Semen Collection in the Emergency Department Context
When an ED note mentions "collecting semen," this most commonly refers to forensic evidence collection following sexual assault, though it can occasionally refer to fertility preservation before urgent medical treatments that may impair fertility. 1
Primary Context: Forensic Sexual Assault Evidence
In the emergency department setting, semen collection is predominantly a forensic procedure performed as part of sexual assault examination. 1
Key Components of Forensic Collection:
Specimen collection must be performed by well-trained forensic physicians or forensic nurses using standardized sexual assault evidence collection kits (SAECK). 1
The primary goal is sperm detection and DNA profiling to identify perpetrators in sex crime cases, where semen serves as crucial corroborating evidence. 1
Collection sites include vaginal, cervical, oral, rectal, or skin surface swabs depending on the assault history, with proper preservation required before laboratory transfer. 1
Time-sensitive nature is critical - specimens should be collected as soon as possible after the assault, as sperm viability and DNA quality degrade over time. 1
Laboratory Processing:
Differential extraction is the forensic standard for separating sperm cells from epithelial cells to obtain male DNA profiles, though this method is time-consuming and may result in some male DNA loss. 1
All laboratory processes must protect both DNA and RNA for potential future confirmatory testing, requiring proper long-term specimen preservation when possible. 1
Secondary Context: Fertility Preservation
Less commonly in the ED, semen collection may refer to urgent fertility preservation before chemotherapy, radiation, or other gonadotoxic treatments. 2
When This Applies:
For pubertal and adolescent males capable of producing a semen sample, the proven treatment option is semen collection and cryopreservation before cancer treatment or other fertility-threatening interventions. 2
Collection should occur via masturbation in a private room, ideally near the clinical laboratory, with the specimen examined and processed within one hour of collection. 2, 3
If sufficient sperm are recovered, gametes can be banked using commercial glycerol-based sperm cryomedia for future assisted reproductive technology use. 2
Critical Distinction for Clinical Context
The ED documentation context determines the interpretation:
Sexual assault cases: Collection is forensic evidence requiring chain-of-custody documentation, specialized training, and adherence to legal protocols. 1
Fertility preservation cases: Collection follows standard semen analysis protocols with 2-3 days abstinence beforehand, though this may be impossible in urgent situations. 3, 4
Common Pitfall to Avoid:
Do not confuse forensic semen collection (from the victim) with diagnostic semen analysis (from the patient) - these are entirely different procedures with different purposes, collection methods, and legal implications. 1, 5