This guide explains common male fertility tests, including semen analysis, what they measure, and how they can help you conceive.

Key Facts

  • In 20% of cases where couples can't conceive, the cause lies solely with the man
  • The sperm test is the most vital fertility test for men
  • Sperm samples can be collected at home or at the fertility centre
  • A second sperm analysis is often conducted for confirmation
  • From infections to lifestyle factors, the causes of male infertility vary widely

Did you know that an unfulfilled desire to have children can be attributed equally to men and women? It is estimated that at least 20% of infertility cases are caused solely by the man, and 30 to 40% are caused by both partners together. Yet, male infertility often goes unnoticed until the couple tries to conceive and fails to achieve pregnancy.

Thus, fertility tests for men are crucial for assessing sperm quality and getting a full picture of male fertility. This process is entirely painless with results available within a week.

In this blog article, you will learn how to get your fertility tested and how these tests can aid your journey towards parenthood.

What is a Fertility Test for Men?

A fertility test for men typically includes a semen analysis, which analyses both the quality and quantity of sperm in the ejaculate. This test measures sperm count and other sperm parameters such as motility, morphology and vitality. A blood test may also be conducted to check iron, vitamin D, inflammation levels, and potential hormone disorders.

At Cada, we conduct a comprehensive fertility analysis typically covered by health insurance. Visit our website here to learn more

Sperm Test

The most crucial fertility test for men is the sperm test, often referred to as a semen analysis or spermiogram. A spermiogram provides vital information about sperm movement (motility), shape (morphology) and viability (vitality). This test can be conducted at home, in a fertility clinic or a urologist's office.

Sperm, also known as spermatozoa, plays a significant role in conception. Sperm cells are part of the male ejaculate and must be present in sufficient quantity and quality to fertilise a female egg, also called ovum.

A spermiogram involves analysing a male semen sample, obtained through masturbation, in a laboratory. It provides information on sperm quality, spermcount, sperm concentration and motility. Studies indicate that in some cases of infertility, the number of sperm falls below the WHO recommended guideline value of 15 million per millilitre.

For more information on how to interpret a semen analysis and understand the individual sperm parameters, click here.

How Does A Sperm Test Work?

  • Sperm Sample Collection: The ejaculate is either collected at home or at a medical practice using a clean cup supplied by the laboratory. It's important to adhere to the agreed waiting period, usually 2-5 days before sperm collection, to ensure reliable results. If the semen is collected at home, the cup should be delivered to the laboratory within an hour.
  • Analysis of Semen Sample: The semen sample undergoes analysis in the laboratory. Parameters such as sperm count, motility, morphology, vitality and other factors like pH value, liquefaction, and consistency are evaluated.
  • Communication of Test Results: Test results are typically available within a few days. They are reviewed during a consultation with a doctor, where further steps are discussed.

Sperm Test At Home?

Men who wish to get a preliminary understanding of their sperm quality can use a home sperm test. While these sperm tests can provide a general idea of sperm quantity, they can't assess all parameters, making them less precise than a professional laboratory test.

Home tests typically only measure the sperm count, specifically whether it exceeds 20 million sperm per millilitre. The reliability of home test results can be compromised by factors like improper sampling or fluctuations in sperm quality due to infections or similar conditions.

How Reliable Is The Result Of A Semen Test?

The reliability of a semen analysis test hinges on several factors. These include the expertise of the laboratory staff conducting the test, compliance with standardised procedures and the quality of the sample. When conducted by a reputable laboratory, semen analysis is generally considered a reliable tool for evaluating male fertility.

If the spermiogram falls outside the normal range, a second test is advisable a few months later. This is because sperm quality can vary due to different factors. A repeated test helps confirm initial findings and discounts temporary influences.

What Other Fertility Tests Are Available For Men?

A range of analyses are performed during a male fertility test to provide a comprehensive view of male fertility.

The following services are typically included in a comprehensive fertility test:

Anamnesis

In a consultation with your doctor, you will discuss your current state of health, your medical history and your family history. This is the first step in assessing your fertility and your doctors can identify potential risk factors and genetic predispositions, such as hereditary diseases.

This medical counselling can also help to reduce the psychological burden associated with fertility problems. Here you can and should talk openly and honestly about any disorders of your sexual function, such as erectile dysfunction or ejaculation disorders. Your doctor is trained to conduct such discussions sensitively and confidentially in order to find the best possible treatment for you.

Blood Test

During a blood test, a basic blood analysis is performed to determine key metabolic values. These values can indicate potential health issues.

The basic blood analysis includes a small blood count which covers the following values, among others:

  • Leukocytes (white blood cells): A high leukocyte level may signify inflammation, infection or other health issues, while a low level can indicate a weakened immune system.
  • Erythrocytes (red blood cells): Erythrocytes transport oxygen in the body. The erythrocyte value reflects the quantity of red blood cells in the blood. Variations from a normal erythrocyte level can suggest anaemia or other blood disorders.
  • Platelets: Platelets are essential for blood clotting. A low value can result in an increased bleeding tendency, whereas a high one can elevate thrombosis risk.

Key values for blood metabolism include:

  • Triglycerides: Triglycerides are a type of fat in the blood. A high triglyceride level may signal an elevated risk of cardiovascular disease, potentially due to an unhealthy diet, severe obesity, or other factors.
  • Cholesterol: Cholesterol is a fat-like substance in the blood. There is "good" HDL cholesterol and "bad" LDL cholesterol. High LDL cholesterol levels can increase the risk of arteriosclerosis and heart disease, while high HDL cholesterol levels can offer protection.

Ferritin Test (Iron Stores)

The ferritin test checks the body's iron stores by taking a blood sample. It is a significant part of assessing male fertility since iron deficiency can impact sperm production (spermatogenesis).

Vitamin D

Testing for vitamin D is also crucial as its deficiency can lead to reduced fertility. A review suggests that adequate levels of vitamin D positively affect sperm motility and influence spermatogenesis.

Hormone Analysis

A hormone analysis can identify hormonal imbalances that may impact fertility. Hormonal imbalances can significantly affect sperm production. Notably, follicle-stimulating hormone (FSH), luteinising hormone (LH), prolactin, and testosterone should be examined. The thyroid hormone (TSH value) is also determined in the hormone analysis:

  • FSH: The follicle-stimulating hormone (FSH) stimulates testicular growth and aids in sperm production. Elevated FSH levels may suggest an abnormal sperm count and impaired sperm morphology.
  • LH: Luteinising hormone (LH) facilitates testosterone production, which is crucial for normal sperm production. A high LH level points to restricted sperm motility and morphology.
  • Prolactin: Prolactin regulates testosterone levels and sperm production among other functions in men. An elevated prolactin level can affect fertility by decreasing testosterone levels and sperm production, leading to reduced semen volume, poor sperm quality, and diminished fertility.
  • Testosterone: As the primary male sex hormone, testosterone is significant for male sexual development, sperm production and fertility. A testosterone deficiency or excess can result in reduced sperm production, limited sperm motility, erectile dysfunction, or ejaculation disorders.
  • TSH: The thyroid gland plays a vital role in regulating metabolism and hormone production in the body. An abnormal TSH value might indicate a thyroid disorder, specifically an underactive thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism). These thyroid disorders can upset the body's hormone balance and adversely affect fertility. For instance, hypothyroidism can lead to reduced sperm production and quality.

Infection Screening

This process includes testing for HIV, hepatitis A, hepatitis B, hepatitis C, varicella, rubella, chlamydia, and cytomegalovirus.

Some of these infections, such as HIV and hepatitis B and C, are sexually transmitted. Therefore, a sexually active man can pass these infections to his partner.

Rubella and chlamydia can severely impact a woman's health, especially if she is planning to conceive. Rubella during pregnancy can cause serious birth defects in the baby.

Furthermore, infections like chlamydia and cytomegalovirus can affect fertility. Chlamydia can cause inflammation of the testicles and epididymis in men, which can reduce sperm production. Cytomegalovirus can lead to decreased sperm quality in male carriers.

Final Consultation and Future Treatment Planning

If your test result suggests reduced fertility, your doctor will discuss with you treatment options to enhance your sperm quality, and schedule a follow-up fertility test. It's crucial to maintain a healthy lifestyle during this time.

If there's no significant improvement post-treatment, your doctor will recommend potential fertility treatments like in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). These procedures can facilitate successful fertilisation despite subpar sperm quality.

Causes of Infertility in Men

Male infertility can stem from various causes and often occurs due to a combination of these factors. The most common causes of male infertility include:

  • Hormonal Imbalances: A lack of hormones like testosterone or an overproduction of prolactin can affect sperm production.
  • Varicocele: A varicocele is a varicose vein in the scrotum that can impair blood flow to the testicles, interfering with sperm production.
  • Infections: Infections of the reproductive organs, particularly inflammation of the testicles (orchitis) or epididymitis, can lead to infertility.
  • Blocked Seminal Ducts: Blockages or constrictions in the seminal ducts can prevent sperm from reaching the ejaculate. Alternatively, retrograde ejaculation ("misdirected ejaculation") may occur, causing sperm to leak into the urinary bladder.
  • Genetic Factors: Genetic abnormalities such as Klinefelter syndrome, cystic fibrosis, or disorders of the androgen receptors can impair sperm production or function.
  • Environmental Toxins: Harmful environmental factors like pesticides, heavy metals, chemicals, and radiation can cause hormonal imbalances or DNA damage in sperm.
  • Lifestyle: Unhealthy lifestyle choices, including smoking, excessive alcohol consumption, the use of recreational drugs, abuse, and obesity, can affect sperm quality and count.
  • Stress and Psychological Factors: High levels of stress and psychological problems can affect sexual function and sperm production.
  • Side Effects of Medications: Some medications, such as certain antidepressants, antihypertensive drugs and hormone supplements, can affect fertility.
  • Chronic Diseases: Certain chronic diseases, like diabetes or coeliac disease (gluten intolerance), can also contribute to fertility issues.

Frequently Asked Questions

When should a fertility test for men be carried out?

A fertility test for men can be carried out at any time to clear any doubts about fertility. However, if you and your partner have been trying to conceive for a year without success, a fertility test can provide critical information.

How much does a fertility test for men cost?

The cost of a fertility test for men ranges between CHF 350 and CHF 1,000 and may be covered by health insurance. Typically, a fertility test includes a spermiogram and a blood test. At Cada, the fertility test for men also includes a detailed medical consultation, extensive blood analysis, hormone test and a spermiogram.

What other tests can I have carried out?

Besides the aforementioned tests, a physical examination or ultrasound of the testicles can also be conducted. Urologists and andrologists can use these tests to identify potential issues such as varicose veins in the scrotum (varicocele) or obstruction of the vas deferens, which can significantly impact semen quality.

How can Cada support me with my fertility test?

Cada provides a comprehensive fertility test with close medical supervision. Your results are available in the Cada app, which provides you with all analysis results and personalised treatment plans. You can also use the app to ask any questions about your treatment.

Takeaway

A study reveals a recent decline in sperm count. Obesity, poor dietary habits and environmental toxins are identified as contributing factors, increasingly impacting fertility. This highlights the importance of fertility tests in evaluating fertility status.

Fertility tests are critical for men seeking to understand the reasons behind their unfulfilled desire to have children. These tests not only assess sperm quality but also analyse key blood and hormone levels that significantly affect fertility. Identifying potential infections is also vital for early recognition and treatment of fertility-limiting factors. Doctors are available for initial consultations and can provide detailed advice on possible treatment options.

Interested in knowing more about your fertility? Our fertility specialists are here to assist you in realising your dream of having children.

Schedule your free initial consultation here to learn more about your fertility.