Surrogacy and male fertility: Don’t overlook the man

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Embarking on a fertility journey can be an emotional rollercoaster, and surrogacy brings its own set of complexities. While much of the focus is placed on the egg donor and surrogate, the male partner’s role often fades into the background. But should it? And does sperm quality make a difference? The answer is a resounding yes.

The overlooked role of male fertility

From the moment a couple steps into a doctor’s office seeking fertility help, the emphasis is largely on the woman. Age, egg quality, and hormone levels become the primary talking points, while male fertility is often reduced to a simple semen analysis. Yet, research shows that male factor infertility contributes to over 50% of IVF cases. Fertility isn’t just a female issue—it’s a shared responsibility.

So why does this matter in surrogacy? Because even with the best egg donor and the healthiest surrogate, you still need a strong, viable embryo. And that requires high-quality sperm.

Why is a basic semen analysis not always enough?

When men face delays in conceiving, a semen analysis is usually the first (and often only) test they’re offered. This analysis looks at:

• Semen volume
• Sperm concentration
• Sperm motility
• Sperm morphology

While useful, this test doesn’t tell the full story. It won’t reveal whether the sperm can effectively fertilise an egg or whether there are underlying genetic issues that could impact embryo health. Yet, despite its limitations, it’s still the standard assessment offered to men.

What if sperm isn’t as healthy as it seems?

Many couples endure multiple failed IVF cycles, with the woman carrying the physical and emotional burden, adjusting medications, trying holistic therapies, changing diets, all in a desperate attempt to improve success rates. Meanwhile, the man, reassured by a “normal” semen analysis, assumes there’s nothing more he needs to do. But what if the sperm is part of the problem?  This disconnect creates frustration and imbalance in relationships. Women feel they’re shouldering the entire burden, while men, unknowingly, may be missing key opportunities to improve their fertility. If male fertility issues are undiagnosed, couples may experience:

• Delayed conception
• Multiple IVF failures
• Poor embryo development
• Recurrent miscarriage

Beyond conception, there’s also growing evidence that male fertility issues can be linked to broader health concerns for both the father and future children. This isn’t just about making an embryo, it’s about long-term health and creating the best possible start for a baby.

What additional testing can reveal

The good news? Sperm are constantly regenerating, meaning even small lifestyle changes can make a big difference in just a few months. However, sperm are also extremely vulnerable to damage, particularly from oxidative stress. Additional testing can help identify underlying issues and provide targeted solutions.

Beyond a basic semen analysis, men may benefit from:

• Sperm DNA fragmentation testing – Assesses sperm’s genetic integrity and links to IVF failures, miscarriage, and live birth rates.
• Oxidative stress testing – Affects up to 80% of men and can damage sperm function.
• Hormone profile – Identifies imbalances that impact sperm production.
• Testicular ultrasound – Detects conditions like varicocele, which affects around 30% of men.
• Infection screening – Undiagnosed infections can harm fertility.
• HBA binding & Physical exams – Provide further insight into sperm function and reproductive health.

Understanding the full picture, lifestyle, diet, medical history, and occupational hazards allows for a personalised approach to improving sperm health and, ultimately, fertility outcomes.

Where to get the right help

Many men feel lost in the fertility process. With most clinics focused on female reproductive health, men can often feel like an afterthought. But finding the right specialist, such as a urologist with expertise in male fertility (also known as an andrologist) can make all the difference. While these specialists can be hard to find, testhim provides a list of UK-based experts in this field.

Simple steps to improve sperm health

While medical intervention or support is sometimes necessary, there are simple, proactive steps men can take to enhance their fertility before and during treatment:

• Follow a Mediterranean-style diet rich in antioxidants.
• Reduce processed, fatty, and sugary foods.
• Cut out alcohol, smoking, and vaping.
• Limit caffeine intake.
• Stay hydrated.
• Exercise regularly, but avoid excessive cycling.
• Avoid heat exposure (hot baths, saunas, tight clothing).
• Ejaculate regularly to reduce oxidative stress.
• Seek emotional and mental health support.

The Bottom Line

Surrogacy is a long and often unpredictable journey. While intended parents focus on legalities, egg quality, and treatment protocols, sperm health must also be a priority. Male fertility testing should go beyond a basic semen analysis to uncover hidden issues and optimise chances of success.

Fertility treatment can feel like a gamble, but taking steps to test, treat, and improve sperm health ahead of treatment can help tip the odds in your favour. Male fertility isn’t just a side note, it’s a key part of the equation.

About testhim

testhim is a pioneering platform dedicated to addressing the often-overlooked issue of male fertility. Founded by Ian Stones, Michael Close, and Toby Trice—leaders in the field with over four decades of combined experience—Testhim aims to bridge the gap in fertility education and support for men. By offering a free questionnaire, men can quickly discover how their lifestyle and health history may be affecting their fertility, with instant recommendations for health, lifestyle changes, and advanced fertility tests. In collaboration with LogixX Fertility and leading clinics, Testhim provides innovative diagnostics such as oxidative stress testing and sperm DNA fragmentation, while also offering high-quality fertility supplements and services. The platform empowers men to take control of their reproductive health, making advanced fertility care more accessible and transforming the male fertility landscape.

• Check out our free questionnaire: www.testhim.com
• Listen to our podcasts: https://podcasters.spotify.com/pod/show/testhim

By Ian Stones

Founder & co director of https://www.testhim.com/

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