Clinical And Home Tests
Male Fertility Testing
|How Is Male Fertility Tested?
In more than half of couples who have trouble conceiving a baby, it is the man who has the fertility problem. As there are many possible causes of male infertility, different tests may be required to identify them. The initial test involves a physical examination and analysis of a semen sample under a microscope. In most cases a diagnosis can be made at this stage - if there is a problem it is usually related to the quality or quantity of the sperm in the semen. Sometimes, but not always a hormone test will be taken to test for any hormone imbalances. Finally an ultrasound scan or a testicular biopsy may be performed if the doctor suspects there is physical damage or a blockage in the reproductive organs. You will need to attend a fertility clinic for the process.
The fertility consultant will perform a physical examination of the groin area, looking for any obvious signs of damage. Be prepared to give a detailed account of your previous sexual activity history. Your doctor isn't prying; he is only trying to calculate your risk of having contracted a sexually transmitted disease (STD) which may have interfered with your sperm production. Next you will be given a sterile container and asked to ejaculate into it to provide a semen sample. Although you may feel embarrassed, you will be given a private room to do this in. In special circumstances it may be possible to provide a sample by bringing in a used non-latex condom from home, but you need to bring it to the clinic within an hour of ejaculation. In both instances you will be told to abstain from ejaculation for 2 to 4 days before the test. You may also be asked to give a urine sample immediately after ejaculation as this will test for retrograde ejaculation (explained in our article on the causes of infertility in men). The samples are then sent to a lab for testing under a microscope. They will evaluate:
Sperm count: While 20 million per ml is considered normal fertility, the average count is between 60 to 80 million per ml. Less than 20 million is termed oligozoospermia (low fertility) and no sperm is termed azoospermia. Less than 5 million per ml can indicate a genetic chromosome defect.
At this point, if you pass your physical test, your medical history is normal and your semen analysis shows no issues, the attention usually shifts back to the female partner (see female infertility). If however the semen analysis indicates problems, further tests may be recommended.
A simple blood test will be performed to check your hormone levels, specifically your levels of testosterone, prolactin, FSH and LH hormones. Any abnormalities in levels could account for problems with production and quality of sperm. If an imbalance is found, it may be possible to treat it with hormone replacement drugs. If it turns out you have testicular failure (indicated by low levels of testosterone and infertility), and you can't produce sperm at all, you may need to consider using donor sperm.
An ultrasound scan (also called ultrasonography) may be ordered to examine the reproductive organs for signs of infection, inflammation or blockages. This could identify varicoceles (type of varicose veins) or the absence of vas deferens (CBAVD), small tubes which link the testes to the penis. If vas deferens is suspected an X-ray (vasography) may also be ordered.
A small sample of tissue is extracted from one or both testicles to check for any signs of sperm development. This test is useful if all the other tests come back normal but there is still a complete lack of sperm in the semen. Sometimes the procedure is also performed to retrieve sperm to use with IVF/ICSI. The biopsy is performed under local anesthesia and takes about 20 minutes.
Men who have a sperm count lower than 5 million per ml may be offered genetic testing. About 4 percent of those with a sperm count less than 5 million and 15 percent of those with no sperm have a chromosome abnormality. It may also be offered to men with CBAVD because the condition is associated with cystic fibrosis. Genetic testing is performed by means of a blood test. Depending on the results you may be referred to a genetic counselor or recommended the aid of assisted reproductive technology (high tech fertility treatments like IVF).
Yes, there are male fertility home tests which are available without prescription in most pharmacies, or online. SpermCheck ($40) is one example, which is FDA approved and is for sale in Walgreens. You place a sample of your semen in a bottle and mixed with a solution. A few drops of the mixed solution is placed on a testing strip which will measure the sperm count of the semen. The results take about 10 minutes and the device will indicate if the count is normal (positive result) or below normal (negative result). The test is 98 percent accurate. New fertility tests are continually being launched on the market, so it is worth doing a little investigation. For example some tests will not only evaluate sperm count but also motility (how strong they are at swimming). This is an important differentiation because while some men may have a high sperm count; it is possible that the sperm are not great swimmers.
Related Articles on Male Fertility Tests
Books on infertility: Understanding the condition and what you can do.
Back To Homepage: Womens Health Advice