Male Fertility & Sperm Health: The Other Half of IVF Success

Fertility discussions often focus on eggs and ovaries, but sperm health is equally important. Men contribute half the genetic material, and sperm quality directly impacts fertilization, embryo development, and pregnancy success.

The good news? Unlike egg quality, sperm quality can often be improved with lifestyle changes—and IVF techniques like ICSI can overcome many male factor challenges.

Understanding Your Semen Analysis

The semen analysis (SA) is the cornerstone of male fertility testing. Here's what the numbers mean:

What Different Results Mean for IVF

• Normal parameters: Standard IVF or ICSI both viable options
• Low count/motility: ICSI recommended—only need one good sperm per egg
• Very low count (<5 million): Severe oligospermia—ICSI essential
• No sperm in ejaculate: Azoospermia—may need surgical sperm retrieval (TESE/micro-TESE)
• Poor morphology alone: Often less significant—ICSI can select best-looking sperm

Beyond the Semen Analysis: DNA Fragmentation

Standard semen analysis doesn't assess DNA integrity. Sperm can look normal but carry damaged DNA that affects:

• Fertilization rates
• Embryo development
• Implantation success
• Miscarriage risk

When to Test for DNA Fragmentation

• Unexplained infertility
• Recurrent pregnancy loss
• Repeated IVF failure with good embryos
• Poor embryo development despite good eggs
• Age over 45
• Varicocele
• History of infection, fever, or toxic exposures

ICSI: The Game-Changer for Male Factor

Intracytoplasmic Sperm Injection (ICSI) revolutionized treatment for male infertility. Instead of placing sperm around an egg and hoping for fertilization, a single sperm is injected directly into each egg.

ICSI allows pregnancy even with:

• Very low sperm counts
• Poor motility (even immotile sperm can work)
• Abnormal morphology
• Surgically retrieved sperm
• Previously frozen sperm

Success rates with ICSI are excellent—fertilization rates of 70-80% are typical, comparable to standard IVF with normal sperm.

Surgical Sperm Retrieval

For men with no sperm in the ejaculate (azoospermia), sperm can often be retrieved directly from the testicle:

• TESE (Testicular Sperm Extraction): Small tissue sample taken from testicle
• Micro-TESE: Microscope-guided extraction for better precision
• PESA/MESA: Aspiration from epididymis (for obstructive azoospermia)

These procedures, combined with ICSI, allow biological fatherhood for many men previously told it was impossible.

Improving Sperm Quality

Unlike eggs (which you're born with), sperm are continuously produced. The sperm you produce today started developing ~74 days ago. This means lifestyle changes now can improve sperm quality in 2-3 months.

Supplements That May Help

Research supports several supplements for sperm health:

Start supplements 2-3 months before IVF for maximum benefit.

Male Age and Fertility

While men can father children much later than women can conceive, male age does matter:

• After 40: Sperm quality begins declining—more DNA damage, lower motility
• After 45: Time to pregnancy increases; miscarriage rates higher
• After 50: Higher rates of certain conditions in offspring (autism, schizophrenia)

The effect is gradual and less dramatic than female age, but it exists. Couples where both partners are older face compounded challenges.

What to Expect on IVF Day

On egg retrieval day, you'll need to provide a sperm sample. Here's how to optimize it:

• Abstinence: 2-5 days beforehand (not longer—quality declines)
• Collection: Usually at the clinic in a private room
• Backup plan: If performance anxiety is a concern, discuss freezing a sample in advance
• Lab processing: Sperm is washed and concentrated for fertilization

When Male Factor Is Severe

For the most challenging cases, additional options exist:

• Micro-TESE: Finding sperm even in non-obstructive azoospermia
• Testicular sperm: Often has lower DNA fragmentation than ejaculated
• Donor sperm: When own sperm isn't available or viable
• PGT-A: Can identify embryos despite sperm issues

Even severe male factor rarely means fatherhood is impossible with today's technology.

Supporting Your Partner

IVF is often harder on women physically, but men play a crucial role:

• Attend appointments: Be present for consultations and procedures when possible
• Learn the process: Understand what she's going through
• Handle injections: Many partners administer the shots
• Manage logistics: Take on extra household tasks
• Emotional support: Listen without trying to fix everything
• Take care of yourself: Your wellbeing matters too

Male Fertility Testing in Colombia

All standard and advanced male fertility testing is available in Colombia:

• Semen analysis: ~$50-100
• DNA fragmentation testing: ~$150-300
• Hormone panel (testosterone, FSH, LH): ~$100-200
• Genetic testing: Available if indicated
• TESE/Micro-TESE: ~$1,500-3,000 (vs. $5,000-15,000 US)

The Bottom Line

Male fertility matters—and the encouraging news is that many male factor issues are either treatable or can be overcome with IVF/ICSI. Key takeaways:

• Get tested early: Semen analysis is simple and informative
• Lifestyle changes work: 2-3 months of optimization can improve quality
• ICSI is powerful: Even severe male factor is often surmountable
• DNA fragmentation: Consider testing if standard parameters are normal but you're struggling
• You're in this together: Your support matters as much as your sperm

Your contribution is half the equation—make it count. 💪