Andrology Angst: What are my Options Doc?

The idea of providing a sperm sample during fertility preservation or reproductive treatment is a bit awkward and uncomfortable for most people considering it. And fair enough – you don’t usually have to ejaculate on command in a foreign location.

All of a sudden, the whole scientific community is in this private sphere of your life, and you have to masturbate into a cup.

But for some people, the idea may be particularly anxiety provoking and distressing.

Why does collection day cause anxiety?

Here are a few reasons why:

  • You may be worried about “performance anxiety” in a strange and clinical environment, and not being able to arouse yourself to ejaculation;
  • You may have been fine when you did the initial semen tests, but now feel the pressure of providing sperm on the actual big-day of treatment;
  • You may have had issues in the past not being able to ejaculate in sexual or medical situations;
  • You may not usually masturbating or you may be used to having a partner with you for sexual stimulation; or
  • You may have personal or religious reasons for not masturbating.

Whatever the reason, some people are unsure whether they will be able to provide a sample on the day of collection.

Pre-existing issues

While some people are unsure how they’ll go on collection day, others may already be  pretty sure or even certain that they won’t be able to produce a sperm sample. This may be because they have tried before unsuccessfully, or because they struggle with delayed ejaculation (a condition where ejaculation takes a very long time or cannot be achieved at all), or another medical condition that impacts ejaculation. Some medications may also impact ejaculation.

What options do I have?

Luckily, there are a range of options available if you are feeling worried about sperm collection day.

Here are some options to try and/or to discuss with your fertility nurse, specialist or counsellor:

Know that some anxiety is normal – As a first step, give yourself permission to feel some anxiety about this – it’s not a super sexy thing to have to do. Know that it may take longer than usual to get yourself aroused and to ejaculate. Taking some deep breaths or doing some relaxation exercises beforehand may help, or any other strataegies  you know that help you manage anxiety.

Book an extended andrology session – If you’re nervous that the usual andrology room booking  (usually 15 or 30 minutes) will not be long enough, ask for an extended booking. You don’t need to rush this.

Go to the andrology room with your partner – Nobody said you had to do this alone. If you think it would be helpful to have a partner involved, ask them to attend the andrology room with you.

Use your own pornography – If you have particular pornography that helps you climax, you can bring this on a phone or laptop, or bring your own magazines.

Practice at home – If you don’t have much experience masturbating, or stimulating yourself without a partner present, try masturbating at home on your own. Many people find nude photography or pornography helpful for this, or playing out a fantasy or previous sexual experience in their imagination.

Freeze a sample ahead of time – If you’re nervous that performance anxiety may take over on the day of a treatment, ask for your sample to be frozen ahead of time.

Home collection – If you can get your sample to the clinic within 30-60 mins, then you can usually produce it at home. Before taking up this option, discuss this with your specialist, nurse or embryologist to make sure you will get the sample to the clinic on time – otherwise sperm motility can be impacted.

Collection condom – If you would prefer to produce your sample via intercourse, your clinic can provide you with a special collection condom. You cannot use a normal condom, as this can reduce sperm quality. And you cannot use a lubricant either. Before taking up this option, make sure to discuss this with your specialist, nurse or embryologist to make sure you will get the sample to the clinic on time – otherwise sperm motility can be affected.

Book a hotel – If you live too far away for a home collection, you could book a hotel room near your clinic for either self-stimulation or intercourse with a collection condom. Then you can deliver the sample to your clinic. Chat to your your specialist or fertility nurse about this, and remember you cannot use a normal condom or lubricant.

See a counsellor – You may find it helpful to see an IVF counsellor at your clinic, or a sex therapist, to discuss your concerns and other strategies to help ease the anxiety of collection day. Strategies might include relaxation training, mindful masturbation techniques, and ideas for managing worries that impact sexual function. Sometimes very simple strategies can go a long way.

Medical procedures – If necessary, medical and surgical procedures (such as testicular biopsy or aspiration) are available for sperm collection. Speak to your fertility specialist if you would like to know more about these options.

Anxiety in other places

Some people who experience nervousness around sperm collection day may also struggle with problems in their sex life, or experience increased anxiety in their day-to-day life. A sexual health physician, psychologist, counsellor or sex therapist can help you to understand these issues better and offer treatment and/or a referral for other help to address these issues.

Warm regards,

Dr. Alice Hucker

Clinical Psychologist

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