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

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


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 when a couple has been unable to get pregnant the natural way.

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

If you're 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.

Produce the Sample at Home

You could find that producing a semen sample at home is much easier than doing so in a doctor's office. Whether or not this is possible will depend on your doctor'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 and kept at body temperature (for example, by transporting it tucked into a sports bra). 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 easy-to-use tests you can perform at home like SpermCheck, which can give you results regarding your sperm count in a matter of minutes.

Approved Lubricant

Typically, you'll be asked to use a dry rub when producing a semen sample. This is because 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 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 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.

Use a Sex Toy

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've never tried this before. Just remember to abstain from producing ejaculate for at least two to five days prior to your analysis.

Collection Condom

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 via intercourse to ensure sperm viability and motility are maintained.

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 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 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 Sample

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 option. But if they don't, don't 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.

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 three kinds of sperm retrieval: percutaneous epididymal sperm aspiration (PESA), needle aspiration biopsy (NAB), and testicular sperm extraction (TESE).

In cases of severe male infertility, an ICSI-IVF, a procedure that injects the sperm cell directly into an egg, will be your 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.

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 that you're going struggle with ejaculation or you find out that you're experiencing trouble, talk to your doctor—ideally before any scheduled treatments. They can help you find a solution.

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7 Sources
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