How long should we try before he gets tested?

The same clock as for the couple: ASRM says more than a year, or less if the female partner is thirty-five or older. There is no reason for his test to sit behind hers in the queue — if anything it should come first, because it is simpler.

He had a bad result. Is that it?

No, and a single result is rarely treated as final. Sperm take over seventy days to develop, so an illness, a high fever or a medication in the three months before the sample can impair what is measured. Repeat testing after an interval is normal, and many contributing factors are modifiable.

Do hot tubs and laptops really matter?

ASRM names both — hot tubs and laptops used on the lap — as situations that raise scrotal temperature and are worth avoiding. They are unlikely to be the whole story on their own, but they are among the easiest things to change while you wait for other answers.

He's on testosterone. Does that matter?

Yes, and it is worth raising explicitly. ASRM lists anabolic steroids and testosterone among the substances associated with impaired sperm function and production. Do not stop a prescribed medication on the strength of a web page — bring it to whoever is running the assessment, because it materially changes the picture.

How long until lifestyle changes show up?

Almost three months, per ASRM, because that is how long the production cycle takes. Changes made now are measured in the sample after next, which is worth knowing so nobody concludes too early that nothing is working.

Before it starts · 4 min read

The half of fertility nobody tests

Roughly half of the picture sits with the male partner, and it is tested last far more often than it is tested first.

The test is a sample in a cup. The one it gets deferred in favor of usually involves scans, bloods, or a procedure.

Last updated August 20, 2026

Why this goes first, not last

NICHD's position, which our page on the thresholds already carries, is that problems in the male are just as likely as problems in the female. That alone should set the order of investigation.

The practical case is stronger still. A semen analysis is non-invasive, quick, and cheap relative to almost everything else on the pathway. Deferring it means months of investigating one partner while the answer may be sitting unexamined.

ASRM frames the trigger as a couple event: see a specialist after more than a year, or less if the female partner is thirty-five or older. Not her, not him — the couple.

Today's sample is about three months ago

This is the single most useful thing to understand before reading a result.

ASRM: sperm take over seventy days — about two and a half months — to develop and mature. So illness or medications within three months of producing the sample can impair the sperm ejaculated on the day of examination.

A bad flu in March shows up in a May sample. So does a course of medication, or a period of heavy drinking, or a stretch of unusual stress and poor sleep. None of that makes the result meaningless; it makes it a snapshot with a long exposure, which is why one result is a conversation rather than a verdict.

The same lag runs the other way. ASRM notes that changes take almost three months to show up as an improvement — so anything you change today is being measured in late autumn, not next week.

What actually affects it

Heat. ASRM advises avoiding situations that raise scrotal temperature — hot tubs, and laptops used on the lap are the two they name.

Smoking is associated with reduced sperm quality.

Recreational drugs, including anabolic steroids and testosterone, are associated with impaired sperm function and production. Testosterone deserves its own line, because men often assume it helps: it does the opposite, and prescribed testosterone is worth raising specifically with the doctor running the assessment.

Weight. Obesity has been linked to impaired sperm production.

Medications, chronic medical conditions and even high fevers can impair the body's ability to make sperm — which is the mechanism behind the three-month lag above.

On the helpful side, ASRM points to a healthy lifestyle: maintaining an ideal weight and a diet rich in antioxidants, with multivitamins potentially improving sperm quality. Give it three months before expecting to see anything.

If he does not want to do it

This is common enough to be worth naming, and it is rarely really about the test.

Fertility is tangled up with how men are taught to think about themselves, and a result feels like a judgement in a way a scan somehow does not. Framing matters: this is the fastest way to rule something out, not an examination of him.

It is also worth saying that a result which does find something is frequently actionable — many of the factors above are modifiable, and the ones that are not can still be worked around with treatment. The worst outcome is not a poor result; it is a year spent not knowing.

Common questions

How long should we try before he gets tested?: The same clock as for the couple: ASRM says more than a year, or less if the female partner is thirty-five or older. There is no reason for his test to sit behind hers in the queue — if anything it should come first, because it is simpler.
He had a bad result. Is that it?: No, and a single result is rarely treated as final. Sperm take over seventy days to develop, so an illness, a high fever or a medication in the three months before the sample can impair what is measured. Repeat testing after an interval is normal, and many contributing factors are modifiable.
Do hot tubs and laptops really matter?: ASRM names both — hot tubs and laptops used on the lap — as situations that raise scrotal temperature and are worth avoiding. They are unlikely to be the whole story on their own, but they are among the easiest things to change while you wait for other answers.
He's on testosterone. Does that matter?: Yes, and it is worth raising explicitly. ASRM lists anabolic steroids and testosterone among the substances associated with impaired sperm function and production. Do not stop a prescribed medication on the strength of a web page — bring it to whoever is running the assessment, because it materially changes the picture.
How long until lifestyle changes show up?: Almost three months, per ASRM, because that is how long the production cycle takes. Changes made now are measured in the sample after next, which is worth knowing so nobody concludes too early that nothing is working.

If it's this, not that

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