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Do I Need to Have a Semen Analysis?

Why Male Fertility Testing Is a Must for Every Infertile Couple


Updated May 20, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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A reader asks: "Do I need a semen analysis? My wife has already gone through fertility testing, and we know she has a problem. If we know the problem is with her, why do I need fertility testing?"

Yes, you do need the semen analysis. Your wife's diagnosed fertility problem doesn't give you a clean bill of health. In fact, up to one-third of infertile couples discover fertility problems in both partners. .

A semen analysis is an essential part of a complete fertility work-up for any couple facing infertility. Because women will often speak to their gynecologist first, semen analysis may not be suggested right away. When it does come up, usually at the request of a savvy gynecologist or at a fertility clinic, some men may not want to go through the testing, whether for ego reasons or religious ones.

It's understandable to be nervous, but it really is best to have a semen analysis test done as soon as possible, before any treatments are started.

Early Sperm Analysis Saves Time

The earlier the testing is done, the sooner you can really know what you're dealing with. If all the focus is on the woman's fertility only, and treatment begins focusing only on her problems, what happens if male infertility is also a factor? You won't know, and the treatments will be either doomed to fail or significantly less likely to succeed.

In the case of Clomid, for example, there are limits on how many consecutive treatment cycles are recommended for a woman to go through. If a woman takes Clomid for the maximum allowed time period, doesn't get pregnant, and only afterward it is discovered that there are male factor infertility issues, the couple will have lost not only the treatment time, but also may need to move onto other medications, or need to wait for the body to rest and recover from the medication use.

Another factor to consider is age. Especially after age 35, a woman's fertility declines at a faster pace. Several months of inappropriate treatment may lead to a lower chance of success once the right treatment option is discovered.

Early Sperm Analysis Saves Money

Consider the cost involved in fertility treatments. Insurance companies vary with regards to coverage, but a cycle or two of gonadotropins (aka injectables) can cost in the thousands of dollars. If IUI, IVF, or IVF with ICSI are what were really required, you will have thrown money away. (Though it would be very unusual for a doctor to go ahead with injectables without some sort of semen analysis.)

But even clomid treatments costs can add up if your insurance doesn't cover ultrasound or blood work for monitoring the cycle.

Not only will you have lost money on treatments that were not appropriate, you will have that much less money for further treatments. With the average cost of IVF between $8,000 and $15,000, every dollar counts.

Sperm Analysis May Save You Some Heartbreak

Perhaps even more important than lost time and lost money, getting the semen analysis done early may save you some heartbreak.

Any couple coping with infertility knows how hard it is to go cycle to cycle. A negative pregnancy tests during treatment is especially difficult. Finding out months later that the treatments had little or no chance for success will add to the sadness its own ocean of anger and pain.

The Bottom Line: Get Tested Before Starting Any Treatments

Save time and heartbreak by getting at least basic fertility testing for both you and your partner right away. When the woman goes to see her gynecologist, the man really should seek out a urologist for an infertility work-up. Or you may both see a reproductive endocrinologist.

If the semen analysis comes out normal, you'll have eliminated a potential cause, If there are problems, you can be sure to start appropriate treatment faster.

Just one last note to nervous husbands and boyfriends: If you're nervous of what your partner will think of you if the sperm is less than stellar, ask her. I'm sure she'll tell you that she will love you as much after poor results as she did before.

I can't say, however, how happy she'll be with you if she goes through fruitless treatments because you refused a simple test early on.

More on male infertility and semen analysis:

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Patient's Fact Sheet: Diagnostic Testing for Male Factor Infertility. American Society of Reproductive Medicine. Accessed May 29, 2008. http://asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/Testing_Male-Fact.pdf

A Basic Guide to Male Infertility: How to Find Out What's Wrong. American Urologic Association. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/patient-guides/whatswrongpg.pdf Accessed May 29, 2008.

Medications for Inducing Ovulation: A Guide for Patients. American Society of Reproductive Medicine. Accessed February 3, 2008. http://asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/ovulation_drugs.pdf

The Costs of Infertility Treatment. RESOLVE: The National Infertility Association. Accessed February 3, 2008. http://www.resolve.org/family-building-options/insurance_coverage/the-costs-of-infertility-treatment.html


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