Problems Ejaculating for Semen Analysis

How to Cope with Performance Anxiety During Fertility Testing or Treatment

cup for a semen analysis
It's normal to have trouble ejaculating for a semen analysis. Khuong Hoang / Getty Images

Needing to produce a semen sample, for either semen analysis or fertility treatment use, may lead to "performance anxiety" or the inability to ejaculate. This should be no surprise when you consider all the factors involved with producing the 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's still not your home or your bedroom. There may be some "inspirational magazines" provided, but it's 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 over the fact that you as a couple could not get pregnant the regular way.

Also, despite the stereotype, not every man enjoys self-stimulation. If you rarely masturbate for pleasure, the chances of being able to produce a sample for clinical purposes are even lower.

What can you do if you must produce a semen sample for fertility testing or treatment, but you can't seem to do it?

Ask if You Can Make the Semen Sample at Home

Being able to produce a sample at home may be much easier than doing so in a doctor's office.

Whether or not this is possible will depend on your clinic's protocols, as well as how far away you live. Long travel time can lead to dead sperm, which is neither good for testing nor treatment purposes.

However, if you think you will feel less anxious at home, it's worth asking about this option. If your clinic is far away, there may even be a possibility of bringing it to a lab that happens to be closer to home.

For a treatment cycle, you may want to consider renting a room in a hotel.

Use an Approved Lubricant

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

If you need lubricant, however, there is an option. Pre-Seed is a popular sperm-friendly lubricant approved for fertility purposes. 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 be lucky enough to find it in a pharmacy. (Call around first.) If not, you can order it online. Be sure to place an order early enough so you'll get it before the testing or treatment date comes.

Use a Vibrator or Sex Toy to Encourage Ejaculation

Another option is to use a sex toy or vibrator to help. You even can bring a battery-operated sex toy to the clinic. (Practice at home on another day first if you've never tried this before.)

Use a Specialize Collection Condom for Semen Analysis and Fertility Treatment

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.

Condoms that are designed specifically for fertility testing and treatment purposes allow the sperm to be collected in a natural way via intercourse. 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.

In order to do this, you'll either need to be within reasonable travel distance (no more than 30 minutes) from your clinic or a nearby lab, or you could rent a day or night in a hotel. These condoms may be purchased directly from your fertility clinic, or you can order one online ahead of time.

Note that lubricant should be used, but you can only use an approved fertility lubricant. Pre-Seed, mentioned above, 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.

Freeze a Semen Sample Ahead of Time...Just in Case

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.

Ideally, your clinic should offer you this anyway. But if they don't, do not be ashamed to ask. It's better to prepare the frozen sample, and never need it, than not prepare it and possibly lose a month's treatment due to performance anxiety.

Last Resort: Surgical Sperm Retrieval

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 ejaculate has zero sperm count. However, surgical sperm retrieval can be used in cases of anxiety-related ejaculation difficulty as well.

Your doctor will administer local anesthetic and may also offer a sedative or light general anesthesia. There are two kinds of sperm retrieval: percutaneous epididymal sperm aspiration (PESA) and Testicular sperm extraction (TESE.)

In either case, with aspirated sperm, you'll need IVF with ICSI—which is a procedure where the sperm cell is directly injected into an egg. (This is opposed to putting many sperm in a petri dish along with an egg.) IVF-ICSI comes with additional risks and costs.

A Word from Verywell

Difficulty ejaculating for fertility testing and treatment is not uncommon. There's no need to feel ashamed or embarrassed. If you suspect you're going to have ejaculation struggles, or you do experience trouble, talk to your doctor. Ideally, talk to them before scheduled treatments. They can help you find a solution.

Was this page helpful?

Article Sources

Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  • Zavos PM. "Seminal parameters of ejaculates collected from oligospermic and normospermic patients via masturbation and at intercourse with the use of a Silastic seminal fluid collection device." Fertility and Sterility. 1985 Oct;44(4):517-20.