What Are Male Fertility Tests?

The journey to parenthood is a shared one, yet conversations about fertility often place the spotlight on women. It's crucial to acknowledge that male factors contribute to approximately half of all infertility cases, making male fertility investigations just as vital [^1]. For many men, however, discussing and investigating fertility can be a deeply personal and vulnerable experience, touching on self-image and the profound desire to build a family.

At Kuon Healthcare, we understand these sensitivities. We are dedicated to providing discreet, professional, and compassionate services with access to a comprehensive spectrum of male fertility tests – from foundational diagnostics to the most advanced, unique investigations, right from the comfort of their home.

What is Male Subfertility and How to Check for It?

Male subfertility means that while natural conception might be challenging, it's often still possible, and many effective treatments can help. It's typically considered when a couple has been trying to conceive for over one year without success (or after 6 months if the female partner is aged 36 or older) [^2].

The initial and most crucial step to check male fertility is the semen analysis test. Should this first test reveal abnormalities, it's usually repeated after about 3 months. Persistent issues will lead to a specialist referral for more in-depth investigation, which could include hormonal blood tests, a thorough physical examination, or an ultrasound scan of the testicles [^2].

Different Types of Male Fertility Tests: Uncovering the Full Picture

While the standard semen analysis is the cornerstone, a truly comprehensive understanding often requires looking deeper. Here’s a detailed overview of the male fertility tests available in the UK, from the essential to the more specialised and advanced:

1. The Cornerstone: Semen Analysis

This fundamental test provides critical insights into sperm health by assessing:

• Sperm Count (Concentration): The number of sperm per milliliter of semen.

• Sperm Motility: The percentage of sperm that are moving, and their quality of movement (how well they swim forward).

• Sperm Morphology: The percentage of sperm that possess a normal, typical shape crucial for successful fertilisation.

• Semen Volume & pH: Overall characteristics of the fluid.

• White Blood Cells: Their presence can indicate an infection.

For accuracy, it's typically recommended to abstain from ejaculation for 2-5 days before providing a sample.

2. Hormonal Blood Tests: Decoding the Chemical Balance

Hormones are vital regulators of sperm production and function. Blood tests can pinpoint imbalances:

• Follicle-Stimulating Hormone (FSH): A key hormone for stimulating sperm production. Elevated levels can suggest issues with the testicles.

• Luteinising Hormone (LH): Stimulates the production of testosterone.

• Testosterone: The primary male sex hormone, essential for sperm development.

• Prolactin: High levels can sometimes negatively impact male fertility.

These tests help clarify if hormonal factors are contributing to lower sperm count or impaired sperm quality.

3. Physical Examination: Identifying Visible Factors

A medical doctor will perform a physical examination to check for:

• Varicocele: Enlarged veins in the scrotum that can elevate testicular temperature, potentially affecting sperm production. This is a common and often correctable cause of male infertility [^2].

• Testicle Size and Consistency: Abnormalities here might signal underlying issues with sperm production.

• Presence of Vas Deferens: Checking for the tubes that carry sperm from the testicles.

4. Sperm DNA Fragmentation Test: Assessing Genetic Integrity

Even with a normal standard semen analysis, couples can face difficulties. The Sperm DNA Fragmentation (SDF) test is an advanced diagnostic tool that assesses the integrity of the genetic material (DNA) within the sperm [^3]. High levels of DNA damage (fragmentation) can be linked to reduced natural conception, lower success rates with IVF/ICSI, and an increased risk of miscarriage. It offers crucial insights, especially for unexplained infertility.

5. Post-Ejaculatory Urine Analysis: The "Retrograde" Check

This specialised test is used when semen volume is low or absent, or if sperm count is very low. It checks for retrograde ejaculation, a condition where semen travels backward into the bladder during orgasm instead of exiting the penis. This can be caused by diabetes, certain medications, or previous prostate surgery [^4].

6. Anti-Sperm Antibody Test: Investigating Immune Reactions

In some instances, a man's immune system mistakenly identifies his own sperm as foreign invaders, producing antibodies that attack them. These antibodies can hinder sperm movement or their ability to fertilise an egg. This test is considered when other semen analysis parameters are normal but conception remains elusive [^5].

7. Genetic Testing: Unlocking Deeper Insights

For men with very low or absent sperm counts, or persistent, unexplained fertility issues, genetic tests can be crucial:

• Karyotyping: Checks for chromosomal abnormalities, such as Klinefelter syndrome (an extra X chromosome, XXY), which can affect sperm production [^6].

• Y-Chromosome Microdeletion Analysis: Looks for missing segments on the Y chromosome, which contain critical genes for sperm development. Deletions in certain regions (AZFa, AZFb, AZFc) are strongly linked to severe sperm deficiencies [^7].

• Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Gene Mutation Test: While primarily associated with cystic fibrosis, mutations in this gene can also cause congenital bilateral absence of the vas deferens (CBAVD), where the sperm-carrying tubes are missing, leading to obstructive azoospermia [^6].

These advanced genetic tests offer a truly "unique" and in-depth look into the fundamental genetic causes of male infertility, often guiding highly personalised treatment plans.

Normal Sperm Count Needed to Get Pregnant

While it technically only takes one sperm to fertilise an egg, the chances of natural conception significantly increase with healthy sperm parameters. According to the World Health Organization (WHO) guidelines, a normal sperm count is considered to be 15 million sperm per milliliter of semen or more [^7, ^11].

However, sperm count is just one piece of the puzzle. Sperm motility (movement) and morphology (shape) are equally vital. For a good chance of pregnancy, at least 40% of sperm should be motile, and 32% should show progressive motility (moving purposefully forward) [^11, ^12]. As for morphology, at least 4% of sperm should have a normal, typical shape [^11, ^12]. Remember, even with seemingly ideal parameters, hidden issues like high sperm DNA fragmentation can play a role.

8 Signs of Healthy Sperm (What a Semen Analysis Reveals)

While you can't visually assess these, here's what lab professionals scrutinise during a semen analysis to determine overall sperm health:

1. Optimal Volume: A typical ejaculate volume ranges from 1.5 to 5.0 milliliters. Too little or too much can affect concentration or signal underlying issues [^12, ^13].

2. Sufficient Count: As per WHO guidelines, at least 15 million sperm per milliliter [^7, ^11, ^12].

3. Vigorous Motility: A significant percentage of sperm actively moving, with a good proportion moving progressively forward [^11, ^12].

4. Normal Morphology: A healthy percentage of sperm (at least 4%) exhibiting the correct oval head and long tail shape for efficient fertilisation [^11, ^12].

5. Balanced pH Level: Semen pH should be between 7.2 and 8.0, providing the ideal environment for sperm survival [^12, ^13].

6. Adequate Fructose: Presence of this sugar, the sperm's primary energy source, indicates healthy seminal vesicle function [^12, ^13].

7. Low DNA Fragmentation: Minimal damage to the genetic material within the sperm, ideally below 15% DFI (DNA Fragmentation Index) [^12, ^13].

8. Minimal White Blood Cells: Fewer than 1 million white blood cells per milliliter, indicating no significant infection or inflammation [^12, ^13].

How to Boost Male Fertility: Lifestyle Strategies

While some conditions require medical intervention, many lifestyle choices can significantly enhance male fertility and sperm quality:

• Maintain a Healthy Weight: Being overweight or obese can negatively impact hormone levels and sperm production [^2, ^15].

• Embrace a Nutrient-Rich Diet: Prioritise fruits, vegetables, whole grains, lean proteins, and healthy fats. Antioxidant-rich foods (like berries, leafy greens, and nuts) are particularly beneficial for protecting sperm health [^15, ^16].

• Limit Alcohol and Avoid Smoking/Recreational Drugs: Excessive alcohol consumption, smoking (including vaping), and drug use (especially anabolic steroids) are well-known to significantly damage sperm quality and count [^2, ^15].

• Keep Things Cool: Elevated testicular temperature can impair sperm production. Avoid prolonged hot baths, saunas, extended sitting, and opt for loose-fitting underwear [^2, ^15].

• Prioritise Stress Management: High stress levels can disrupt hormone balance. Incorporate stress-reducing activities like exercise, meditation, or hobbies [^15].

• Engage in Regular, Moderate Exercise: Physical activity can improve overall health and potentially sperm parameters, but avoid excessive or high-impact activities that could cause injury [^15].

• Minimise Environmental Toxin Exposure: Be mindful of exposure to pesticides, lead, and certain industrial chemicals, which can harm sperm. Use protective measures in relevant occupations [^15].

It's important to remember that it takes approximately 70-90 days for new sperm to fully develop, so consistent lifestyle changes typically require a few months to show a noticeable effect on semen parameters [^2, ^15]. Patience and persistence are key.

Taking the Next Step Towards Clarity

Understanding the comprehensive range of male fertility tests available, and the factors influencing sperm health, is the empowering first step towards clarity. At Kuon Healthcare, we are committed to providing these essential services with the empathy, discretion, and professionalism you deserve. If you have any concerns about male fertility, we encourage you to discuss them with your GP or connect with an accredited fertility clinic to explore the most appropriate tests and pathways for you.

Accredited Sources for Male Fertility Information:

[^1]:

Human Fertilisation and Embryology Authority (HFEA). Causes of infertility. Available at: https://www.hfea.gov.uk/treatments/explore-all-treatments/causes-of-infertility/

[^2]:

NHS. Low sperm count - NHS. Available at: https://www.nhs.uk/conditions/low-sperm-count/

[^3]:

Fertility Solutions. DNA Fragmentation Test. Available at: https://fertilitysolutions.co.uk/dna-fragmentation/

[^4]:

British Association of Urological Surgeons (BAUS). Patient information: Retrograde Ejaculation. Available at: https://www.baus.org.uk/patients/conditions/11/retrograde_ejaculation

[^5]:

American Society for Reproductive Medicine (ASRM). Immune Infertility. Available at: https://www.asrm.org/news-and-publications/patient-resources/fact-sheets-and-infographics/immune-infertility/

[^6]:

Imperial College Healthcare NHS Trust. Male fertility. Available at: https://www.imperial.nhs.uk/our-services/fertility-and-reproductive-medicine/male-fertility

[^7]:

North West London Pathology. Andrology - Genetic Tests. Available at: https://www.nwlpathology.nhs.uk/specialist/andrology/genetic-tests/