Understanding Fertility Testing and Diagnosis for Men

Almost half of all infertile couples are affected by male infertility. Lifestyle factors, issues with sperm production, mobility, or form, sperm antibodies, chromosome and DNA abnormalities, hormone disorders, erectile and ejaculatory difficulties, and erectile dysfunction are the most common causes. The good news is that the majority of these factors are easy to identify and treat or overcome to help a couple conceive.

How soon should men seek fertility testing?

  • Couples who have been trying for a year without success (or six months if the woman is over 35) should receive fertility tests for both partners.
  • If a guy has a medical history or condition that could lead to infertility, he may want to get fertility testing done sooner rather than later in case of:
  • Symptoms of testicular trauma
  • Difficulty in achieving or maintaining an erection
  • Previous attempts to combat cancer
  • Previous Infection with the Measles
  • Urinary tract operations in the past

Diagnosis and treatment of male infertility

Doctors suggest that male infertility can be caused by a number of different things. Examples of possible diagnostic procedures are:

1. Medical history review and physical examination

You will be asked about things like your health, any injuries or operations you’ve had, and any family medical history that may have an impact on your fertility. The male might expect questions from the doctor regarding his sexuality and way of life.

Scrotal masses, varicoceles, and undescended testicles will all be on the list of things the doctor will be looking for during the physical examination.

2. Semen Analysis

Examining sperm is the quickest and cheapest technique to learn about male fertility. Often, here is where the investigation into male infertility will begin. An examination of sperm involves determining their concentration motility, and morphology.

Having a high sperm count indicates that a sufficient number of your sperm are actively swimming toward the egg, increasing the likelihood of fertilization. The number of motile sperm you have may be impacted by factors such as low sperm concentration, low testosterone levels, and sperm swimming ability.

Incorrectly shaped sperm have a harder time fertilizing eggs, therefore morphology is also crucial.

Around 35% of sperm in a sample of normal semen will be of the correct form and size. Most of the remaining 65% of sperm are not normal in form or development. Reduced fertility may result from an inadequate number of healthy sperm.

3. Anti-Sperm Antibodies

The immune system and the rest of your body rarely come into contact with sperm. Nevertheless, this defense mechanism can be compromised by things like an accident, surgery, or an infection of the prostate gland.

Furthermore, anti-sperm antibodies can be created when sperm comes into touch with the immune system.

If your doctor still can’t pin down the root of your infertility, he or she may suggest testing for anti-sperm antibodies.

You will be required to submit a sperm sample. Using a chemical that attaches specifically to impacted sperm, the test examines your semen for antibodies that battle against your sperm.

Antibodies have a negative impact on sperm, decreasing their ability to fertilize an egg. (Because these antibodies are also present in females, your doctor may recommend that your spouse be tested.)

4. Sperm penetration assay (SPA)

Tests a man’s sperm for its ability to adhere to and penetrate an egg membrane, a necessary step in fertilization. In the Sperm Penetration Assay (SPA), also called the “hamster test,” the success rate of sperm in piercing a pretreatment hamster egg is used as an indicator of how well that sperm will do in penetrating a woman’s egg.

5. Strict Criteria (Kruger) Morphology

Strict criterion morphology analysis is a method used to evaluate sperm based on their physical appearance. When paired with other fertility treatments, the morphology (shape) of your sperm can determine how successfully they will fertilize an egg. A sperm’s head, tail, mid-piece, and tail attachment are all closely examined.

6. Retrograde Semen Analysis

For men with a low sperm count, we may suggest a retrograde semen analysis. A low sperm count can be diagnosed from the outset by analyzing the sample of sperm. Sperm entering the urinary bladder from the urethra is called retrograde ejaculation. You can expect to find sperm in your urine if you experience retrograde ejaculation.

Most men who have retrograde ejaculation have a history of surgery or a medical condition that has led to this. Some of the best doctors agree that retrograde ejaculation can be caused by a number of factors. In this category, you may find:

  • Cancer of the testicles, surgical procedure (RPLND)
  • Prostate removal through the urethra
  • Urinary bladder resection in children
  • diabetes
  • Injuries to the spinal cord due to Multiple Sclerosis

7. Genetic tests

Very low sperm counts may have a hereditary basis. Little variations in the Y chromosome may indicate a genetic disorder and can be detected by a simple blood test. To identify different congenital or hereditary disorders, a genetic test may be required.

8. Testicular biopsy

If all other tests are negative, this one can be the last resort.

An incision is made in the scrotum or a needle is used to extract a sample from the testicle for analysis. If your infertility is confirmed after a testicular biopsy and sperm production is found to be normal, the issue may lie in the sperm’s inability to reach an egg successfully.


Depending on the severity of your illness, you may need to dig deep within yourself and tap into resources you didn’t know you had.

Yet, if you need help getting pregnant, you have numerous possibilities. The good news is that many of the causes of male infertility are treatable. You should consult the best sexologist doctor soon away to get a proper diagnosis and treatment plan tailored to your needs.


1. When is the right time for a male to take a fertility test?

Couples who have been trying for a year without success (or six months if the woman is over 35) should receive fertility tests for both partners.

2. What do male fertility tests reveal?

In the lab, they will count the sperm, examine their morphology (form), and motility (movement) for any abnormalities, and report their findings to you. You should expect the lab to test your semen for issues like infections if you send it in.

3. Is it possible for fertility testing to be incorrect? 

Ovulation tests, like pregnancy tests, can give a false negative result in some cases. To lessen the likelihood of a false-negative result, it’s important to time your tests appropriately in the cycle.

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