'I'm a fertility expert. This is the one question you should ask your partner right now.'

It's becoming more common for women to book an AMH Blood Test, to monitor their egg reserve as they plan for the future. 

But why should we have to do all the work? It takes two to tango, after all.

We recently shared the story of a woman who underwent invasive, exploratory fertility surgery when she couldn't get pregnant. Only to find out that she had no problem at all.

Her partner's sperm was causing the issue, and a simple cup-ejaculation test could have prevented her going under the knife.

It's proof that there is one question you need to ask your man: will you also get checked?

We spoke with fertility specialist, Dr. Simon Nothman, about the importance of a semen analysis not only for family planning, but for a broader review into your partner's internal health, plus, how you can go about bringing this up with your partner. 

What is male fertility testing?

According to Dr. Nothman, "A basic semen analysis offers men the same early window into reproductive health that an AMH blood test gives women." 

There is, however, a significant difference between an AMH egg reserve test and a semen analysis. 

Females' egg counts fall in numbers throughout the duration of their lives, so AMH is simply about understanding the number of eggs remaining.

In comparison, males continue to produce sperm into their later years in life, but face a decline in quality and strength.

So, a semen analysis from a single sample can be used to report a few important parameters such as ejaculate volume and sperm count. These factors shed light on "treatable conditions such as varicoceles [an abnormal enlargement of veins in the scrotum], and point to the value of banking sperm while quality is good."

This is helpful to discover sooner rather than later, avoiding a halt in family planning down the line. 

Watch: When to seek help for fertility. Post continues below.

What do they need to know about getting a test?

Male fertility tests aren't as widely spoken about, with most men not even considering testing unless they have issues conceiving.

Dr. Nothman says this may be later than ideal, "both because early detection of problems may facilitate early intervention or preventive treatments, and because fertility may reflect general health."  

He suggests that if fatherhood is not on the cards in the near future, it could still be worth doing a baseline test in your late 20s-30s, especially if risk factors such as past testicular surgery, and heavy vape or smoke use are present. 

"While the impact of age on female fertility is well known, its impacts on male fertility are discussed far less but are very important: sperm counts and motility drift down and DNA damage tends to rise from the mid-30s onwards."

When taking the test, Dr. Nothman says it is important to have an appropriate abstinence window of ideally two to three days prior, and to avoid testing within three months of a significant fever.

A single test is generally acceptable, if the results are well within the normal range. 

But, if results are borderline or low, a repeat test is required after at least six weeks. "This is because semen parameters naturally fluctuate, and the process of sperm production takes about two-and-a-half months."

It is important to note that a previously normal result can't guarantee a positive record in the future, as age also impacts male fertility. 

"Health, including fertility health, is dynamic and needs to be cared for and monitored over time," Dr. Nothman says.

A basic fertility test would typically follow this timeline: 

1. The taking of the sperm sample (this may also be tested for sperm DNA fragmentation and anti-sperm antibodies).

2. Depending on the result, another test may be requested such as a blood test for hormones, or a scrotal ultrasound.

3. The turnaround is typically quick, ensuring you have the knowledge quickly.

Accessibility and cost.

Now all of this sounds easy, but how much does it cost? And is it easy to book an appointment? 

Dr. Nothman says an accredited semen analysis is widely available through pathology networks and fertility clinics across Australia. 

He notes, "costs are modest compared with most medical imaging, and a referral can attract a Medicare rebate in many circumstances."

But it is important to research which pathology labs near you offer specialised testing, as this is not guaranteed across all pathology centres. 

The impact of testosterone.

Dr. Nothman warns that it's important to think about your sperm count and quality before starting testosterone replacement therapy (TRT).

"External testosterone switches off the hormonal signals that drive sperm production, (quite like how the contraceptive pill blocks ovulation in women) and many users are left with very low or even zero sperm counts."

A semen analysis can be helpful in identifying the impact this may have caused and whether it is salvageable for men who are currently using, or have recently stopped TRT.

Dr. Nothman says, "Recent studies show that many men fail to regain normal sperm numbers after stopping therapy, even when given medical treatment to try to improve sperm production."

So he suggests to anyone considering TRT, to document their semen quality first, or freeze some to keep their future options open. 

How to talk to your partner about their fertility.

It can be tricky to bring up fertility with your partner.

Men are often conditioned to assume their sperm is strong, or that having 'strong swimmers' is a reflection of their strength as a man. So, approach the conversation carefully and with curiosity — not judgement.

Dr. Nothman recommends: 

1. Keep it practical & team-based: "Let's both get a fertility check so we're making decisions with facts."

2. Normalise it by comparing it to other health screenings.

3. Link it shared goals and timing: Use an external prompt (planning future pregnancy, considering egg-freezing, or a GP's suggestion.)

4. Offer to book together: It's important to review results with a specialist as a pair. 

He stresses, "It's important not to view fertility challenges in terms of blame on one partner or the other, but rather as a matter that requires the attention and collaboration of both partners."

Listen: Dr. Sonja Jessup talks about the possibility of male infertility, and everything in between. Post continues below.

How to safeguard male fertility.

So, how can men maximise and maintain good fertility levels? Dr. Nothman has a couple of suggestions. 

"The highest yield and highest priorities should be to stop smoking and cut back on alcohol," he says.

Maintaining a healthy weight, regular moderate exercise, and a good sleep schedule are other good habits that have "important outcomes for both general and reproductive health."

Activities you might not assume to be harmful, such as religiously attending saunas and hot tubs, and having your laptop on your lap for extended periods of time, can also impact sperm. 

Dr. Nothman explains this is due to "excessive heat exposure". He adds that this, combined with "toxin exposures, may impact sperm quality, so being mindful and addressing these risks is also important."

Dr Simon Nothman is a Sydney‑based fertility specialist at Genea who pairs evidence‑based medicine with truly individualised care to help individuals and couples navigate their reproductive choices with confidence.

Feature Image: Getty.