hydrochloric acid solution
- Isopropyl alcohol solution
- Methyl alcohol (methanol) solution
- Perchloric acid (8%) solution
LabCorp will provide Safety Data Sheets (SDS) on initial delivery of a product containing these substances. If additional copies of these SDS are needed, please contact your local branch/port manager.
Note: Patient isolates are not to be submitted to LabCorp for testing needed to rule out any Centers for Disease Control and Prevention (CDC) Select Agents and Toxins. These isolates are to be forwarded directly to the appropriate public health laboratory, and the appropriate public health laboratory should be contacted in advance of that forwarding.
Special Transport Requirements
Instructions for Transporting Diagnostic Materials and Infectious Substances
The US Department of Transportation (DOT) in Title 49 of the Code of Federal Regulations (CFR), The International Civil Aviation Organization (ICAO), and the International Air Transport Association (IATA) regulate the transportation requirements of Category B Infectious Substances (formerly known as “diagnostic specimens” and “clinical specimens”), Category A Infectious Substances, and Patient Specimens. When the specific instructions for container types, volume requirements, causes for rejection, etc, listed in individual tests and/or profile descriptions are followed, this helps ensure compliance with these regulations.