As a Reproductive Urologist, I specialize in treating male patients who want to get their partner pregnant or preserve their fertility. Even though men are 50% of the fertility equation, the topic of male fertility is not discussed nearly enough or as thoroughly as female fertility. So, how do you know when to get your male partner's fertility tested?

Signs It's Time To Seek Male Fertility Testing

1. You’ve made the decision to try to get pregnant.

When couples decide to try to conceive, it’s time for both partners to get their fertility evaluated. For the female, this means a preconception evaluation with her OBGYN or a consultation with a fertility specialist. For the male, this means a semen analysis and a consultation with a male fertility specialist or Reproductive Urologist. Half of all fertility issues involve a male factor, so getting your partner’s fertility checked at the beginning of your conception journey helps avoid delays that are statistically as likely to occur as female factors. 

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2. Your partner wants to be helpful.

Dads don’t smoke cigars in the hospital anymore, and they also don’t want to be passive on-lookers during the conception journey. If your partner is asking what he can do to help, suggest that he get his fertility evaluated. If he has anxiety about masturbating in a doctor’s office or is worried about what he may learn about his swimmers, reassure him that at-home semen analysis kits are available and that many of the most common causes of male infertility are highly treatable. Male partners who are proactive and supportive throughout the conception process are better prepared to share the mental load of parenting, as well. This is a win/win!

3. You’ve had recurrent miscarriages, unsuccessful IUI or IVF, or haven’t conceived at all.

While 1 in 8 couples have difficulty getting pregnant, the fact that one-third of infertility is male or sperm-related, one-third is female or egg-related, and one-third involves issues related to both partners, is less well known. Meaning if you’re having difficulty getting pregnant, or it is taking longer than you’d hoped, it's worthwhile to get a semen analysis to determine if there are improvements to be made on the sperm side of things to optimize your timeline and the chance of pregnancy each month, or even improve your success with IUI or IVF.

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If you’ve had recurrent miscarriages, or an unsuccessful IUI or IVF cycle, it’s worth focusing more attention on the male before starting another round of hormone injections. Often, the quality of sperm can be significantly improved through medication, lifestyle changes, and other treatments. This affords the embryologist better suitors from which to choose to fertilize the egg(s). Rejuvenating sperm can take 70-100 days, which could be an unwelcome delay for couples who have been trying to conceive for many months. However, this is a low-cost, relatively non-invasive step that can help ensure your next round of IVF or IUI is more successful.

4. Your partner takes testosterone or has an issue known to affect fertility.

Most guys and couples have no idea that many things in their history, ranging from childhood to current lifestyle, can affect sperm production. For example, Testosterone Replacement Therapies have become common among men with symptoms associated with low testosterone. If your partner has a history of taking testosterone to treat “Low T” he should get a semen analysis and take steps to optimize his sperm health.

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Testosterone replacement actually decreases sperm production, and can even make guys sterile, as in zero sperm. In medical terms, this is called azoospermia. Male fertility specialists and reproductive urologists are able to help patients address the underlying symptoms that led them to seek testosterone therapy and can recommend treatments to treat “Low T” that will not impact fertility. Other possibilities that affect male fertility include a history of undescended testicles, varicocele (dilated veins in the scrotum), heat exposures, pelvic surgery, and congenital conditions to name just a few.  A Posterity Health Male Fertility Workup includes a thorough history to determine if any of these underlying factors are at play.

5. Your partner is facing chemotherapy, radiation, or other treatments that can affect fertility.

Whether your partner has an autoimmune disorder or has been diagnosed with cancer and is preparing for chemotherapy or radiation, it’s important to have his fertility checked as a matter of evaluating his overall reproductive health. The vast majority of young, otherwise healthy males who are diagnosed with cancer do not receive fertility counseling prior to starting treatment. Completing a semen analysis helps inform your choices about whether the cryopreservation (freezing) of your partner’s sperm is the right choice for your family.

Despite decades of advancement in gender equality in the home and workplace, the responsibility of getting pregnant still falls mainly on the female partner. I am passionate about helping couples get pregnant, and assure you it’s never too soon to check the sperm!

Kelly Walker, M.D., is a Reproductive Urologist and serves as Medical Director for Posterity Health. Dr. Walker completed medical school at Northwestern University’s Feinberg School of Medicine and completed her urology residency at the University of California San Francisco and a fellowship in male fertility and microsurgery at the Medical College of Wisconsin. She also holds an MBA from Northwestern’s Kellogg School of Management and focuses her research on quality improvement and telehealth to deliver exceptional male fertility care.