Male Infertility

At the same time as her, from day one, because the male factor contributes in about half of infertile couples and the test is a simple semen analysis. The tradition of exhaustively working up the woman first while the man waits untested wastes months and sometimes years. A semen analysis is cheap, painless and definitive about where things stand. If a couple has tried for a year, or six months when she is over 35, both partners get evaluated. Starting with the easier test is just sense, and if the semen analysis is abnormal, that is when the rest of the workup, hormones, ultrasound and history, earns its place.

Often, yes, because sperm production responds to the same things the rest of health does. Heat is the quiet enemy: hot tubs, saunas and laptops on laps suppress production. Weight, alcohol, tobacco and untreated sleep apnea all lower counts. Testosterone therapy shuts sperm production down, a trap for men who started TRT without being told.

Marijuana belongs on that list too. THC acts directly on receptors in the testicles and on sperm themselves, and regular use is associated with lower counts, weaker movement and more abnormal forms. Few men have ever been warned about it, because marijuana's reputation is far gentler than its actual effect on fertility.

Often the testicles are simply not getting the signal they need, and medications that raise your own production can push them back to work. The environment sperm grow in matters too, and the supplements I actually recommend for it are at Peri Health & Hormones. The only catch is the calendar: a sperm takes about 74 days to mature, so every fix needs three months before the semen analysis can show it. Improvements are real but never instant.

Fertility supplements I recommend →

Reversal exists and succeeds in returning sperm for many men, but the honest framing comes before the vasectomy: think of it as permanent. Success falls with years elapsed, the operation is microsurgery measured in hours rather than minutes, it costs many times what the vasectomy did, and pregnancy rates trail sperm-return rates. Men banking on reversal as an undo button are making a plan out of an exception. For a couple already past a vasectomy and wanting children, reversal and sperm retrieval with IVF are both real paths, each with its own math.