Sperm Nurse

Sperm Nurse

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How Much Does It Cost to Freeze Your Sperm?

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Male Fertility Assessment 101: What to Expect

What You Need to Know About Pregnancy After a Vasectomy

Where to Start With the IVF Process

Should You Still Pee After Sex If You Are Trying to Get Pregnant?

9 Measures of Semen Health, What They Mean, & Why They May Be Abnormal

Sperm Motility: Everything You Need to Know

What to Expect at a Female Fertility Assessment

Why Male Fertility Testing Is a Must for Every Infertile Couple

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Rachel Gurevich is a fertility advocate, author, and recipient of The Hope Award for Achievement, from Resolve: The National Infertility Association. She is a professional member of the Association of Health Care Journalists and has been writing about women’s health since 2001. Rachel uses her own experiences with infertility to write compassionate, practical, and supportive articles.
Leyla Bilali, RN is a registered nurse, fertility nurse, and fertility consultant in the New York City area. She works in house at a reputable private clinic in New York City while also seeing her own clients through her concierge fertility consulting and nursing services business.

Producing a semen sample for semen analysis or fertility treatment may lead to the inability to ejaculate. There are several factors involved with producing the sperm for a sample that may contribute to this type of performance anxiety.

Fortunately, there are ways to overcome your stress and anxiety and still eject sperm for testing or treatment. Here is what you need to know about collecting a semen sample.

Often the semen sample must be produced in the fertility clinic , in a room set aside for this purpose. While a good clinic will do its best to provide a sense of privacy, it is still not your home. There may be some inspirational magazines provided, but it is far from romantic.

Plus, there's the anxiety of being evaluated and the worries about a treatment cycle working. Feelings of shame may arise, especially when a couple has been unable to get pregnant without assistance. 1

Many men, especially those who might masturbate less than the average male, find it uncomfortable to self-stimulate at a clinic. In these cases, the chances of being able to produce a sample for clinical purposes are subsequently lower.

If your healthcare provider has asked you to provide a semen sample, they will likely give you a list of guidelines to follow prior to the collection. In order to get the most accurate results possible, it is important that you follow these instructions to the best of your ability.

For instance, they may ask to you avoid ejaculation for three to seven days prior to the test. 2 This means abstaining from and masturbation. They also may ask you to avoid caffeine, alcohol, and drugs prior to the test. You also should talk to your provider about any supplements or medications you are taking.

Because the composition of your semen can vary significantly from day to day, your healthcare provider may collect two or three samples of semen for more accurate information and analysis. Try not to think about how many times you will have to visit the office to give a sample because this could just add to your stress and anxiety on the day of collection.

If your stress level is particularly high that day, you may want to try using relaxation techniques or mindfulness activities prior to the collection. Anything you can do to relax prior to giving your sample can help you manage your stress and get through the process.

Producing a semen sample at home may be much easier than doing so in a healthcare provider's office. Whether or not this is an option for you will depend on your provider's protocols, as well as your proximity to the clinic.

The clinic will need to provide a sterile cup ahead of time. A semen sample is still viable if it is brought to a lab within 45 minutes to an hour of being produced 3 and kept at body temperature (for example, by transporting it tucked into a sports bra so that it is held securely close to the body).

If your clinic is far away, it might be possible to bring your sample to a lab that's closer to home. Or, for a longer treatment cycle, you may consider renting a room in a hotel nearby.

There are also tests you can perform at home, like SpermCheck, which can give you results regarding your sperm count in a matter of minutes. But these are generally for your information only.

If you are undergoing fertility testing or treatment and are struggling to produce a semen sample at a clinic, fortunately, there are options and other alternatives available to you.

Typically, you'll be asked to avoid all lubricants when producing a semen sample. This is because lubricants, even those that are not spermicidal, can damage or hinder sperm. 4

If you need lubricant, however, there is an option. Pre-Seed is a sperm-friendly lubricant approved for fertility purposes that has shown the best results for sperm vitality. It does not damage sperm and can be used for testing and treatment. (It can also be used during intercourse when you're trying to get pregnant.)

Your clinic may sell Pre-Seed, or you may find it in select pharmacies. (Try calling around first.) If not, you can also order it online . Be sure to place an order early enough so you'll get it before your testing or treatment appointment. Also, be sure to let your healthcare provider know if you plan to use a lubricant.

Another option is to use a sex toy or vibrator to help with stimulation. You may bring a battery-operated sex toy to the clinic, but consider practicing at home first if you have never tried this before. Just remember to abstain from ejaculating prior to your analysis.

One option that may actually produce a better semen sample than self-stimulation is using a specialized collection condom. Note that you can not use a regular condom, which can damage sperm even if it does not contain spermicide. 5

Condoms designed specifically for fertility testing and treatment allow the sperm to be collected via intercourse to maintain sperm viability and motility.

The semen is then taken from the collection condom, and prepared or analyzed in the clinic. Studies have shown that sperm counts collected in this way tend to be higher than when collected via self-stimulation. 6

In order to do this, you will either need to deliver your sample to your clinic or a nearby lab within one hour. These condoms may be purchased directly from your fertility clinic, or you can order them online ahead of time.

Note that lubricant is allowed, but only an approved fertility lubricant. Pre-Seed is safe to use with these specialized condoms. Also, you may want to purchase more than one, so you and your partner can practice before the big day.

If you have any concern about being able to produce a semen sample on the day you need to for IVF or IUI treatment , talk to your fertility clinic and ask if you can produce a sample ahead of time. They can freeze it and use it as back-up, in case you can't produce a fresh semen sample. 7

Ideally, your clinic should offer you this option. But if it doesn't, do not be ashamed to ask. You're better off preparing a frozen sample and never needing it than not preparing one at all and losing a month's treatment due to performance anxiety.

For freezing, you need to have infectious disease blood test results (syphilis, HIV, hepatitis C and hepatitis B) on file within a year of specimen collection. Both the collection and bloodwork need to be planned in advance, so make sure to plan ahead. This is usually not something that can be arranged at the last minute.

If you cannot produce a semen sample via ejaculation, there is an alternative—surgical sperm retrieval. This is typically reserved for men who can't ejaculate for medical reasons, or for men whose semen has zero sperm count.

That said, surgical sperm retrieval can be used in cases of anxiety-related ejaculation difficulty as well. Your healthcare provider will administer local anesthetic and may also offer a sedative or light general anesthesia.

There are three kinds of sperm retrieval. These include percutaneous epididymal sperm aspiration (PESA), needle aspiration biopsy (NAB), and testicular sperm extraction (TESE). 8

In cases of severe male infertility, ICSI-IVF, a procedure that injects the sperm cell directly into an egg, is the recommended form of treatment. This is different than an IVF, which leaves multiple sperm and an egg in a petri dish to fertilize on their own. It should be noted that ICSI-IVF comes with additional risks and costs .

Difficulty ejaculating for fertility testing and treatment is not uncommon. There's no need to feel ashamed or embarrassed. If you suspect that you are going struggle with ejaculation or you find out that you're experiencing trouble, talk to your healthcare provider—ideally before any scheduled treatments. They can help you find a solution.

National Library of Medicine. Semen analysis .
Wang C, Swerdloff RS. Limitations of semen analysis as a test of male fertility and anticipated needs from newer tests . Fertil Steril . 2014;102(6):1502-1507. doi:10.1016/j.fertnstert.2014.10.021
Mowat A, Newton C, Boothroyd C, Demmers K, Fleming S. The effects of vaginal lubricants on sperm function: an in vitro analysis . J Assist Reprod Genet . 2014;31(3):333-339. doi:10.1007/s10815-013-0168-x
Shah R. Surgical sperm retrieval: Techniques and their indications . Indian J Urol . 2011;27(1):102-109. doi:10.4103/0970-1591.78439
California Sperm Bank. Semen analysis preparation .
John Hopkins Medicine. Sperm retrieval procedures .
Urology Care Foundation. Sperm retrieval .
Vasan SS. Semen analysis and sperm function tests: How much to test? . Indian J Urol . 2011;27(1):41–48. doi:10.4103/0970-1591.78424

By Rachel Gurevich, RN

Rachel Gurevich is a fertility advocate, author, and recipient of The Hope Award for Achievement, from Resolve: The National Infertility Association. She is a professional member of the Association of Health Care Journalists and has been writing about women’s health since 2001. Rachel uses her own experiences with infertility to write compassionate, practical, and supportive articles.

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When we ask a man to bring a semen sample for analysis or other studies there is usually no problem. He obtains it at home and brings it to us. However, when it is time to provide the sample for an In-Vitro Fertilisation, things change.
In general they are nervous, hypersensitive because of the responsibility it takes to do it right. They fear not being able to achieve an adequate arousal in unfamiliar surroundings, like a hospital environment and often with the wife in the operating room for egg retrieval. If to this, we add a male factor as the reason of the infertility, their feeling of guilt increases even more.
We, doctors, ask them if they think they will have problems that day. Most of them say no, others prefer to bring it from home, the hotel or previously frozen because they fear that difficulties may arise. They appreciate a lot the possibility to speak with the doctors and to see it is a common problem, because of course, in front of their wife they cannot complain or expose any fears since the answer usually is, “Well, honey, that’s all you have to do…”.
The male which have “no prolem” often leave the sample room with a “mission accomplished” face, but fearing that the quantity was too little or that the semen sample quality was worse than other times.
The semen quantity, (volume of ejaculate), its the quality and the level of orgasm depend on the degree of sexual arousal reached previously. That means that it is better when the intensity and time of excitement has been longer. This is due to the increase of vascularization of the seminal vesicles and prostate, which are the glands producing seminal fluid and thus favor a complete ejaculation.
When the excitement is less, as it often happens that day, ejaculation is usually incomplete and the man notices that. In some cases a blockage occurs, they are not able to provide a sample and it becomes a traumatic experience. In these situations we ask if they can not get an erection or if they are excited but cannot ejaculate. In the first case we give them a tablet to induce an erection. But mostly they don’t manage to ejaculate because, due to a psychological effect, this reflex is blocked. In this case we give an anxiolytic.
We ask all of them to relax while sitting or walking for an hour and we tell them not to worry if they cannot make it because we can extract the spermatozoa with a simple technique. Although they already imagine that this simple technique consists of puncturing a testicle, they are not scared, it actually takes away their stress. However, having to go for a B plan is totally exceptional.
The wives of the blocked men are surprised from the role suddenly acquired by their partners as she is actually the one coming out of the operating room!
The truth is that in the IVF cycles men are the forgotten ones and we intend to help them. From my experience, I think semen collection rooms must be redesigned not to make them look like they are inside a clinic and, on the other hand, we have to explain them how they can emotionally support their wife throughout the cycle and especially during the time waiting for the pregnancy test.
Therefore, I have spent months asking many men how they would like the room to be. Well, I have not received much information because each of them has very different tastes.
The results of my own research are as follows: men have in common the desire for intimacy, to feel isolated in order to concentrate on the sexual stimulation. They also greatly appreciate hygiene and a prior knowledge of the place, as this gives them security.
As I said, there is great variation depending on each individual in terms of what excites them, as well as which position facilitates ejaculation. This also happens in the position used during sexual intercourse, as some will prevent ejaculation. Thus, according to my statistics, most of them would like to masturbate sitting on a comfortable sofa, others prefer to lie down and some to remain standing.
To provide all possible sexual stimuli I started to think about the offer we should have in our collection rooms so they could have the chance to choose.
On the internet and in the sex-shops, the great number of sex toys for women and the few for heterosexual men called my attention. Finally the selection is as follows:
On this video, you can see how our new semen collection rooms look.
I have to say that the experience of using VR glasses for the donation made the whole process a lot easier, it was more like a game instead of a medical procedure. Very happy about that.
I think that the hardest part is to put everything in the recipient, to meet the target you would need to put the recipient upside down but then not much quantity would remain inside for long, so you end up doing strange malabarisms. Also touching the edges is not too comfortable either and trying not to touch while maintaining the recipient on target is a distracting task. IMO redesigning the recipient as a silicone vagina or condom would make the whole process a lot more successful.
Also when you are about to ejaculate it’s very funny trying to find the recipient with the VR glasses on.
Dear Mike,
I am glad that you felt it more like a game instead of a medical treatment. Thank you very much for your opinion.
We really appreciate your feed back and we will take into consideration your recomendations to improve our system.
Kind Regards,
Interesting how you tried to take the nurse pictures out of magazines. Here a couple could be going through a serious and sad struggle with their marriage (namely not knowing if they can ever have children) without encouraging porn and he’s told to look at other women besides his wife. How do you think she feels. I think your perspective was off at that moment.
But the religious factor. Though masturbation is a gray area as far as religious beliefs go, we both just simply try to steer clear of it. I laugh because I told him if he feels that being alone will be more effective, well, it’s for science right? But over all, we just try not to.
The religious problem I find is the porn, soft or not. It is against our vows, religion and total mindset to look at another in lust besides each other. We have been married 9 years and we are super open with each other. We’re one of those annoying couples that prove all the “Just give it a year” naysayers wrong and snog in a corner at social gatherings. He is amazing and our faithfulness to each other (and the sex ) is the most beautiful thing we will not give up. We even speak up if we chance a peek. I’m not fooling myself. Sorry for the rant.
So my question is, do they have the right to tell me he has to use a different means to ejaculate besides me. I’m pretty decent at a hand job especially if there were a specific kind of lubricant they needed me to get. And is at home always an option since it’s just for an SA for after a vasectomy? We live only a couple minutes from one of his clinic’s locations. I just want to be prepared if they tell us I “can’t” be there.
You tell me that you live a couple minutes from one of a clinic’s locations. I recommend you go to this clinic to be told what options you have, since there are several methods to obtain a sample, such as using a condom without spermicide or ejaculating in a specific sterile bottle.
good explanation about semen collection.. thanks for sharing
Thanks for an excellent article on the subject.
I went though the same process while I had to give it for a semen test.
I was under huge stress because I did not knew if I would get aroused and would be able to conduct the process.
Unfortunately, the testing lab where I had to give the sample told me to got to the toilet and get the sample.
and the toilet had a kind of odour and was kind of a confined space and not ventilated enough.
I tried and failed, the environment was not at all comfortable.
At times
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