Male Fertility Testing | What test can be done at home?
About 9% of men of reproductive age in the United States have experienced fertility problems1. In one-third of infertile couples, the problem is with the man. Studies suggest that after 1 year of having unprotected sex, 12% to 15% of couples are unable to conceive, and after 2 years, 10% of couples still have not had a live-born baby. In a previous post, we covered the main reproductive hormones responsible for fertility. In this post, the focus is on male fertility testing.
Several factors can affect male fertility and male fertility testing, including anatomical issues, infections, genetic, systemic diseases, neurological diseases, trauma, sperm antibodies (e.g., sperm autoimmunity). As shown in the table below, about 12% of these factors are untreatable due to poor semen quality or genetics, 18% are based on treatable conditions and the other 70% are due to untreatable subfertility conditions1. It means that men with irreversible sterility can be spared from ineffective treatments while those with potentially treatable conditions can solve their fertility issues with medications, while those with subfertility would need other types of solutions. Male fertility testing at home can be a very good starting point in this investigation.
| Type of Infertility | Percentage (%) of total infertile cases |
|---|---|
Untreatable sterility |
12% |
|
Primary seminiferous tubule failure |
12% |
Treatable conditions |
18% |
| Sperm autoimmunity: self-antibodies again your sperm |
7% |
| Obstructive azoospermia: absence of spermatozoa in the ejaculate despite normal spermatogenesis |
10% |
| Gonadotropin deficiency: a condition in which low levels of LH and FSH hormones lead to testosterone deficiency |
0.5% |
| Reversible toxin effects |
0.02% |
Untreatable subfertility |
70% |
| Low sperm count (oligospermia) |
35% |
| Reduced sperm motility (asthenospermia) and abnormal morphology (teratozoospermia) |
30% |
| Normal values of all ejaculate parameters (normospermia) but with functional defects |
5% |
Male fertility testing at home
In addition to medical history, physical examination imaging, and testis biopsy, male fertility testing at home includes hormone measurements and semen analysis. The relevant hormones are Luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, testosterone, sex hormone-binding globulin (SHBG).
For your semen analysis, you can either ejaculate into a special container or, if this isn’t an option because of your religious or cultural beliefs, you can use a special condom during intercourse. Semen analysis checks:
- Semen volume measures how much semen in total is in your sample.
- Sperm concentration or home testing sperm count checks if your sperm counts at or above 15 million sperm per milliliter of your semen as average.
- Vitality examines what percentage of sperm are alive
- Sperm motility analyzes if your sperm are moving? Above 63% motility indicates fertility, while less than 32% indicates subfertility.
- Morphology looks at how your sperm shape. You would need at least 12% of your sperm to be normal to conceive.
In parallel, it is important to verify you do not have any signs of infections as the presence of bacteria in your semen can cause normozoospermic infertility, meaning that the sperm cells themselves are infertile. A Urinalysis test may help in normozoospermic infertility, which might cause by infectious.
Low sperm motility
Healthy sperm tend to have a uniform shape that allows for proper swimming and aids in the fertilization process. There are many different examples of poor sperm morphology, the most common ones are:
- large sperm head
- Small sperm head
- Double-headed sperm
- Crooked sperm tail
- Short sperm tail
- Elongated sperm tail
- Double sperm tail
Abnormal sperm morphology matters simply because sperm morphology affects sperm viability and motility. Sometimes poor morphology can indicate other issues as well.
Treatment of abnormal sperm morphology
Although abnormal sperm morphology is not treatable by medication, to overcome abnormal sperm morphology, several procedures are possible, such as:
- Sperm Washing –removing low-quality sperm and mucus from a man’s semen
- Intrauterine Insemination (IUI) – placing sperm directly inside of a woman’s uterus.
- In Vitro Fertilization (IVF) – fertilization of an egg inside of lab before transferring the embryo to a woman so it can be carried to term.
- Intracytoplasmic Sperm Injection (ICSI) – ICSI may be used as part of the IVF process. This involves the direct injection of sperm into an egg.
Sperm antibodies
At puberty, when the sperm first appear in the testis and epididymis, the human immune system may “see” it as a foreign antigen and develop antibodies against your own sperm. Semen can cause an immune system response in either the man's or woman's body. The antibodies can damage or kill sperm. If many sperm antibodies meet a man's sperm, it stops the sperm from fertilizing an egg.
An anti-sperm antibody test looks for antibodies (part of the immune system) that fight against sperm in blood, vaginal fluids, or semen. Treatment for the anti-sperm antibody is available and based on intra-cytoplasmic sperm injection (ICSI). It is an in vitro fertilization (IVF) procedure in which a single sperm cell is injected directly into the cytoplasm of an egg. The decision to use ICSI depends on the level of the antibodies that are present, as lower levels may have no noticeable effect on fertility. An anti-sperm antibody test can tell if an ICSI procedure is relevant for you.
Sperm DNA fragmentation
A sperm DNA fragmentation analysis measures the percentage of abnormal or damaged DNA carried by your sperm. A high level of sperm DNA fragmentation causes infertility and recurring miscarriage. Some lab providers also offer Sperm DNA fragmentation analysis in addition to the common sperm analysis.
Vasectomy Test
Some labs offer a Vasectomy Test. Testing the success of your vasectomy is the only way to know for sure that you are no longer fertile and not able to conceive.
Are home sperm tests accurate?
There are many options for at-home male fertility tests. But are they accurate? Does it give you meaningful information? Are these tests worth their cost? The answer is it all depends on the specific product and service. Some just tell you if you have an adequate amount of sperm in the ejaculate or not but in many cases, that is not enough. If you are ‘positive’, is it enough? Those kinds of tests do not tell you if your sperm is alive or if there are any motions or abnormalities. Also, the method of transportation and storage are critical because you want to make sure your sperms arrive intact to the lab for analysis. So, take a deeper dive into the analytes included and more info on the Fantestico platform as it will tell you what is actually measured, reported and if there is more information regarding quality preservation during transportation.
Sperm storage
In addition to sperm analysis, labs offer sperm storage for future use. There are several reasons why it is important to store your sperm. For example, for men undergoing testicular surgery, chemotherapy, hormone replacement therapy, or radiation therapy, it is recommended for them to preserve their future fertility. Another reason is that sperm quality diminishes with age, so you may choose to freeze sperm if you are getting older and want to preserve fertility. For some men, their occupations put them at risk like military, space-traveling, and alike-- People with high-risk jobs can freeze sperm to make it available to them or their partners. Finally, in case you are considering a vasectomy, you may want to consider freezing your sperm as well.
The key factors in sperm storage are:
- transportation to make sure nothing would happen during transportation to the cryogenic storage facility,
- appropriate cryogenic storage at a constant temperature of minus 196 degrees centigrade (-320 Fahrenheit, an average home freezer is about zero Fahrenheit.)
- redundancy to ensure more than one vial and even more than one storage facility-- If one freezer fails, the remaining sperm samples remain safe.,
- authentication, no one wants that his sperm would be replaced…, and
- time a few years of storage would cost much less than lifetime storage.
Cost of male fertility testing
High-quality male fertility testing in a fertility clinic can be expensive at the level of thousands of dollars. On the other hand, rapid tests normally provide a quick screen on a few parameters like count or motility, ranging between $25 to $100. Specialized at home male-fertility-lab pricing is between $100 to $200. Adding storage can range from $350 for 1 year up to $4000 for lifetime storage.
Conclusion
Basic male fertility tests measure sperm count — the number of sperm in the ejaculated fluid (semen). But sperm count is only one factor in male fertility. In addition to hormones tests, several other factors affect your fertility like viability, mobility, morphology, your or your partner's immune system that might attack your sperm, DNA fragmentation and more. Still, there are specialized lab providers that have developed reliable male fertility testing kits that guarantee their quality and your privacy.
Are you taking the future of your family in your hand?...
- Shlomi Barak et al., Clinical Management of Male Infertility, MDText.com, Inc.; 2000–.2016 Feb 5. PMID: 25905383 Bookshelf ID: NBK279160