Dear Mr. Dad: My wife and I have been trying to conceive for nine months and our fertility doctor is suggesting that we consider IVF (in-vitro fertilization). Step one is for me to bring in a sperm sample for analysis. What are they analyzing? Frankly, I find the idea of producing a sample on demand rather embarrassing. And the way a friend described the process—dingy bathroom with a few sticky porn magazines—was really of off-putting. Isn’t there some other way to get semen out of me than the usual?
A: Let’s start with your second question. The one-word answer is, Yes. There are other ways. But they’re extremely expensive and not nearly as fun. The two most common techniques are called “testicular sperm extraction” (TESE) and “microsurgical epididymal sperm aspiration” (MESA). Both involve making incisions in the scrotum and testicles, and either manually removing sperm cells or actually cutting away a small piece of testicular tissue. (I’ll bet just reading that last sentence probably made most male readers involuntarily grab their crotch.)
As far as what they’re analyzing, the lab will be looking for a number of things, including count (how much semen is produced and how many sperm are there per milliliter), motility (how quickly and how straight the sperm swim), morphology (size, shape, and appearance of the individual sperm), and concentration (how many actual sperm there are per drop of semen).
The easiest, cheapest, and least painful way to collect semen, whether for analysis or the artificial insemination itself, involves some kind of sex (I’m using a somewhat broader definition than Bill Clinton does). In many cases, the festivities will happen at your partner’s OB’s office. Chances are they have a room that’s outfitted with a few raggedy porn magazines (though hopefully the pages won’t be stuck together), where you’ll be expected to masturbate into a clean collection cup. Your partner will not be invited to assist. And keep in mind that any feeble attempts at humor, such as asking the nurse whether she’d give you a hand, won’t go over well. Especially if your partner finds out about it. If you need any other visual aids, you can download plenty of them onto your PDA or smartphone.
If you’d rather not produce your sample in the doctor’s office, you may be able to do it at home, just as long as you can get the fresh sample there within an hour. The at-home approach gives you a few other options as well. You could do it yourself. Or your partner can help by bringing you to orgasm any way she wants and collecting the sample in the cup. Or you could have sex and collect the sample by withdrawing before climaxing or using s special condom that the doctor will give you.
But even this approach has some drawbacks. One of the most frustrating things for fertility docs is trying to get guys to bring in semen samples. Kind of makes sense: few self respecting men want to walk into a lab with a cup full of sperm, hand it to the cute receptionist (and they are always cute), and whisper to her what it is. It can be, as you say, embarrassing. Evan Simckes, an OB in St. Peters, Missouri (www.FertilityPartnership.com), has a solution: Let your wife do it for you. “Women have no problem with this at all,” Simckes told me. “They hold it up like a glass of Chardonnay and proudly announce, ‘This is my husband’s sperm. Look how much there is. He’s a very healthy guy, you know.’”