A common concern for medical providers and couples is the issue of masturbation. This may not be a topic discussed in the couple�s relationship, so the medical provider needs to be available to describe collection procedures. For some medical providers, issues of sexuality are difficult and it may be one reason why so many couples who seek infertility evaluation never participate or are offered routine semen analysis.
There can be anxiety for the man in participating in the testing process. Myths and cultural beliefs about sperm quality can challenge someone�s understanding of masculinity and sexual performance. Some times men are reminded of testicular injuries in childhood and they fear the worst. In addition, the collection process may be difficult or expose a sexual dysfunction that is not initially presented in the early assessment of the infertility.
For men who learn that they are azopermic on testing, it is important that they are encouraged to consult with urologist to determine etiology and fertility options: epididymal extraction and intacytoplasmic sperm injection and the use of donor semen. It is not uncommon for men who receive this information to delay referral. Finally, encourage the individual/ couple to seek information and support available from a local regional support group.
For couples who receive good news following completion of the semen analysis, introducing the basal body temperature graph and charting ovulation initiates the next step in the level one evaluation process.