World IVF Day 2026: What Couples Should Know About Male Fertility Before Starting Their Journey

For almost 50 years, in vitro fertilization has given hopeful parents a path forward when conceiving naturally hasn’t worked. It remains one of modern medicine’s most remarkable achievements. And for the couples who go through it, it’s one of the most demanding processes. A single IVF cycle can require a significant financial investment, a physically involved process, and an emotional commitment that can stretch across many months. 

Because so much rides on each cycle, it is worth pausing before you begin to make sure both pieces of the fertility picture have been fully evaluated. 

This is where many couples don’t have the full picture. Male-factor infertility contributes to nearly half of the cases in which couples struggle to conceive, yet the male side of the evaluation is often the last piece examined—if it is examined at all. 

This World IVF Day, we’re celebrating how far reproductive medicine has come, as well as exploring what questions can help couples move forward before they begin the IVF process.

When couples begin fertility care, attention tends to center on the woman. That focus is understandable, but it can leave a major contributor to infertility unexamined. Understanding why so many men are never fully evaluated and what a more complete evaluation can reveal can change the course of a couple’s entire fertility journey.

A standard semen analysis measures three things: sperm count, morphology (shape), and motility (movement). These are a valuable starting place, because they confirm that sperm are present and able to move toward an egg. What they do not measure is whether those sperm are actually capable of fertilizing an egg. As a result, many men whose results fall within “normal” ranges still experience unexplained infertility.

That gap matters, because it can send couples down the wrong path. When a male factor goes undetected, couples may move through repeated rounds of intrauterine insemination (IUI) or IVF without success. Beyond the physical, emotional, and financial toll, these cycles may not improve the odds of pregnancy if the underlying issue is never addressed.

This is the gap PS Fertility set out to close. PS Detect is a non-invasive, at-home sperm test that measures the percentage of sperm carrying phosphatidylserine (PS). PS is a biomarker on the sperm’s surface that must be present for fertilization to occur. Rather than counting sperm, PS Detect is a functional test that measures sperm competency: the ability to fertilize an egg. Our science has shown that most men who have achieved a pregnancy have a normal PS Score.

Why Varicoceles Matter Before IVF

Among the causes of male-factor infertility, varicoceles are one of the most common and most overlooked. A varicocele is an enlargement of the veins inside the scrotum, and while it is often symptomless, it affects more than 41% of infertile men. Because it can quietly reduce sperm quality, it is exactly the kind of treatable factor worth identifying before starting IVF.

Here is where PS testing becomes especially useful. Men with a varicocele tend to have lower PS Scores, and one study found that varicocele repair restored PS Scores to normal in every participant who began below the normal range. Notably, a PS Score is not correlated with the size or grade of a varicocele, meaning a physical exam alone cannot tell you whether repair is likely to help. But measuring the PS Score can.

The research backs this up. A 2025 analysis in the World Journal of Men’s Health looked at nine studies of men with varicoceles and found a clear pattern: when the varicocele was repaired before ICSI, couples saw better fertilization rates, better pregnancy rates, and about double the odds of a live birth. A 2020 review from Johns Hopkins researchers found the same thing. In one of the larger studies they looked at, about 63% of couples got pregnant when the male partner had his varicocele repaired first, compared with 47% of those who didn’t, and the live birth rates were 48% versus 29%. It’s worth noting that the benefit shows up most clearly with IVF and ICSI.

In other words, a varicocele may be a fixable reason a man’s fertilization potential is lower than it should be. If your PS Score is low and you have a varicocele, repair is likely to bring that score back up. And varicocele repair is linked to improved IVF outcomes. So if you know a repair can improve your PS Score, the best time to do it is before you start IVF, not after.

The Case for Testing Your PS Score Before IVF

Testing PS before IVF can help you walk into the process with a complete picture instead of a partial one. If you have a low PS score and a varicocele, it may be worth taking the time to fix the varicocele

This is especially important when a low PS Score points to a varicocele. If you have both a low PS Score and a varicocele, it may be worth repairing the varicocele before beginning IVF, as studies have shown that IVF outcomes improve following varicocele repair. Fixing a treatable factor first can give a cycle its best possible chance rather than working around a problem that could have been addressed.

Your PS Score can also help guide which fertilization method might be best for your IVF journey. If a male factor has been identified, most physicians recommend ICSI (intracytoplasmic sperm injection), in which a single sperm is injected directly into an egg, over conventional IVF, where sperm and egg are combined and fertilization is left to occur on its own. Knowing there is a male factor in play ahead of time helps your care team choose the approach most likely to help improve fertilization.

For physicians, this kind of early, functional insight supports more accurate diagnosis, more tailored treatment plans, and fewer unnecessary procedures. For patients, it offers something just as valuable: clarity and a sense of control at a moment that often feels uncertain.

None of this is about adding another hurdle before IVF. It is about removing guesswork. A PS Score is a single, at-home step that can either confirm the male side of the equation is ready or point to a specific, treatable reason it is not.

Is There Anyone Who Shouldn’t Do Varicocele Repair Even if Their PS Score is Abnormal?

There is an honest complication worth naming. Repairing a varicocele is not an instant fix. Because sperm take roughly three months to mature, it can take about 90 days after a repair before the improvement shows up in a man’s fertility.
That waiting period matters differently depending on where a couple is in their journey. When the female partner is around 38 or older, reproductive endocrinologists may advise against having her wait through a partner’s repair and recovery. If the physician is concerned that a 3-4 month delay in IVF treatment could impact outcomes due to declining egg quality, he or she may recommend that the male patient forgo a varicocele repair to expedite IVF treatment.

This is exactly why testing early is so valuable. Knowing your PS Score before you are up against the clock means the decision is yours to make rather than one forced by circumstance. Many couples have room to repair a varicocele and let the benefits take hold before starting IVF. A couple facing a tighter timeline can weigh their options with clear information instead of guesswork. Either way, the earlier you know, the more choices you have.