When It's Time for Fertility Testing

Male Fertility Testing

Women are not the only ones who will receive fertility tests. It is also important to find out if your partner is producing quality sperm. Your healthcare provider will begin by obtaining a thorough medical history. He or she may ask if your partner has had any problems that might affect his fertility, such as:
  • Any injuries to the groin
  • Hernia repairs
  • Mumps after puberty
  • History of undescended testicles
  • Possible STDs
  • Prostatitis
  • Urinary tract infections
  • Impotence or ejaculatory problems
  • Excessive smoking, drinking, or drug use
  • Taking certain medications.
Your partner may also have a physical examination, which can include:
  • Checking the pattern of hair growth around the genital area
  • Examining the penis for any abnormalities
  • Examining the scrotum for size and firmness of the testes
  • Examining the prostate.
Blood work may also be ordered to check various hormone levels.
Your healthcare provider will also order a complete semen analysis, which is the single most important test of male fertility. This involves a man masturbating to produce a semen specimen into a collection cup provided by the lab. He can do this at the lab or at home. In some cases, sperm can also be collected during sex using a special condom that your healthcare provider can provide. The semen should be examined within a few hours for the most accurate results.
In many cases, your partner will be advised to abstain from ejaculation for two to three days before the specimen is collected for the best results. Having a shorter interval may result in a lower sperm density -- with a longer period of abstinence, the sperm may have lower motility. There are a number of other factors that may affect the results, such as fatigue, stress, and caffeine use. Because of the variation in the semen specimen, some healthcare providers may want to obtain several samples to make sure sperm quality is adequate.
The semen analysis will check for the following:
  • Sperm count 
  • Motility (ability of sperm to swim)
  • Total semen volume
  • Velocity and forward progression of the sperm
  • Morphology 
  • The liquefaction of the semen (the ability to go from a normal, gel-like state at ejaculation to a liquid state).
A Kruger morphology test may also be done, which examines the shape and size of the sperm head.
If there are no sperm present in the semen sample, the semen will be tested for seminal fructose, which is normally produced by the seminal vesicles. If there is no fructose, it can mean congenital absence of the vas deferens and seminal vesicles, or obstruction of the ejaculatory duct.
Your healthcare provider may order cultures, which will test the semen and/or the urethra for the presence of any STDs or other bacteria. He or she may also check for sperm antibodies, which prevent the head of the sperm from penetrating an egg or prevent it from swimming properly.
There is also a sperm penetration assay (SPA), which is also known as the hamster egg test. This involves combining a man's sperm with the eggs from hamsters to evaluate the sperm's ability to break through the outer membrane of the egg and fuse with the egg cytoplasm.
Although rarely used due to the increased use of assisted reproductive technology, the hemizona assay test may be ordered to evaluate the sperm's ability to fuse with a previously frozen but no longer viable human egg.
Last reviewed by: Arthur Schoenstadt, MD
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