IVF for Men: What to Expect, How It Works, and When It’s Needed

On the IVF journey, most of the attention is on the woman’s role. They’re the ones who undergo hormone injections, egg retrieval, embryo transfer, and carry the resulting baby to term. But it’s still critical to understand IVF for men, including when it is used, what it’s like, and all that it requires. 

Studies show that male-factor infertility accounts for roughly 20–30% of cases on its own and contributes to about 50% of infertility cases overall. Using IVF to overcome male factor infertility means that men play a vital role in the IVF process.

This guide explains how IVF works for men, how sperm is collected, what to expect if you have a low sperm count, and how male couples can build families through reciprocal IVF. 

When is IVF Needed for Men? 

IVF may be recommended for men when a man’s sperm quality, quantity, or function makes natural conception or simpler treatments like IUI unlikely to succeed. Common situations include: 

• Low sperm count (Oligospermia): When sperm concentration is too low to reliably reach and fertilize the egg naturally. IVF with ICSI (Intracytoplasmic Sperm Injection) allows fertilization with even a single viable sperm.

• Poor sperm motility (Asthenozoospermia): When sperm move too slowly or irregularly to reach the egg on their own. IVF/ICSI bypasses this issue by manually injecting sperm into the egg. 

• Abnormal sperm morphology (Teratozoospermia): When sperm are misshapen and unable to penetrate the egg naturally. IVF with ICSI overcomes this mechanical barrier. 

• Azoospermia (no sperm in ejaculate): Caused by either a blockage (obstructive) or failure of sperm production (nonobstructive). Sperm can often be surgically retrieved from the testicle via TESE or micro-TESE and used in IVF.

• Genetic or chromosomal Factors: Conditions like Y-chromosome microdeletions or Klinefelter syndrome can impair sperm production. IVF with genetic testing (PGT-A/PGT-M) can help identify healthy embryos. 

• Previous vasectomy or blockage: If sperm can’t exit through the vas deferens, IVF with sperm retrieval (PESA, TESA, or TESE) is often used instead of vasectomy reversal. 

• Retrograde ejaculation or ejaculatory dysfunction: When sperm are released into the bladder instead of exiting the urethra. Sperm can be recovered from urine and used in IVF/ICSI.

• Immunologic infertility (anti-sperm antibodies): When the body’s immune system attacks its own sperm. IVF/ICSI helps sperm bypass antibody interference

• Unexplained infertility after other treatments fail: Even when semen parameters look normal, functional sperm defects can cause fertilization failure. IVF helps identify and overcome hidden sperm issues.

How Do Men Give Sperm for IVF? 

An essential step in the IVF process is retrieving sperm from the man in order to fertilize the eggs retrieved from a female.  

In most cases, sperm is collected through ejaculation on the day of egg retrieval. This is done privately at the clinic, or occasionally at home if the sample can be delivered to the lab within one hour.  

If ejaculation isn’t possible or the sperm count is very low, your care team may recommend a surgical sperm retrieval procedure, such as: 

• TESA (Testicular Sperm Aspiration): A fine needle is inserted into the testicle to extract sperm. 

• TESE (Testicular Sperm Extraction): A small tissue sample is taken from the testis. 

• Micro-TESE: A microsurgical version of TESE that allows the surgeon to identify small pockets of active sperm production. 

Is IVF Painful for Men? 

For most men, IVF isn’t painful at all. 

Providing a sperm sample through ejaculation is quick and completely noninvasive. 

Even when surgical sperm retrieval is needed, discomfort is minimal and temporary.  

These minor procedures are performed under local anesthesia or light sedation. Studies have found that most men report only mild soreness or bruising for a few days afterward.  

Pain scores for micro-TESE procedures are typically low to moderate on standard pain scales, resolving within 24–48 hours.

These forms of extraction were rated by patients as significantly less painful than vasectomy or reversal surgeries. 

And while TESE was perceived to be more painful compared to PESA, the absolute levels of pain were still moderate, and very few patients reported extreme pain or long delays in recovery.  

The Emotional “Pain” of IVF for Men 

The emotional component of IVF, however, can be more taxing. Men often feel pressure to “perform,” anxiety about results, and that they have to be supportive (like a “rock”) for their partners while dealing with their own emotional burdens.  

This is why it’s important for both men and women to seek support on the IVF journey, whether it’s physical, emotional, relational, or all of the above.  

IVF for Men with Low Sperm Count 

If you’ve been diagnosed with a low sperm count (oligospermia), IVF can still help you achieve pregnancy.  

In fact, a technique where a single healthy sperm is injected directly into an egg called Intracytoplasmic Sperm Injection (ICSI), was developed specifically for this reason. 

ICSI has made pregnancy possible even for men with severely impaired sperm parameters.

Studies show that with ICSI, fertilization rates remain high even when sperm counts are extremely low.

Before IVF, many clinics recommend pre-cycle lifestyle and medical protocols to optimize semen parameters, including: 

• Improving diet and reducing alcohol or tobacco use 

• Treating varicocele or hormonal imbalances if present 
• Taking antioxidant-rich supplements such as zinc, vitamin C, and CoQ10 

Reciprocal IVF for Men 

The term “reciprocal IVF” traditionally refers to female same-sex couples; one partner provides eggs, the other carries the pregnancy.  

With reciprocal IVF for male couples, a similar collaborative model takes place using donor eggs and a gestational carrier (surrogate). 

Here’s how it works: 

• Each partner can provide sperm. 

• Donor eggs are fertilized using IVF + ICSI. 

• Embryos are transferred into a gestational carrier. 

Some couples choose to fertilize eggs with sperm from both partners, so embryos from each can be transferred or frozen.  

The rationale behind reciprocal IVF for men is that it allows both men to participate biologically and emotionally in the family-building process. 

Even when using advanced techniques like ICSI, sperm health still matters. DNA damage or oxidative stress can impact embryo quality and pregnancy rates.

To optimize sperm health before IVF: 

• Eat a diet of nutrient-dense, low-carb foods centered around whole foods replete with healthy fats, omega-3s, folate, zinc, and other antioxidants 

• Quit smoking 

• Limit alcohol 

• Limit soy intake 

• Avoid common environmental toxins such as Organochlorine compounds, Bisphenol A (BPA), Organophosphate pesticides and herbicides 

• Exercise regularly but avoid overtraining 

• Limit heat exposure by avoiding saunas, laptops on lap, and hot tubs 

• Get adequate sleep and manage stress 

• Fortify yourself with clinically backed fertility supplements such as Male Preconception+ from Molecular Fertility 

For a more comprehensive guide to improving sperm count and overall male fertility health, click here.  

IVF for Men: The Bottom Line 

IVF is often seen as a female-focused treatment, but it’s truly a team effort. For men, IVF involves sperm collection, emotional support, and in some cases, minor surgical procedures.

Though the physical discomfort that men go through with IVF is lower than that of women, the man’s role is still significant.  

Whether you’re navigating low sperm count, exploring reciprocal IVF for men, or simply wondering how men give sperm for IVF, the CNY Fertility team is here to guide you with compassion, expertise, and affordability at every step. Schedule a consultation today!  

FAQ: IVF for Men 

Do men ever take hormones during IVF? 

No, not typically. Hormone therapy for men is only used if a doctor identifies a hormonal imbalance that can be corrected before IVF such as low testosterone or gonadotropin deficiency. 

How long before IVF should men abstain from ejaculation? 

Most clinics recommend 2–5 days of abstinence before giving a sample. This balance maximizes sperm count while maintaining good motility.

Can IVF work for men with no sperm in the ejaculate (azoospermia)? 

 Yes. With micro-TESE, sperm can be found in up to 50–60% of men with nonobstructive azoospermia.

Does sperm retrieval surgery affect testosterone or fertility long-term? 

Minor reductions in testosterone can occur after open testicular biopsy, but levels usually return to baseline within months. Long-term complications are rare.

Is IVF painful for men? 

No. Most men describe the experience as only mildly uncomfortable, if at all. Surgical retrieval involves minor soreness for a few days, but not severe pain.