JMIR Publications

ABSTRACT

Background:

Recruiting asymptomatic men for research involving semen analysis is challenging; however, little empirical research has been performed to examine why men decline participation in workplace–based studies.

Objective:

This study aimed to identify overt and latent barriers to male participation in workplace–based reproductive health research involving semen analysis.

Methods:

In April and May 2025, we conducted an anonymous web–based cross–sectional survey among male employees in Japan who were eligible for but did not participate in a workplace semen–analysis study (recruitment: November 2024–January 2025). The questionnaire used branching logic. Part 1 (mandatory) assessed awareness of the parent study, reasons for nonparticipation (multiple responses), interest in information on male reproductive ability, and intention to participate in future semen–analysis research. Part 2 (optional) assessed age, psychological resistance to semen analysis, anxiety about potential poor semen analysis results, concerns about collection location or privacy protection, expected reactions of others, awareness of the association between sperm condition and systemic health, perceived importance of male health for future conception, and willingness to undergo semen analysis under simplified conditions. Responses were summarized descriptively; 95% confidence intervals (CIs) for proportions were calculated using the Wilson score method.

Results:

We obtained 108 valid responses from nonparticipants; 83 respondents completed Part 2. Awareness of the parent study was low: 68.5% (74/108) (95% CI 59.3%–76.5%) were unaware of the project. The most common overt reason for nonparticipation was not knowing that the study existed (63.0%, 68/108, 95% CI 53.6%–71.5%). Only 10.2% (11/108, 95% CI 5.8%–17.3%) wanted to cooperate in future semen–analysis research, whereas 40.7% (44/108, 95% CI 31.9%–50.2%) reported willingness if conditions were met. In Part 2, anxiety about potential poor results was reported by 62.7% (52/83, 95% CI 51.9%–72.3%), concerns about collection location or privacy by 57.8% (48/83, 95% CI 47.1%–67.9%), and psychological resistance by 50.6% (42/83, 95% CI 40.1%–61.1%). Only 3.6% (3/83, 95% CI 1.2%–10.1%) reported knowing well the association between sperm condition and systemic health, although 95.2% (79/83, 95% CI 88.3%–98.1%) perceived male health as important for future conception. Under simplified conditions, 43.4% (36/83, 95% CI 33.2%–54.1%) were willing to undergo semen analysis.

Conclusions:

Barriers to participation showed a stratified structure: limited awareness dominated overt explanations, whereas privacy–related and psychological concerns—particularly anxiety about potential results—emerged as prominent latent barriers when assessed directly. Future workplace–based semen–analysis research should improve study visibility while strengthening privacy–sensitive procedures and addressing psychological concerns to support truly informed, voluntary participation. Clinical Trial: None