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Why should I get STI testing if I’m trying to conceive or freeze my sperm?

Roughly 15% of male infertility cases are caused by sexually transmitted infections, or STIs. The Centers for Disease Control and Prevention (CDC) recommends STI testing every 3–12 months, depending on your risk factors. This is especially true if you are trying to conceive or considering freezing your sperm as STIs can have an impact on sperm health, including key metrics like motility, concentration, morphology, and sperm count. Undetected and untreated STIs can also be spread to a partner; STIs can affect pregnancy and overall fertility. 

This article will explore how to test for STIs, which STIs are associated with poor sperm health and infertility, and how to choose between at-home STI testing and in-clinic testing.

Key takeaways:

  • If you are trying to conceive or considering freezing your sperm, it is recommended to get tested for STIs as they can have an impact on sperm health and be spread to your partner or child. 
  • Legacy’s at-home STI test kit screens for chlamydia, gonorrhea, hepatitis B and C, HIV, and syphilis, which can cause complications, like poor sperm parameters and sperm DNA fragmentation. 
  • If you are planning to freeze your sperm, testing for STIs ensures your sample will be viable and cleared to use at fertility clinics in the future for IUI and IVF cycles.
  • Legacy’s at-home STI testing is more private and cost-efficient than in-clinic testing and does not require a prescription or insurance coverage. 

What are STIs, and how do you test for them? 

A sexually transmitted infection is an illness that is spread during unprotected sex with an infected partner. The pathogens that cause sexually transmitted infections can be passed through an exchange of fluids — such as blood, semen, or vaginal fluid — or via skin-to-skin contact in the genital region.

“STIs” is often used interchangeably with sexually transmitted diseases, or STDs, but they are not the same thing. An STI indicates the presence of pathogens, even if a person doesn’t develop symptoms. An STD is the actual illness caused by those pathogens. Whether you have symptoms or not, these pathogens can negatively impact fertility, even if your STI never progresses into an STD.

Depending on which STIs you’re testing for, you’ll either provide a urine sample (chlamydia, gonorrhea), or a blood sample (HIV, hepatitis, syphilis), or both. In some cases, you may provide a cheek swab, genital swab, or a sample of fluid from a sore or blister. Some doctors may visually examine you for STIs but will usually need to send a sample to their lab for confirmation.  

The importance of STI testing 

Testing regularly for STIs helps to protect your sperm health, fertility, and overall health. But it can also protect your partner from catching an undetected STI that can negatively impact their fertility and overall health. Sometimes, a simple course of antibiotics can clear up an STI, like gonorrhea or chlamydia. So if you catch it before you start trying to conceive, the chances of running into long-term issues are significantly decreased. 

Find out more about how early STI testing can help improve your chances of conceiving and lead to a smoother sperm freezing experience. 

For those who are trying to conceive

Some research shows STIs may be linked to male-factor infertility, including poor sperm parameters and sperm DNA fragmentation. Testing early can help you avoid unsuccessful attempts at conceiving and costly treatments in the future if your fertility does become irrevocably impaired.

Testing for STIs can also prevent you from passing an infection to your partner, which can affect their pregnancy and increase chances of miscarriage. In some cases, STIs can even be passed to your baby. Here’s what you should know about how specific STIs affect your fertility and a future pregnancy:

  • Chlamydia: Research shows chlamydia may increase the risk of sperm DNA fragmentation, which is genetic damage that can contribute to infertility. But when caught early, antibiotics can clear up the infection and reverse the fragmentation. If passed to a partner with ovaries, chlamydia may cause pelvic inflammatory disease, which is also associated with infertility.   
  • Gonorrhea: Studies show that gonorrhea is associated with the development of urethritis, which can cause inflammation of the testicles and lower sperm quality. And, like chlamydia, gonorrhea can also cause pelvic inflammatory disease, which lowers fertility rates.
  • HIV: Though medication has been shown to significantly increase life expectancy in people with HIV and AIDS, the drugs that help manage the virus may also reduce sperm parameters, like sperm motility, sperm counts, and semen volume. HIV can also potentially be passed to the baby during birth or breastfeeding.
  • Hepatitis B and C: Studies show both hepatitis B and C can decrease sperm quality and potentially cause male-factor infertility. There is also an association between hepatitis C and antisperm antibodies, in which the body mistakenly identifies sperm as a foreign invader. And like HIV, hepatitis B and C can also be passed from mother to child and cause adverse outcomes, like preterm birth and low birth weight.
  • Syphilis: Untreated syphilis can cause infertility because of its ability to damage all organs and nerves in the body. Studies also show that 50% of pregnancies in which the childbearing parent has untreated syphilis ends in miscarriage or stillbirth.

For those who want to freeze their sperm

Testing for STIs before freezing your sperm can help ensure the sperm you are freezing is of high quality and viable for future use. If you choose to freeze your sperm with Legacy’s at-home sperm freezing kit, STI testing is not required, but it is required by other fertility clinics, with different regulations in different states. Therefore, STI testing before freezing gives you the peace of mind that your sperm will be safe to use at any clinic in the future. It is recommended to test for STIs six months prior to freezing your sperm.

If you test positive for an STI, you can still freeze your sperm, though your samples may be “quarantined,” or stored separately from others’, to prevent any cross-contamination (though cross-contamination is highly unlikely). If you plan to use your sperm in intrauterine insemination  (IUI) or in vitro fertilization (IVF), it will typically be “washed,” or separated from the semen. This is because the semen is what carries infection, not the sperm itself. The process of sperm washing is effective at removing pathogens from sperm samples. In one study, which reviewed 11,000 cycles of IVF/IUI that used washed semen samples from male HIV patients, not a single instance of transmission to the female partner was found. 

At-home STI testing for men

At-home, mail-in testing offers a convenient, safe and confidential option to screen for STIs. Legacy’s at-home STI testing kit allows you to test for six common STIs that may affect your fertility: chlamydia, gonorrhea, hepatitis B, hepatitis C, HIV 1 and 2, and syphilis. Results are 99% accurate. Keep in mind that the majority of STIs are asymptomatic, so even if you don’t have any symptoms, it’s always a good idea to get tested.     

Legacy’s at-home STI test kit is included with the For Tomorrow and Forever sperm freezing bundles. If you are purchasing a Standard Semen Analysis semen analysis with monthly, yearly, or five-year cryogenic storage, it is recommended to order an at-home STI kit as well.

In your kit, you’ll find a urine sample collection kit, as well as a “finger prick” blood sample collection kit. After your tests have been analyzed, your user-friendly results will be discreetly uploaded to your personal client dashboard in about 3–5 business days. Along with learning more information about each infection, the tests performed, and what your results mean, you’ll also receive the best next steps for you, based on your results and whether or not you plan to freeze your sperm. Every report includes a downloadable summary to share with your doctor.

At-home vs. in-clinic testing

Research shows most people prefer to test for STIs in the comfort of their homes, with at-home testing rates being up to 11 times greater than in-clinic testing. Not only is testing at home more private, but it is typically more cost-efficient as well. It also takes less time because you don’t have to drive to a clinic, have a consultation, or return for your results, and the results are just as accurate.   

At-home STI testing with Legacy does not require a prescription or insurance coverage. And the six STIs screened are all that is required in 49 of 50 states for use in a fertility clinic. However, if you plan to use your sample for IUI or IVF in the state of California, your fertility clinic may also require screening for HTLV (human T-lymphotropic virus). Unfortunately, there is currently no at-home testing option for this virus so it is recommended you talk to your doctor about in-clinic HTLV testing.

Cost and coverage for STI testing

Legacy’s at-home STI test kit is not covered by insurance, but it costs just $150. Comparable testing in a clinic or lab would cost around $350, not to mention any added fees for a clinic visit and consultation. You also don’t have to miss work or drive anywhere to use an at-home test. If you’re planning on freezing your sperm, at-home STI testing is included with the For Tomorrow and Forever sperm freezing bundles.

Cost of sperm testing

STI testing is just one way to take charge of your reproductive health. Getting a sperm analysis is another important step. This kind of test will provide key insights into your overall sperm health, including your count (how many sperm you’re producing), sperm motility (how your sperm move), and morphology (how your sperm are shaped). Sperm testing is also a way to understand your sperm health if you’ve had and recovered from an STI in the past.

Just like an at-home STI test, Legacy’s at-home semen analysis kit allows you to provide your sample and receive results in the comfort and privacy of your home without having to visit a fertility clinic. It costs just $295 and may be covered by your insurance or employee benefits plan. 

Learn more about Legacy’s full suite of products, including STI testing, sperm testing, and sperm freezing bundles.

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