1. Semen Analysis

• Purpose: Semen analysis is the most common of male fertility testing, assessing sperm count, motility (movement), morphology (shape), and other parameters.
• Procedure: A semen sample is collected through masturbation into a sterile container after a period of abstinence (typically 2-5 days). The sample is then analysed in a laboratory to evaluate sperm quantity and quality.

2. Hormonal Testing

• Purpose: Measures hormone levels that play a crucial role in sperm production and overall reproductive function.
• Procedure: Blood tests are conducted to assess hormone levels, which can indicate issues with hormone production or regulation affecting sperm production.

3. Genetic Testing

• Procedure: Involves blood testing or, in some cases, buccal (cheek) swabs to collect DNA for analysis
• Purpose: Identifies genetic factors that may contribute to male infertility, such as chromosomal abnormalities or genetic mutations.

4. Physical Examination

• Purpose: Evaluates the reproductive organs and identifies any physical abnormalities that may affect fertility, such as varicocele (enlarged veins in the scrotum) or structural issues.
• Procedure: Includes a comprehensive examination of the genitals. The doctor may also assess secondary sexual characteristics and overall health.

5. Sperm Function Tests

• Purpose: Assess sperm function beyond basic parameters like motility and morphology for sperm viability (ability to survive), sperm penetration assay (evaluates sperm's ability to penetrate an egg), and sperm DNA fragmentation (checks for damage to sperm DNA).
• Procedure: These tests are performed in specialised laboratories and can provide additional insights into sperm health and potential fertility issues.

6. Ultrasound Imaging

• Purpose: Uses ultrasound technology to visualise the reproductive organs and detect abnormalities such as varicocele or obstruction.
• Procedure: Scrotal ultrasound is non-invasive and painless, allowing for detailed imaging of the testicles, epididymis, and other structures.

7. Post-Ejaculation Urinalysis (PEU)

• Purpose: Determines if sperm are entering the bladder instead of being ejaculated normally, a condition known as retrograde ejaculation.
• Procedure: The patient provides a urine sample immediately after ejaculation, which is examined under a microscope to detect the presence of sperm.

8. Sexually Transmitted Infection (STI) Testing

• Purpose: It is also important to think about STI tests as they can impact fertility and are generally something recommend for both partners during this process.
• Procedures: The procedures for STI testing varies, however physical examination, urine samples, blood samples and swab tests are the most common.

A comprehensive evaluation by a fertility specialist can help identify potential causes of male infertility and guide appropriate treatment options to optimise fertility and increase the chances of achieving pregnancy.

Why do these tests?

It is important to think about why someone should take a sperm fertility test, due to the varying outcomes. Zita West is a big advocate for only taking sperm fertility tests (when not actively trying for a baby or preparing for assisted fertility treatments) if you're prepared to get the answers. For example, if the outcomes aren't favourable, you need to think about what your next steps are.

A suitable next step would be to look into supplements which can improve men's fertility. Zita West suggests Menceive, a friendly bacteria supplement for sperm health.

Additionally, Zita West and Aria Fertility Clinic Director & Embryologist Robert Smith offer a free masterclass on how to improve chances of IVF, including sperm health physically and holistically. To learn more about male reproductive health, read our male reproductive health guide.

Where to go next

If you are reviewing semen analysis, sperm count, motility, morphology or DNA fragmentation, these related guides may help you understand the wider male fertility picture.

• For a broad overview of male fertility causes, sperm health, lifestyle foundations and next steps, read our main male fertility issues guide.
• For a deeper explanation of sperm count, motility, morphology, DNA fragmentation and the 72 to 90 day sperm development window, watch our Sperm Health Masterclass.
• For an expert-led introduction to male fertility, testing, sperm health, nutrition and lifestyle, read or watch Male Fertility Matters.
• If supplements are being considered alongside testing and professional advice, read our male fertility supplement guide.
• For wider context on population-level sperm quality trends, environmental factors and lifestyle considerations, read our guide to the decline in sperm quality.