Inna DuckworthFor her — a full clinical workup.
For you — a sample cup and three numbers.
That is the asymmetry standard fertility care has not corrected.
Standard semen analysis measures three things. Your contribution to a pregnancy depends on at least seven more. The factors that matter most in complex cases — seminal microbiome biofilms, latent infections, oxidative stress, and environmental load — are rarely tested in standard clinics.
This page explains why deep male screening is the missing half of a successful pregnancy.
Comprehensive Male Screening
Revealing the forgotten 50% of the fertility equation.
The 50% almost no one investigates
Standard fertility care investigates her thoroughly. It investigates you in three numbers.
When a couple has trouble conceiving, the female partner is typically investigated thoroughly. Hormones across the cycle. Ovarian reserve. Tubal patency. Uterine anatomy. Sometimes immune markers, microbiome panels, autoimmunity.
The male partner gives a semen sample. Count, motility, morphology. If the numbers fall within reference range, the workup is over.
This made sense in the 1970s, when semen analysis was the only tool we had. It does not make sense now. We can measure considerably more. We just don't, in standard care, because the system has not caught up with the science.
What standard semen analysis does not measure
Three things standard analysis does not test for — and any one of them can be the reason.
Sperm DNA fragmentation
Damage to the DNA inside the sperm cell. Not visible under a microscope. Not part of standard analysis. High fragmentation correlates with failed fertilisation, poor embryo development, recurrent miscarriage and failed IVF cycles. A man with normal semen analysis can still have a DNA fragmentation score that explains everything.
The seminal microbiome
The bacterial communities living in your reproductive tract. Standard analysis does not look for them. Yet seminal microbiome dysbiosis drives three things: chronic uterine inflammation in the female partner, embryos that may not implant or hold, and placenta blood clots caused by viruses like Cytomegalovirus.
Latent infectious load
TORCH-spectrum infections — Cytomegalovirus, Epstein-Barr, Varicella — that reactivate under stress and shed into the seminal fluid. Lyme disease and its co-infections. Mycoplasma and Chlamydia chronically present intracellularly. Standard care does not screen any of this in men. None of it.
Why this matters for her
The ping-pong effect — why her treatment cycle keeps failing.
This is the pattern that keeps couples in failed cycles for years.
She is diagnosed with chronic uterine inflammation, or recurrent Gardnerella, or unresponsive endometrium. She is treated. Antibiotics, hormones, immune modulators. The picture improves for a few weeks. Then it returns.
It returns because the source of the problem was somewhere no one was looking. It was in his seminal microbiome — re-exposing her uterus to bacterial signals every time they tried to conceive. You cannot treat the receiving end of a problem indefinitely. You have to treat the source.
Both partners screened. Both partners supported. There is no other way to do this work properly.
What screening looks like
Nine things I investigate that standard care does not.
Sperm DNA fragmentation
Full DNA fragmentation panel — measuring damage that standard semen analysis cannot detect. High fragmentation explains a very large proportion of unexplained infertility and recurrent IVF failure.
Seminal microbiome with biofilm-buster
A seven-day protocol before the sample is collected that breaks down bacterial biofilms. Without this preparation, the test reads as a false negative — the bacteria driving uterine inflammation are not detected. This single piece of preparation is what changes the result.
TORCH and beyond
The same comprehensive infectious screening I run for the female partner. At cellular level — where active reactivation is detectable, not just visible. Chlamydia, Varicella, plus Toxoplasmosis, Cytomegalovirus, Herpes, Epstein-Barr, Mycoplasma, Lyme and its co-infections.
Oxidative stress markers
Excess oxidation in the seminal environment damages sperm membranes and DNA. Oxidative stress is one of the main mechanisms by which environmental toxins, chronic infection and lifestyle factors impair male fertility.
Hormonal balance and methylation
Testosterone, but also oestrogen metabolism, cortisol patterns, methylation cycle markers. The endocrine environment around sperm production — read against your specific case, not against population reference ranges.
Nutrigenomic profile
How your specific genes affect detoxification, hormone processing, B vitamin metabolism, oxidative stress response. Same Lifecode Gx panels I run for the female partner. Because the same nutrient at the same dose works differently for different bodies.
Comprehensive Metabolic Review
Advanced metabolic panels reading the metabolic state of the body — energy production, mitochondrial function, oxidative stress, inflammation markers. Especially valuable when energy and recovery are part of the picture.
Gut & food sensitivity
Comprehensive stool analysis and food sensitivity panels. The gut microbiome shapes inflammation and nutrient absorption — both directly affecting sperm production, DNA integrity and oxidative stress.
Metabolomics + toxic elements
A metabolomics panel mapping thousands of metabolic markers at once. Plus toxic element screening and mycotoxin panel — especially for men with environmental exposure (industrial work, construction, water-damaged buildings).
The critical piece of preparation
Why the seminal microbiome test fails — and what makes it actually work.
Most men who have ever been tested for seminal infection were tested without preparation. The test came back negative. They were told all is well.
Here is what was missed. Bacteria in the reproductive tract live inside protective layers called biofilms — a kind of bacterial fortress. A standard sample collection captures the bacteria swimming freely in the seminal fluid. It does not capture the bacteria embedded in biofilm matrices. So the test reads negative even when the prostate, the vas deferens and the urethra are populated with bacterial communities driving chronic inflammation.
The biofilm-buster preparation breaks open these matrices over seven days before the sample is collected. The bacteria that have been hiding for years become detectable. The test reads accurately.
This is not a luxury. It is the difference between a useful test and a useless one.
In my practice, the seminal microbiome test is never done without biofilm preparation. Anywhere it is done without preparation, the result should not be trusted.
If you are reading this because your wife asked you to
Let me address you directly.
You have probably been through some version of this conversation already. She has been having a hard time. The IVF cycles have not worked. The pregnancies have not held. She has been investigated extensively — and you have been investigated minimally.
She has probably suggested before that the issue might also involve you. You have probably said your semen analysis came back fine.
Here is what I want you to understand: your semen analysis covered roughly half of what should be investigated in a complex fertility case. The other half — DNA fragmentation, seminal microbiome, latent infectious load — was not assessed. Not because you were unwilling to do those tests, but because they were not offered.
The reason most cases of unexplained infertility turn out to be explainable is that the missing investigations were on the male side. This is not theory. This is what shows up in my practice, in case after case, after the female partner has been treated extensively for issues that originated with the partner.
If your wife has asked you to read this page, she is right. The next step is not a fight. The next step is a thirty-minute Introductory Review together, which costs £200 for the couple. We look at where you both are, what has been done, what is missing. You decide from there.
Standard semen analysis vs my screening
Side by side — what is investigated, what is not.
| Aspect investigated | Standard analysis | My screening |
|---|---|---|
| Sperm count | Yes | Yes |
| Motility | Yes | Yes |
| Morphology | Yes | Yes |
| Sperm DNA fragmentation | Not tested | Yes — full panel |
| Seminal microbiome | Not tested | Yes — with biofilm-buster preparation |
| TORCH and beyond | Not tested | Yes |
| Lyme and co-infections | Not tested | Yes |
| Mycoplasma / Chlamydia | Not routinely tested | Yes |
| Oxidative stress markers | Not tested | Yes |
| Hormonal balance | Testosterone only | Full endocrine panel + methylation |
| Gut health & food sensitivity | Not tested | Stool analysis & sensitivity panels |
| Environmental / mycotoxins | Not tested | Toxic elements + mycotoxin panel |
| Nutrigenomic profile | Not tested | Lifecode Gx panels |
Patterns I see — on the male side
What complex looks like in the men I screen. Anonymised cases.
A man in his late 30s with normal analysis
Story: His partner had three IVF cycles (two failed, one biochemical). Investigated extensively. His semen analysis was normal, investigation stopped.
What standard missed: DNA fragmentation at 38% (severe). Seminal microbiome showed Enterococcus/Streptococcus. Active Cytomegalovirus.
Working with me: Six months targeted protocol: DNA repair, microbiome treatment, antivirals. DNA frag dropped to 12%, microbiome clear. Next IVF worked.
A man in his early 40s tested normal twice
Story: Partner had four 1st trimester losses. She was investigated for autoimmunity, microbiome, thrombophilia. He was tested twice, both normal.
What standard missed: DNA fragmentation at 41%. Active Lyme infection contributing to chronic inflammation. Significant oxidative stress.
Working with me: Eight-month protocol. Combined antimicrobial and DNA repair support. Lyme treatment in parallel. Semen parameters improved, natural pregnancy to term.
The missing piece of recurrent IVF failure
Story: Partner had three failed IVF cycles. Told egg quality was the issue, donor egg recommended. They asked for one more look.
What standard missed: Normal semen analysis but DNA frag at 35%, severe seminal dysbiosis (anaerobic pathogens), CMV. She had some issues, but his was the larger picture.
Working with me: Six months focused work on both. Her egg quality retest improved (responded to environmental factors addressed). Next IVF with own eggs worked.
What this costs
Investment for the comprehensive male screening.
Introductory Review (couple)
30 minutes, both partners present
Advanced Functional Testing
4-6 weeks. Both partners tested in parallel. Plus £300 admin per partner.
Comprehensive Consultation
75 minutes for female partner, 45 minutes for male partner
Monthly Support
6-12 months — both partners supported together
What I expect from you
The honest version of what working with me requires. These are not optional.
- Active participation: You attend consultations, read test results, ask questions, and take protocols seriously.
- Lifestyle commitments (6 months min): No alcohol. No tobacco/vaping. Sleep 7+ hours. Minimise heat to testes (no saunas/hot tubs). Specific dietary changes. Weight management if applicable.
- Personalised Supplements: Designed for your case, not standard protocols.
- Testing properly: Including biofilm-buster preparation, and specific lab timing/procedures.
- Patience for the timeline: Sperm production takes 74 days. Real change takes 3 to 6 months. If this is not workable, we address it at the Introductory Review.
The Hidden Side of Male Fertility
The Hidden Side of Male Fertility
Most fertility tests overlook critical factors that can affect conception, IVF outcomes, and recurrent pregnancy loss. This free guide explains what comprehensive male fertility screening actually looks like — beyond standard semen analysis.
- DNA fragmentation and hidden sperm damage
- The seminal microbiome and silent infections
- Oxidative stress, inflammation, and methylation
- Why “normal” results may still miss the issue
- Advanced markers rarely explained in routine testing
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Frequently asked questions
About the testing
About the protocol
About the cost
Ready to start?
Book the Introductory Review together. Thirty minutes. £200 for the couple. We look at what has been done, what is missing, what is realistic. You decide from there.
Book your slotIf you have questions before booking — write to support@innaduckworth.com.
If your partner is the one who found this page, share it with him. The thirty minutes start with both of you in the room.