{"id":478726,"date":"2026-02-19T23:04:13","date_gmt":"2026-02-19T23:04:13","guid":{"rendered":"https:\/\/www.newsbeep.com\/us\/478726\/"},"modified":"2026-02-19T23:04:13","modified_gmt":"2026-02-19T23:04:13","slug":"a-guy-necologist-startups-push-semen-analysis-as-male-pap-smears","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us\/478726\/","title":{"rendered":"A ‘guy-necologist’? Startups push semen analysis as male Pap smears"},"content":{"rendered":"

In his 1694 review of magnifying lens technology, \u201cEssai de Dioptrique<\/a>,\u201d Dutch naturalist Nicolas Hartsoeker included a drawing<\/a> destined to make a lasting impression on future students of human reproduction. Inside a drop-like form with a long, straight tail is the lower part of a human body, crouched and holding its knees below a large sphere with an open perforation at the top. It\u2019s the most accurate depiction of what sperm was believed to be at the time: containing a full, minuscule human, ready to be implanted and grow in the womb.\u00a0\u00a0<\/p>\n

It would take more than a century for sperm to get its name \u2014 spermatozoa, from the Ancient Greek for\u00a0\u201cseeds of living beings\u201d \u2014 and even longer until its physiology was understood.\u00a0<\/p>\n

Alas, there are no homunculi crammed inside the smallest human cells. Yet recent research in fertility and urology suggests Hartsoeker\u2019s image could work metaphorically: Sperm can be a proxy for the health of the person who produced it, giving insight into far more than fertility.<\/p>\n

At a pace of about 1,500 units per second, 300 million per day, and a lifetime production of up to a trillion sperm cells, spermatogenesis is a marvel of abundance. A single ejaculation contains up to 300 million sperm cells each made over two to three months, in a process that starts at puberty and typically ends at death.\u00a0<\/p>\n

Yet for the 11.4% of men<\/a> in the U.S. (a value in line with global rates<\/a>) who struggle with some type of infertility the numbers are far lower, with implications that can be broader than reproductive health. \u201cWe know that a low sperm count is a biomarker of other things \u2026 and that includes current health \u2014 we call it comorbidity burden \u2014 and future health,\u201d said Paul Turek, the director of the Turek Clinic and an expert of male fertility and health. Metabolic disorders, cardiovascular disease, cancer, especially testicular and prostate: All show correlation<\/a> with infertility, and particularly low motile sperm count.\u00a0<\/p>\n

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In 2025, a study from Copenhagen University<\/a> looked at the data of nearly 80,000 men who had their semen quality assessed over 50 years, between 1965 and 2015. It found that men with a low motile sperm count (under 5 million) had a life expectancy nearly three years shorter than men with normal sperm count. Further, issues with any sperm quality parameters were found to be positively correlated with all-cause mortality. \u201c[S]ome men with impaired semen quality may experience less healthy ageing than men with better semen quality and could benefit from being identified at the time of semen quality evaluation,\u201d conclude the study authors.\u00a0<\/p>\n

With data like this, Turek, along with a growing number of other men\u2019s health experts have a bold idea: have men routinely undergo a semen analysis, for the sake of fertility and general prevention of disease.<\/a> \u201cI am trying to propose to the world that we need guy-necologists,\u201d he said, \u201cand that \u2026 the semen analysis is the new Pap smear for men.\u201d\u00a0<\/p>\n

As has happened in other areas of testing (think full-body scans, multi-cancer detection tests<\/a>), the technology and business is developing faster than scientific consensus. The nascent notion that semen analysis could be a helpful biomarker, coupled with a more general increased interest in male fertility, is beginning to attract entrepreneurs in the testing and fertility spaces, with a clutch of companies offering mail-in semen analysis, and even at-home sperm testing. Turek himself is on the advisory boards of at least two fertility companies, Legacy and Future Family, and the co-founder of AlphaSperm, a company offering pre-conception nutritional supplements for men.<\/p>\n

But the push to use semen analysis as an entry point into broader male health also draws considerable skepticism from experts on medical testing and public health. \u201cAll of this sounds like speculation. And I\u2019m very skeptical about medical practice that is based primarily on speculation,\u201d said Steven Woloshin, a former director of the Office of Disease Prevention at the National Institutes of Health.<\/p>\n

Case for semen analysis as good prevention<\/p>\n

Semen analysis identifies four measurements: how much semen, sperm concentration, speed of sperm movement, and shape. Together, these parameters reflect a picture of fertility in the first instance, but also of overall health: Turek likes to refer to them as a hand of cards to be played together with an eye toward statistics and probability, rather than individually as gambling.\u00a0<\/p>\n

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Low motility, for instance, can indicate high alcohol or marijuana consumption, while low volume can point to issues of obstruction. Morphology is sensitive to several factors (including genetics and environmental). For low sperm count, some of the causes are well known and easily addressable: the most common is varicocele (an enlargement of the veins in the scrotum), while others include taking too many hot baths<\/a> or wearing overly tight underwear, smoking, sleep deprivation, and certain medications.\u00a0<\/p>\n

But there are cases of infertility that don\u2019t have a clear cause, and that is where using semen analysis as a biomarker would hold the most value, said Turek. While semen analysis may not give granular information about what is wrong, it can raise a flag in the same way that high blood pressure or routine bloodwork does. However, not only do men rarely undergo the test, but when they do, it\u2019s usually in the context of female fertility treatments, which doesn\u2019t necessarily offer the best opportunity to address underlying causes, said James Smith, a professor of urology at the University of California San Francisco, and chief medical officer of semen analysis company Fellow.<\/p>\n

It\u2019s only when a couple has been trying to conceive for at least a year (or six months if the mother is over 35) that a semen analysis is typically performed. When the sperm count is low, the couple often moves on to IVF, said Smith, rather than taking the time to visit a man\u2019s health specialist to identify and potentially address the causes of the low count. It takes three months to make new sperm, and from a couple\u2019s perspective \u201cthe clock is ticking,\u201d said Smith.<\/p>\n

This is also a barrier to research on male fertility. \u201cIt\u2019s been difficult to recruit men to some trials,\u201d said Michael Eisenberg, a professor of urology at Stanford. \u201cThey don\u2019t want to be randomized to potentially placebo or nothing when they and their partner have been trying [to conceive] for 12, 18 months.\u201d<\/p>\n

Further, since low sperm count doesn\u2019t necessarily equal infertility, many men never learn their status anyway.<\/p>\n

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But if the analysis were done independently from current fertility goals, it could afford men the opportunity to get a sense of their reproductive health, and the time to address any lingering causes of infertility or low sperm count before they are trying to conceive. It could even indicate that they should be monitored for future health conditions, said Turek, or tested for genetic variations that increase cancer risk, such as BRCA.<\/p>\n

Unless there were more complex conditions, a primary care doctor could address many of the issues, and would be well positioned to investigate root causes. \u201cI see men in my practice often who are smoking weed, drinking, smoking tobacco, taking testosterone, taking peptides \u2014all sorts of things that are very modifiable, just general health risk factors,\u201d said Smith. \u201cI\u2019m then plugging them into their primary care.\u201d\u00a0<\/p>\n

The added advantage, proponents of this approach believe, is that men would become better acquainted with the health care system: similarly to how women got in the habit of visiting the gynecologist annually to get Pap smears<\/a>, young men would be lured into the doctor\u2019s office, a place they are known to avoid<\/a>. \u201cThere are a couple of things where younger men will go to the doctor, and that\u2019s if their penis doesn\u2019t work or their testicles don\u2019t work,\u201d said Smith, whose semen analysis showed him men are increasingly more curious about their fertility.\u00a0<\/p>\n

\u201cIt\u2019s always hard to figure out how to motivate people and motivate men,\u201d said Eisenberg, who thinks perhaps getting a sense of their fertility could work as an incentive for men to see doctors, \u201cas a measure of fertility, as a measure of health, maybe as a measure of masculinity.\u201d Like Smith, Eisenberg \u2014 who is an adviser to Legacy \u2014 reports sensing curiosity among men. \u201cWe\u2019ve done studies here at Stanford, and there are men that \u2026 want to participate just because they want to know what their semen quality is,\u201d he said.\u00a0<\/p>\n

\u201cWe have the opportunity to perform preventative medicine on young men for the first time ever,\u201d said Turek, who two decades ago was a recipient of the first government grant for male fertility specialists and is an adviser to the Men\u2019s Health Network,<\/a> an organization devoted to closing the lifespan gap between men and women. \u201cWe can tell them \u2018your sperm count\u2019s low, this is maybe what\u2019s going on: You need to lose weight, you need to kill diabetes, you\u2019re at risk for this, you should get checked for this.\u2019 \u2026 This is a golden opportunity that we\u2019ve never had before.\u201d\u00a0<\/p>\n

Case for caution: more doesn\u2019t equal better health<\/p>\n

\u201cThis whole idea about screenings or health checks \u2026 intuitively it makes total sense,\u201d said Barry Kramer, a professor of medicine at Dartmouth and a researcher of overdiagnosis. \u201cBut it turns out there\u2019s really no good evidence that health checks in general help make people feel better and live longer,\u201d he said. \u201cCommon sense is not a reliable index of usefulness in medicine.\u201d<\/p>\n

When it comes to semen analysis in particular, he is skeptical that it would be beneficial when performed at a broad population level. \u201cNon \u2026 predicate al mondo ciance,\u201d he said, citing Dante\u2019s \u201cParadiso\u201d in Italian: Don\u2019t go around preaching nonsense to the world. \u201cIn the absence of a particular symptom, you have to really think really hard why you\u2019re doing a test, any test,\u201d he said. When it comes to a semen analysis, he sees it useful as a diagnostic test when a man is facing fertility issues. \u201dBut outside of that context, I don\u2019t know of any reason why you would be doing it,\u201d he said.<\/p>\n

Kramer is unconvinced that a semen analysis would be worth doing just to assess a man\u2019s baseline fertility, without thinking about the broader biomarker concept, so that any issues can be addressed ahead of his trying to conceive. \u201cThe idea of doing it prophylactically doesn\u2019t make any sense to me,\u201d he said.\u00a0<\/p>\n

\u201cThis sounds like a very nonspecific way to address someone\u2019s health profile,\u201d said Woloshin. \u201cI\u2019d sure like to know what the sensitivity and specificity are, and the predictive value of getting a sperm test.\u201d Prior to expanding the scope of any tests \u2014 in this case, beyond men who are experiencing fertility problems \u2014 it\u2019s essential to assess whether it is reliable and accurate for the intended population, said Woloshin. More importantly, he said, there has to be evidence that it improves outcomes, such as quality of life, overall health, and life expectancy, something that is yet to be proven for semen analysis, given that it hasn\u2019t been performed on a sizable scale so far.\u00a0<\/p>\n

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Woloshin brings up an ethical issue, too, raising the threshold these kinds of tests need to clear in order to be considered beneficial: This wouldn\u2019t be something that is done in response to a patient complaint, but upon physician prompting. \u201cThe doctor is saying, \u2018you may think you\u2019re healthy and you may not recognize the problem, but let me tell you something that I think you should get\u2019,\u201d he said. This can cause distress, misplaced concern, and overdiagnosis: all harms that have to be weighted against the potential benefits provided by the test.\u00a0<\/p>\n

Turek isn\u2019t too concerned about causing undue health concern. In fact, he sees it as potentially helpful. \u201cPatients unfortunately get a little worried, and that\u2019s important because we\u2019d like them to worry because men aren\u2019t immortal,\u201d he said.\u00a0<\/p>\n

But the cascade of tests that may follow a semen analysis that showed low sperm count or other issues has to be considered from an economic point of view, too, said Emmanuel Drabo, a health economist at the Johns Hopkins Bloomberg School of Public Health. \u201cLiterature generally tells us that semen analysis could be leveraged in primary care as some sort of a gateway for men\u2019s health, using fertility concerns as some sort of an entry point,\u201d he acknowledged.\u00a0<\/p>\n

Though as promising as semen analysis may be as a biomarker, he said, it may not be the best screening tool. \u201cAre we going to have unnecessary imaging, unnecessary hormonal tests, unnecessary referrals that are due to mildly abnormal semen results?\u201d he said, noting that this would have an impact in terms of health equity, too. \u201cResources that we divert toward semen testing are resources that we could have used in other areas of health,\u201d he said.\u00a0<\/p>\n

Still, Drabo doesn\u2019t altogether discount the value of introducing semen analysis in absence of specific symptoms. \u201cPublic health is not only about treatment of diseases, it\u2019s about prevention,\u201d he said. \u201cThere is potential value in anticipating and addressing problems up-front.\u201d\u00a0<\/p>\n

The business of semen analysis\u00a0<\/p>\n

The public health experts STAT spoke with were especially skeptical about the idea that a semen analysis could draw men at scale into the doctor\u2019s office.\u00a0<\/p>\n

It would be \u201ca new test that costs money, takes time, requires the patient to do something it wouldn\u2019t ordinarily do and bring in his sperm for analysis,\u201d said Woloshin.\u00a0<\/p>\n

Indeed, even those who are excited about the potential of expanding the scope of semen analysis point to the logistical challenges the test presents. The gold standard is to test the semen within an hour of ejaculation to get an accurate evaluation. To do so, a patient has typically two options, neither of which is especially comfortable. One is \u201chaving the collection process in a strange room in a strange office, and a lot of guys understandably aren\u2019t comfortable with collecting a specimen in that way,\u201d said Charles Jenkins, the product director of Quest Diagnostics women\u2019s and reproductive health. \u201cThe other way is to collect it at home and drive it in and then you\u2019re kind of that NASCAR driver trying to make sure that you\u2019re gonna get over the finish line in time,\u201d he said.\u00a0<\/p>\n

Adding to the complexity is the fact that not all labs offer semen analysis, which requires dedicated instruments and expertise but is not reimbursed at a level that makes it worth the investment, so for many patients even finding a lab may require some effort. \u201cThere\u2019s a ton of barriers, and that leads to men not doing [semen analyses] very often,\u201d said Smith, who points out that for this reason only 30% of men who had a vasectomy follow it up with a semen analysis to check that it worked, despite it being the recommendation.\u00a0<\/p>\n

Hoping men would overcome such challenges just to get a peek into their fertility may be too optimistic. But even before benefits are unequivocally demonstrated, the interest in making semen analysis more easily accessible is being accompanied by business innovation and growth. Enter mail-in testing, one of the offerings trying to benefit from the growing male infertility market, estimated at $4 billion a year.<\/a><\/p>\n

Fellow, Smith\u2019s semen analysis company, developed technology that preserves sperm for up to 72 hours, allowing patients to collect samples at home and send them in a package specially developed to maintain their quality. The company, which launched its services in 2020, will test semen to assess fertility for $199, with an option to pay $140 to freeze sperm. Tests can be ordered directly by patients, who then may need to find specialists to interpret them<\/a>, or by physicians. Legacy, a competitor, offers standard semen analysis for $295, which goes up to $540 for sperm freezing. Jenkins\u2019 lab, which he founded in 2008 as ReproSource then sold to Quest, doesn\u2019t provide direct-to-consumer options, and offers a broader range of fertility testing. Though it, too, processes mail-in samples (its technology keeps them viable for 26 hours).\u00a0<\/p>\n

These labs\u2019 potential client base would grow exponentially, if Turek and other semen analysis enthusiasts \u2014 who all have at least some involvement with businesses offering convenient semen analysis solutions \u2014 are successful. He is determined to be, as he sees popularizing the test as his contribution to ending what he calls a neglect of male health. \u201cThe richest men in America live six years less long than the poorest woman,\u201d he pointed out. \u201cWe have a huge life expectancy discrepancy in America, and this is my approach to eliminating it.\u201d<\/p>\n

STAT\u2019s coverage of health challenges facing men and boys is supported by Rise Together, a donor advised fund sponsored and administered by National Philanthropic Trust and established by Richard Reeves, founding president of the American Institute for Boys and Men; and by the Boston Foundation. Our\u00a0financial supporters<\/a>\u00a0are not involved in any decisions about our journalism.<\/p>\n","protected":false},"excerpt":{"rendered":"In his 1694 review of magnifying lens technology, \u201cEssai de Dioptrique,\u201d Dutch naturalist Nicolas Hartsoeker included a drawing…\n","protected":false},"author":2,"featured_media":478727,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[687,16347,8278,97,5599,28532],"class_list":{"0":"post-478726","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-cancer","9":"tag-chronic-disease","10":"tag-diagnostics","11":"tag-health","12":"tag-public-health","13":"tag-reproductive-health"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/478726","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=478726"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/478726\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/478727"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=478726"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=478726"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=478726"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}