Last week, I saw a new patient whose story is common. She is in her early 30’s and had been trying to conceive for 4 years. During this time, her OB/Gyn gave her clomiphine citrate (Clomid) for 7 months, did about eight blood tests and performed surgery on her twice. During our first meeting, I inquired about her husband. He had never gotten her pregnant, nor had he ever gotten anyone else pregnant in any previous marriage or relationship. I asked if his sperm had ever been checked and she looked frustrated. During all these years, he had never gotten a test. Sometimes, this is a sign that the husband does not want a child as enthusiastically as the wife. However, she reassured me that he and his parents were strongly pressuring her to do all the operations and fertility testing because they very much wanted a child. I asked why he had never been tested. Apparently, he was healthy and was quite insistent that it was her problem.

Finally, after I spoke with him directly, he consented to get tested this week. He has zero sperm. When I broke the news to them, he was still not convinced and insisted on getting a repeat test at an outside lab. I agreed that it would be a good idea. At least he was acknowledging the possibility of having a problem.

The good news is that we can now start moving forward in the right direction. The lesson is that unless a man has proven fertility, no matter how healthy and virile he may seem, the only way to confirm for sure that he has sperm is to do a semen analysis.