Did you know that across infertility cases, 40-50% are related to male factor infertility? Despite how common it is, it can be a tough subject to navigate for yourself or with a partner. Because of stigma and a lack of awareness, it’s often overlooked – especially at the beginning of the journey to conceive. To help you understand what may be affecting your path to parenthood, we’re exploring the what, why, and how of male fertility testing. Keep reading to learn about test types, treatments that may be available, and ways to navigate male fertility test results.
An overview of male fertility testing
Let’s jump right in! The purpose of fertility testing in general is to identify variables that may be making it more difficult to get pregnant. Male fertility testing is often done when you’ve been trying for a little while without success, and is a common part of the process when seeking help for conception. If you have already conceived but it’s been a while, or if you’ve had fertility struggles in the past, testing may also be done preemptively. Testing utilizes a semen sample, which will be analyzed and measured for a variety of factors:
Concentration – how many sperm there are. A sperm count is considered normal when there are at least 15 million sperm per milliliter (mL) of semen.
Motility – how the sperm are moving. 50% or more active sperm is ideal for those trying to conceive.
Morphology – the size and shape of sperm. This affects how well they can fertilize an egg, and semen is considered normal when at least 4% of sperm has standard morphology.
Volume – how much semen was provided in the sample. At least 1.5 mL (around half a teaspoon) is common.
Chemical makeup – pH level to measure the acidity in semen. High pH is alkaline, while low pH is acidic, with normal pH sitting between 7.1 and 8.0.
Liquefaction time – the time it takes for thick semen to become liquid. A time over 20 minutes could indicate a problem.
Fructose level – the amount of fructose in semen. This is usually tested if no sperm is found in a semen analysis and helps assess if there may be an obstruction blocking sperm.
How do you test for male fertility issues?
Testing begins with a semen sample, taken at home or at a doctor’s office. Often, multiple samples will be tested over a period of up to three months. Gathering a sample will require an ejaculation into a collection cup, or sometimes into a special condom to collect the sample during sex. The semen is often sent for testing in a medical lab and the results are provided back through a report or your doctor. It’s important to note that test results can’t always definitively indicate fertility – for example, those with low sperm counts can conceive, while someone with a ‘normal’ sample analysis may still struggle to.
Questions from your doctor or a questionnaire may accompany your semen sample, covering topics like medical history, overall health, sex life, lifestyle, and sex-related conditions (like Erectile Dysfunction or issues with ejaculation).
Testing at home
At-home testing may not always be as thorough as the wide range of tests that can be ordered by a doctor – but you shouldn’t write it off. Over the counter or home tests are a great first step in fertility evaluation. If you’re trying to conceive without success, these tests can answer some questions before you reach out to an ObGyn or fertility specialist. In fact, testing a home test is often recommended by doctors as an initial step. Home testing is often preferred by people being tested – providing your semen sample in a dark room at the doctor’s office isn’t exactly sexy.
Some male factor infertility issues aren’t caused by low sperm count or other factors that can easily be tested at home. For a deeper look into male fertility, a visit with an Urologist or to a fertility clinic may be needed. In addition to a fresh semen sample for analysis, doctors may request samples of other bodily fluids – urine and blood are the most common. Urinalysis can track up to five biomarkers in urine that can impact male fertility. Blood samples can be analyzed for hormones including follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone.
Several other tests can be done at a fertility clinic, ranging from ultrasounds (to find obstructions in the reproductive system) to genetic testing. While these always aren’t routine, they may be ordered as-needed.
What type of at-home of over the counter fertility tests are available?
There are a few types of tests that can be done at home, by purchasing online or over the counter. These tests use a variety of methods to analyze the sperm sample in your home – or, they allow you to preserve it while you send it off to a lab for testing. One option to consider for at-home testing is Legacy, America’s #1 at-home fertility clinic for people with sperm. Their test can be purchased on our site here.
Some at-home male fertility tests are intended specifically for post-vasectomy semen sampling, so look out for that as you’re reviewing your options. Home fertility tests analyze male factors including concentration, volume, and sperm count. Once a semen sample has been collected, tests that provide immediate results will check for fertility factors; if the rates are in line with expected levels, the test will often return a ‘normal’ or ‘positive’ result. When at-home tests require lab analysis, results are usually provided around 48 hours after the sample is received. Options for at-home fertility testing have expanded in recent years due to improved tech and reproductive health services. Many home tests now include in-app or electronic results – and sometimes an optional consultation with a virtual specialist to understand the results.
Types of male infertility treatments
Thankfully, there are many types of treatments, each addressing different types of male factor infertility. Treatments can be medicinal, hormonal, physical, surgical, mental, or a combination.
Hormonal issues may be fixed through medications or hormone replacements, to correct the hormone levels that may interfere with insemination and conception. If infection or other medical conditions are affecting fertility, antibiotics or prescriptions can be used.
Physical concerns, like blockages in the reproductive system or a prior vasectomy, can be addressed through surgery or sperm retrieval techniques. Non-surgical physical barriers such as premature ejaculation and erectile dysfunction can be treated through educational counseling or medications.
Assisted reproductive technology (ART) can also be used. With this method, sperm are obtained by ejaculation or surgical extraction, either from you or from a donor. Sperm can then be used for intracervical insemination (ICI), intravaginal insemination (IVI), intrauterine insemination (IUI), or with other conception methods like in vitro fertilization (IVF) and surrogacy.
Chances of getting pregnant with low sperm motility
Lots of variables have an impact on male fertility, but motility is a big one. To reach and fertilize an egg, sperm must travel quite a ways (relative to their size)! The chances of getting pregnant with low motility vary depending on the method of insemination (and more).
If the motility in a sperm sample is far below 50%, ART may be recommended – but it’s not the only option. Motility (and other male fertility indicators) can be affected by temporary factors. So testing and trying over a few cycles can help move you closer to a BFP before moving on to other treatments. Talk to your doctor if you have any questions about getting pregnant with low sperm motility.
It can be difficult to think about infertility and how it might be affecting your ability to conceive. With almost half of infertility cases citing male factors, it shouldn’t be overlooked. If you’ve started trying or are thinking about it soon, we encourage you to consider male fertility testing at home as an early step. No matter what results you may get, we’re here for you along the way.