Your part in this

What happens, and where you come in

Testing

If you are the one providing the sperm, you will be asked for a sperm analysis, usually produced at the clinic or brought in within a strict time window. It is an odd, faintly humiliating half hour in a small room, and everyone finds it so. Results vary a lot between samples, so one result is rarely the whole story, and clinics will often repeat it. If a donor is being used, or if you are not the person being tested at all, this stage is mostly paperwork, consent forms and waiting — and being the one who reads them properly is a real job.

Stimulation, roughly two weeks

Daily injections, early morning scans, and a partner whose hormones are being driven hard. Your job here is logistics and steadiness: knowing the schedule, doing the injections if that helps, driving to the 7am scan, and absorbing a bad evening without making it about you.

Egg collection day

A short procedure under sedation. You are usually needed to be there and to take them home, and if you are providing the sperm you will often be asked for a fresh sample the same morning. Clear the whole day. They will not be fit to be alone that afternoon, and sedation makes people foggy and emotional.

The lab days

Phone calls each morning with numbers: how many eggs, how many fertilised, how the embryos are developing. The numbers usually fall at every stage, and that is expected rather than a disaster. Agree in advance who takes the call and how you tell each other.

Transfer and the two week wait

The transfer itself is quick. Then comes the two week wait, which almost everyone finds the worst part, and during which there is genuinely nothing either of you can do to change the outcome. Plan things. Not big things — a walk, a film, a day out of the house.

What a sperm analysis actually measures

Worth reading if sperm from you or a partner is being used. The report will look alarming because most of the numbers sound low. Here is what the words mean.

• Concentration — how many sperm per millilitre. Total count is that times the volume.
• Motility — how many are moving, and how many are moving forwards rather than in circles.
• Morphology — shape. It is entirely normal for the large majority of sperm in any sample to be an unusual shape. A figure like 4% is not the catastrophe it reads as.
• DNA fragmentation — breaks in the genetic material. Not part of standard testing everywhere, and clinics disagree about how much it matters.
• Azoospermia — no sperm found in the sample. It does not automatically mean none are being produced, and it warrants a specialist opinion rather than conclusions.

If something comes back low, ask what it means for the treatment plan and whether it should be repeated. Ask whether you should see a urologist.

A poor result is a piece of medical information about a part of your body. It is not a verdict on you, however much it feels like one at first.

What is genuinely hard about this, from where you're standing

Nobody asks how you are. Every appointment, every form, every leaflet is addressed to your partner, and you become the person holding the coats. That is a strange and lonely position and it is entirely normal to find it so.

There is also the helplessness. You cannot take any of the physical part off them and you cannot make it work, and if the sperm is yours, the one thing you are asked to contribute is a sample in a side room. Then there is the money, which often lands disproportionately as a worry on whoever is watching the account.

And if the cause turns out to be sperm-related and the sperm is yours, there is a specific and rarely discussed kind of guilt attached to that. It is very common. It is also not useful, and it is worth saying out loud to someone rather than carrying quietly.

How to be useful without taking over

• Learn the process properly. Know the protocol, the dates and the drug names. Being the person who knows what happens on Thursday is worth more than any speech.
• Take on the admin. Appointments, prescriptions, pharmacy runs, chasing the clinic, checking the invoice. It is real work and it is genuinely helpful.
• Ask before you fix. “Do you want me to help with this or just listen?” is one of the more useful sentences available to you.
• Don’t police them. Comments about coffee, wine, exercise or stress land as blame, whatever you meant. They already know.
• Speak in appointments. Ask your own questions. It signals to everyone in the room, including your partner, that there are two of you here.
• Say the plain thing. “This is hard and I’m here” beats optimism. Avoid “it’ll definitely work” — you don’t know that, and it leaves them nowhere to be frightened.

Looking after your own head

You are allowed to find this awful. Being the steady one does not mean being fine, and pretending otherwise tends to come out sideways — as irritability, as working late, as drinking more than you meant to.

Tell at least one person outside the relationship what is going on. Most clinics offer counselling to partners as well as patients and it is often included in what you have already paid, so ask. The British Infertility Counselling Association can also point you to specialists who understand fertility treatment specifically.

If you find yourself feeling hopeless, or not able to see a way through, please talk to your GP, or the Samaritans on 116 123, free, any time. Where to get real support.