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We appreciate our numerous colleagues that refer patients for the infertility workup and treatment. We also appreciate the many physicians that refer patients for andrology services, such as the semen analysis. We make many of our "services requests" forms available on-line for physicians. The forms can be completed and faxed to our office at (801) 878-8890.
Please make a copy(s) of the form(s) to store on your computer. When you click on the form link some computers will immediately present the "File Download" menu box. If this is the case with your computer, simply choose "Save As " from the Internet Explorer "File" menu, and name the file using your last and first name as the file name. Next download the form to your computer in a location where you can find it once completed. It is very important that you follow the "Save As" file naming procedure above as the original on-line forms are "write protected" so that they cannot be changed.
Your computer may present the form "on line" when clicking the link. If this is the case with your computer, then save a copy on your computer by selecting "Save As" from the Internet Explorer menu . When prompted for a "File Name" please enter your last and first name. If you are submitting several requests, change the file name by placing a numeral behind your name. Be sure to place the form in a location on your computer where you can find it. Once the form(s) is completed, please fax it to our office at (801) 878-8890.
Semen testing and analysis
Basic Semen Parameter Testing.................................................................................................................... $42
Includes volume, concentration and motility. Typically used for post vasectomy patients to confirm azoospermia (no sperm) and for evaluation of IUI prepared samples.
Comprehensive Semen Analysis with Kruger Strict Morphology................................................................... $170
Includes volume, concentration, motility and morphology using Kruger criteria (best correlation for predicting fertilization rates in vitro). It is also very helpful to determine which patients might benefit from IUI versus IVF procedures. Kruger strict morphology is used at RCC instead of the sperm penetration assay (SPA or HEPT) in order to predict fertilization capability and the need for ICSI. This is the initial test recommended by RCC physicians for evaluation of male infertility.
Reports are usually completed within 3 days of sample collection.
Semen analysis testing must be scheduled in advance by calling 801-878-8888. Testing is available M-F.
Intrauterine insemination (IUI) related services for married couples (available 7 days per week)
Semen preparation (husband’s sample)....................................................................................................... $150
(includes basic semen parameter testing, IUI prep, report, syringe and catheter)
Donor sample preparation for IUI (IUI ready sample)..................................................................................... $92
(includes semen thaw, basic semen parameter testing, report, syringe and catheter)
Donor sample processing and preparation for IUI (intracervical insemination sample).................................. $150
(includes semen thaw, basic semen parameter testing, wash and preparation, report, syringe and catheter)
Intrauterine insemination by RCC staff........................................................................................................... $185
Samples can be prepared by RCC for insemination by the ordering physician’s staff or the staff at RCC will perform the IUI at the request of the Physician.
Anticipated IUI procedures should be scheduled by calling 801-878-8888 by 2 pm prior to the day of insemination. Please review the clinical information with RCC nursing staff.
After hours, calls to the office will be referred through the answering service to the RCC physician on call.
Donor sperm samples may be ordered from any AATB/FDA approved Cryobank. A tank and specimen handling fee of $50 is charged for each shipment received. Samples may be stored at RCC. Storage fee is $33/month (arranged in advance). Attempts will be made to coordinate monthly shipments the first week of each month to minimize shipping costs for the patient.
Semen samples collections may be obtained by masturbation (spouse welcome if desired) in a private, quiet room provided by RCC or at home (containers and instructions supplied – sample must be kept warm). Collections may also be completed using special condoms ($12) available at RCC or on the web at https://www.INGfertility.net/.
Payment for the above services are expected at the time the service is provided. Prices above assume that services are offered on a pre-paid cash basis. Checks, cash and credit cards are accepted. A receipt will be provided if a patient desires to file for insurance reimbursement. We are preferred providers for United Healthcare and Aetna. Insurance billing is only provided for these specific companies. Insurance prices are usually higher than the pre-paid cash prices. |
