IVF: Men, Sperm and the Things I Wish I’d Known

9 September 2026

Guest Contributor

Why IVF can feel like a woman’s journey

IVF is, for many reasons, overwhelmingly focused on the woman. The physical and emotional burden is enormous. There are scans, blood tests, injections, procedures, hormones, appointments and an almost endless cycle of hope and disappointment.

By comparison, the man can feel somewhat like a spectator. We’re generally assessed through a semen analysis, looking at things such as how many sperm there are, how well they move, their shape and appearance (concentration, motility and morphology). But there is a huge grey area beyond those basic measures, and I wish I’d understood that at the beginning.

My sperm was ‘acceptable’ but something still felt off

My sperm quality was borderline. I was sitting right on the cusp of what was considered acceptable, but my DNA fragmentation was high, albeit technically within the acceptable range by just 1%.

We were told that ZyMōt and ICSI should help overcome some of the problems. ZyMōt is a selection technique that helps select sperm that move well without the need for the usual spinning and separation process (centrifugation), while ICSI involves injecting a single sperm directly into an egg. Put crudely, ZyMōt puts the sperm through somewhat of an assault course before the embryologist selects the best ones for ICSI.

Confident in the positive effect that ZyMōt and ICSI would have on my sperm we proceeded with two egg collections. Looking back, my wife had a gut feeling that there was more to the puzzle and that there were other variables that needed to be addressed, including my lifestyle choices and certain medical avenues worth exploring.

When our embryos weren’t developing

Our first few embryo transfers failed, and one of the things that became increasingly obvious was that our embryos weren’t particularly great quality. The grades weren’t amazing, albeit embryo grading is a snapshot of a specific point in time, and we had a significant number of embryos stop developing after day four, something our specialists told us could be consistent with male-factor infertility issues.

Now, I can’t say that our first few transfers failed solely because of my sperm. Fertility is complicated and embryo development is influenced by many factors. But I became increasingly convinced that we hadn’t properly investigated my side of the equation.

Sperm DNA fragmentation test

Eventually, we went to see Professor Jonathan Ramsay, nicknamed “The King of Balls”, and I was tested for damage to the DNA carried by my sperm. Sperm DNA fragmentation refers to breaks or damage in the DNA within sperm. There can be damage affecting one strand of DNA, or both. The science around how best to test for and address this is still developing, and different techniques can detect different types of DNA damage.

In my case, we found high levels of both single and double strand DNA fragmentation. Professor Ramsay then tested my sperm using different sperm-selection approaches, including different ZyMōt techniques, to determine which produced the best result in my particular circumstances.

Diagnosis

The next issue to address was my high, but technically acceptable, level of single-strand DNA fragmentation. Following an ultrasound, it was discovered that I had a moderate Varicocele vein, which is essentially an enlargement of the veins around the testicle. Varicoceles can make the testicle warmer than it should be and increase oxidative stress (essentially an imbalance that can damage cells, including sperm and their DNA). Both can affect sperm production and DNA integrity.

I subsequently underwent a relatively minor procedure to embolise the problematic vein. Essentially, the procedure blocks the affected vein so that blood can be redirected through healthier veins. Three months later, my follow-up ultrasound showed that the problematic vein had been successfully treated.

Lifestyle changes

Three months is also the length of a cycle of sperm production, so during that period I made a number of significant lifestyle changes. I had already stopped smoking a couple of years earlier, but I cut out alcohol, cut out caffeine and heavily processed foods, improved my diet and started exercising more consistently.

I wasn’t doing this because I believed there was a magic formula for producing better sperm. There isn’t, and none of this is a guarantee of success. But I wanted to know that I had done everything reasonable within my control to help our chances of having a family.

Final embryos

The difference in our subsequent and final batch of embryos was striking. They were significantly better quality and, importantly, we didn’t see the same drop-off after day four. Thankfully, our latest transfer is going well so far.

I’m not claiming that sperm quality was the sole reason our earlier attempts failed, or that the changes I made were responsible for our latest result. IVF simply isn’t that straightforward or linear. Around the same time as my changes, my wife also underwent successful surgery to remove endometriosis and addressed a multitude of thyroid and immunology factors.

However, I do believe that sperm quality was a significant contributing factor in our case. Which leaves me wondering, why didn’t we investigate it properly at the beginning?

What advice I would give to any man before starting IVF

Women starting IVF undergo an extraordinary amount of testing, yet men can, in comparison, have remarkably little investigation beyond the basic semen analysis and (depending on your clinic) single strand DNA Fragmentation test. Perhaps that’s because we still think about male fertility in overly simplistic terms, you’re either shooting blanks or you’re fine.

That said, fertility isn’t necessarily that binary and there are things about sperm quality that a standard semen analysis or single strand DNA fragmentation test may not tell you. There are also lifestyle factors and other medical issues that may be worth exploring.

That doesn’t mean every man embarking on IVF needs every conceivable test, nor that sperm is more important than egg quality. It means the man’s contribution deserves to be properly understood too. Male factor infertility contributes to infertility in around half of couples experiencing infertility, either alone or alongside female factors. More importantly, there can be a real cost to not knowing. For us, it potentially meant additional treatment, more money, more time and, most importantly, more emotional turmoil and heartache. 

There is another significant reason why I think men need to take this seriously. You can’t take your partner’s injections, you can’t go through the egg retrieval, you can’t experience the physical effects of the treatment on her body or take away the pain that she will go through. But you can, and should take responsibility for your own fertility.

You can get properly assessed, you can ask questions, you can make sensible lifestyle changes, and you can be there for your partner when the process inevitably becomes overwhelming. That last bit matters more than you will ever know.

Women have to go through so much during IVF and it’s brutal. As a man, sometimes the most useful thing you can do is cook dinner, clean the house, listen when she needs to vent, give her a hug and avoid being an antagonist, but don’t confuse being supportive with being passive.

If you’re starting IVF, don’t just assume that because you’ve produced sperm, your job is done. Talk to your doctor or fertility specialist about your own fertility and whether further investigation is appropriate in your circumstances. Make smart lifestyle choices. It isn’t forever, and it’s a small sacrifice in the bigger picture.

This isn’t about blaming men for failed IVF. It isn’t about pretending sperm is the only thing that matters. And it certainly isn’t about suggesting that lifestyle changes can magically solve infertility. It’s about leaving as few stones unturned as possible. Looking back, I wish I’d known that earlier. Because as men, it’s sometimes easier to ignore the things we don’t want to think about and hope they’ll sort themselves out.

But I think you’re more of a man for owning your stuff and doing something about it rather than ignoring it and hoping for the best. Do it for your partner, do it for your potential future family, and, if nothing else, do it so that you don’t look back and wonder whether there was something you could have done differently.