Fertility 101: a Quick Guide for Gay Men

You may be surprised to learn that your diet, lifestyle and environment all have a profound bearing on your individual reproductive health.

If you’re a gay man considering starting a family with Assisted Reproductive Technology (ART), and plan on using your own sperm, you should keep in mind that your reproductive health has an important part to play in the process, with diet, lifestyle and environment all having an effect.

To father a child through surrogacy and egg donation, your reproductive system must be functioning properly. This means:

  • The testes produce viable, or normal, sperm as well as testosterone, the male hormone.
  • You have the ability to achieve an erection and ejaculate normally.
  • The sperm that are produced are properly shaped, able to move rapidly, and can accurately fertilise the egg.

Infertility can happen if there are problems with any of the above steps. Please remember that anyone can be affected by infertility, and while it can be a challenging experience, the good news is that there may still be options available to achieve a pregnancy.

Factors that Affect Fertility

Male Fertility

Some of the factors that can affect male fertility are:

  • The quality of sperm (motility, morphology, count and vitality)
  • Sexually transmitted infections
  • Zinc deficiency
  • Alcohol and smoking
  • Recreational drugs
  • Excessive heat
  • Constant exposure to toxic substances
  • Genetic conditions


Female Fertility (Known Egg Donor and/or Surrogate)

If you’re thinking about using someone you know as an egg donor and/or surrogate, it’s important to know there are several things that can lead to fertility issues in women.

Some of the factors that can affect female fertility are: age, medical history, genetic factors and lifestyle (including smoking and weight).


What Fertility Tests are There?

Male Tests

  • Semen analysis to evaluate the amount and quality of semen and sperm: this is sometimes called a sperm count and tests motility (movement), morphology (sperm shape), count and vitality (ability to live and endure) of sperm.
  • Blood test to examine hormone levels: assesses FSH, LH and testosterone.
  • Other tests: depending on results of the initial tests, your treating doctor may require a sperm DNA fragmentation test, an immunobead test or a testicular biopsy.


This section gives you detailed explanations of these male-specific tests – select an option below to learn more.

Semen Analysis

Semen analysis evaluates the amount and quality of a man’s semen and sperm to determine male fertility. This test is sometimes called a sperm count.

Semen analysis is used to assess the following:

  • motility: movement of the sperm (swimming ability)
  • morphology: percentage of sperm that have a normal shape
  • count: the number of individual sperm present in one ejaculation
  • vitality: sperm’s ability to live and endure

A semen analysis can help clarify whether a man has a reproductive problem that is causing infertility, and also determine what fertility treatment options are reasonable. A severely low sperm count or low motility may indicate the need for an advanced approach, whereas a normal semen analysis might suggest a more conservative approach.

A semen sample is usually collected by masturbation, directing the semen into a sterile container. No lubricants should be used as it might kill the sperm.  Two to five days of abstinence is recommended before a semen analysis, to ensure the reliability of the test. Longer periods of abstinence may affect the accuracy of the results (less active sperm). Once the semen sample has been collected it should be delivered to the lab within one hour. The sample should be kept close to body temperature.

For more information download our Semen Analysis Fact Sheet.

Sperm DNA Fragmentation

A Sperm DNA Fragmentation test provides a reliable analysis of sperm DNA integrity that may help to identify men who are at risk of failing to initiate a healthy ongoing pregnancy. Information about sperm DNA integrity may help in the clinical diagnosis, management and treatment of male infertility.

The genetic integrity of the sperm is essential for normal embryo development. A high level of DNA fragmentation in sperm cells may represent a cause of male infertility that a conventional semen analysis (sperm concentration, motility analysis, morphology assessment) will not detect. Results reported in the scientific literature have shown that, regardless of the Assisted Reproductive Technology (ART) used, an elevated level of sperm DNA fragmentation will significantly compromise the possibility of a successful pregnancy.

The test is performed at the lab. The sperm are captured within an inert agarose gel. These are treated with an acid denaturant, which removes already fragmented DNA. The remaining material is then treated with a lysing agent, which frees the intact DNA into the agarose gel. This agarose gel is then stained to highlight the released DNA and evaluated to determine the degree of fragmented vs. intact DNA.

Depending on what caused damage to the sperm’s DNA, there may be ways to improve it. These include: adopting a healthier lifestyle, stopping smoking, avoiding exposure to toxins, and taking a daily supplement of antioxidants and zinc. Further clinical options can be discussed with one of our specialists.

Immunobead Test (IBT)

Some men can experience immunological infertility. This happens when the male immune system reacts to its own sperm as if they were invading cells. It can be caused by an infection, cancer or a vasectomy. An immunobead test (IBT) is used to check for antisperm antibodies, which can inhibit the ability of sperm to fertilise an egg. An IBT can detect different kinds of antisperm antibodies in several biological samples, can indicate the class and the severity of the antibodies and identify the part of the sperm affected.

One of the techniques used for antisperm antibodies detection is “Direct” IBT testing on the semen sample itself.  In this test a small portion of the neat semen sample is mixed and incubated with latex beads and antibodies, then checked for a reaction.  A positive reaction is where the sperm and beads become bound to each other.

Testicular Sperm Aspiration (TESA)

A Testicular Biopsy, also known as Testicular Sperm Aspiration (TESA), is a test to extract sperm directly from the testicles for analysis. Testicular Biopsy is performed when the male does not have sperm in his seminal fluid. This could be due to a number of reasons, including: previous vasectomy, failed vasectomy reversal, obstruction, retrograde ejaculation, abnormal anatomy (such as an absence of the vas deferens) or certain genetic defects.

Sperm are produced within a network of tiny tubes called “Seminiferous Tubules” inside the testicles. In the Testicular Biopsy (TESA) procedure, a very fine needle is passed into the testicles under anaesthetic, and a tiny amount of tubules is removed. These tubules are then processed in the laboratory and checked for the presence of sperm, which can either be used to fertilise eggs or frozen for use in the future with Intracytoplasmic Sperm Injection (ICSI) – a specialised form of  In Vitro Fertilisation (IVF). Sperm retrieved from the Seminiferous Tubules in a Testicular Biopsy procedure are less mature and less motile than sperm found in ejaculated seminal fluid. As such, IVF with ICSI is required to achieve fertilisation with TESA sperm.

Other screening and diagnostic tests for severe male infertility

  • Genetic Testing (chromosomal)
  • Microdeletion
  • Nuclear Chromation Fragmentation
  • Hormonal Screens
  • Cystic Fibrosis Screening


Who can Carry out the Fertility Tests?

You can start the process of fertility testing with your GP, or (with a referral from your GP) a dedicated fertility specialist. If you’ve been referred to a specialist, you’ll be able to claim the costs of a specialist back through Medicare.



At Rainbow Fertility, our specialists have extensive experience in helping create LGBTQIA+ families. Feel free to contact our friendly team to learn more about the fertility treatment options available to you.

Call: 1300 222 623
email: info@rainbowfertility.com.au



Current as at 01.02.2016

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