By Dr. Oliver Pack (Medical Doctor – Reg. No. 030308944).
Although attention has traditionally focused on women when discussing reproduction, it is essential to emphasize that men play an indispensable role throughout the entire process: they contribute 50% of the genetic material required for conception.
In assisted reproduction, male participation is not always active (as is the case, for example, with couples who seek treatment due to difficulties conceiving). In some situations, participation is passive and involves contributing genetic material through sperm donation. This is essential for treatments involving couples in which the man cannot provide his own genetic material, such as in cases of male infertility, or for same-sex couples.
Semen contains the sperm cells necessary to fertilize a woman’s egg. On average, a single ejaculation can contain between 30 million and 1 billion sperm cells in total. However, not all sperm are equally effective. In fact, only a very small number reach the egg during the fertilization process, if fertilization occurs at all. Semen quality, including motility (the ability to move) and morphology (the shape of the sperm cells), plays a crucial role in successful fertilization.

The fertilization process begins when a sperm cell travels through the cervix and uterus to the fallopian tubes, where it may encounter an egg. Once the sperm reaches the egg, it must penetrate its outer layer, known as the zona pellucida. In doing so, it fuses with the egg’s membrane and releases its genetic material. This union forms a single cell called a zygote, which contains the combined genetic material of the egg and the sperm, thereby initiating embryonic development.
One of the first steps in assisted reproduction treatment is conducting tests to evaluate semen quality. The most common of these is a semen analysis (also known as a spermiogram or seminogram), which assesses sperm count, motility, and morphology. This may be complemented by hormonal tests to measure levels of key hormones involved in male fertility, such as testosterone and FSH (follicle-stimulating hormone).
In some cases, genetic testing is also performed to detect possible chromosomal abnormalities that could affect fertility or the future development of the baby. As with female eggs, sperm can also be cryopreserved, ensuring the availability of a man’s own sperm for future assisted reproduction cycles. This is commonly done prior to oncological treatments that may impair male fertility.
When semen quality is sufficient, men can participate actively in assisted reproduction through various treatments. These include artificial insemination (in which sperm is introduced directly into the woman’s uterus to facilitate fertilization) and in vitro fertilization (IVF-ICSI), which is used particularly in cases of low sperm motility or other sperm-related issues. In IVF, fertilization takes place in the laboratory, and the resulting embryo is then transferred to the uterus. When semen quality is very poor, the ICSI technique allows for the selection of a single sperm cell, which is injected directly into the egg to ensure fertilization.
Finally, in more severe cases where semen quality is inadequate or sperm are absent, a testicular biopsy may be performed to retrieve sperm, or sperm donation may be considered.
Future fathers not only play a genetic role in assisted reproduction treatments but often also serve as a vital source of emotional support for women undergoing pregnancy.
Women frequently undergo multiple physical and emotional procedures, but men may also experience significant levels of stress, frustration, and anxiety. Fertility treatment can lead to feelings of helplessness and concerns about masculinity and their role as future fathers. It is therefore essential for both partners to communicate openly and support one another throughout the process.
Men should also be aware that male fertility is just as important as female fertility to the success of treatment. In fact, it is estimated that male factor infertility accounts for approximately 40% of fertility problems in couples. For this reason, its evaluation is a fundamental component of any assisted reproduction treatment.