CreditAlexandra Citrin/The New York Times

An equal number of infertility cases are caused by male factors as by female ones, according to the United States Department of Health and Human Services. But thats not the perception: Many couples who have trouble conceiving assume the woman is at the root of any problem, and thats how they go about seeking help. I have a long list of anecdotal stories of people who went forward with fertility treatments only to recognize later that the guy had a significant issue that explained his sperm count and their difficulty getting pregnant, said Dr. Joseph Alukal, M.D., a urologist at Columbia University Irving Medical Center. Several start-ups are trying to address the sperm side of things and to rebalance responsibilities around family planning.

[Male infertility: what to know and how to cope]

Legacy, a start-up out of Harvard Innovation Lab, began in 2018 to make inconvenient meetings with physicians a thing of the past. Customers mail their semen to the company in temperature-controlled kits. Then Legacy, in partnership with clinical labs, analyzes the deposit for factors like sperm motility and quality, provides recommendations if necessary and sets up a plan to cryogenically store the best sperm. We are working toward creating a new social norm for men, a world where all men are freezing their sperm at a young age, when they have their healthiest genetic material, said Khaled Kteily, the companys chief executive officer. A similar company named Dadi began this year. Both have raised several million dollars in funding. (Theres also Yo, an at-home testing kit, that employs a glass slide and an app to analyze sperm number without shipping them anywhere.)

Convenience and cost. Dadi charges $99 for the testing kit and $99 for annual storage. Legacys pricing starts at $199 for clinical fertility analysis; optional cryogenic storage is $149 a year. Traditional sperm banks can cost around $1,000 for semen analysis and a year of storage.

Experts say these mail-in kits cannot replace in-office visits. Neither Dadi nor Legacy is able to offer what would be legally considered medical advice, and in cases of results that indicate a problem, they refer customers to fertility specialists who will most likely redo the test and ask more comprehensive questions, said Dr. Alukal. Some of the start-ups tests could also be falsely reassuring or falsely alarming without the necessary context, added Dr. Zev Williams, M.D., Ph.D., chief of the Division of Reproductive Endocrinology and Infertility at Columbia. When it comes to sperm-freezing, doctors we spoke with agreed that anything that makes a man consider his fertility is a boon: There is no demographic that sees a doctor less than men between the ages of 18 and 45. But they werent convinced that banking was necessary beyond specific populations like men with cancer or other diseases that could affect fertility, those in the military or trans patients. I still think its overkill to recommend that everyone bank their sperm in their 20s, said Dr. Bobby Najari, M.D., a urologist and the director of the Male Infertility Program at N.Y.U. Langone Health.

Lauren is a project manager for NYT Magazine Labs and freelance journalist in New York.

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What's the Deal with Mail-In Sperm Start-Ups? - NYT Parenting

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