Semen Analysis & Fertility Blood Tests for Male

by | Oct 9, 2023 | Fertility

Types of Fertility Blood Tests for Men

  1. Semen Analysis: This is one of the most common tests to assess male fertility. A semen sample is collected and analyzed to evaluate factors such as sperm count, sperm motility (movement), sperm morphology (shape), and seminal fluid quality. Abnormalities in any of these parameters can indicate potential fertility problems.
  2. Hormonal Tests: These tests assess the levels of hormones crucial for male reproductive function. Key hormones include:
    • Testosterone: Low levels of testosterone can impact sperm production and overall sexual health.
    • Follicle-Stimulating Hormone (FSH): Elevated FSH levels can indicate problems with the testicles or the pituitary gland, affecting sperm production.
    • Luteinizing Hormone (LH): Abnormal LH levels can also point to issues with the testicles or pituitary gland.
  3. Anti-Müllerian Hormone (AMH): Although primarily associated with female fertility, AMH can also provide insights into the quality of a man’s sperm production.
  4. Prolactin: Elevated levels of prolactin can interfere with testosterone production and, subsequently, sperm production.


What Tests Should Be Done to Diagnose Infertility in Men?

Diagnosing male infertility involves a combination of tests to pinpoint the underlying causes. Here’s a step-by-step process:

  1. Medical History and Physical Examination: The initial step typically involves discussing the individual’s medical history and lifestyle factors that may affect fertility. A physical examination may identify physical issues such as varicoceles (enlarged veins in the testicles) or structural abnormalities.
  2. Semen Analysis: As mentioned earlier, this test assesses sperm count, motility, morphology, and seminal fluid quality. A series of abnormal results may prompt further investigation.
  3. Hormonal Testing: Hormonal tests, including testosterone, FSH, LH, and prolactin levels, help identify hormonal imbalances that could contribute to infertility.
  4. Genetic Testing: Some genetic abnormalities can affect sperm production and quality. Genetic tests can identify conditions like Klinefelter syndrome or Y-chromosome microdeletions.
  5. Imaging Studies: Ultrasound or other imaging techniques can be used to visualize the reproductive organs and detect physical abnormalities, such as blockages or varicoceles.
  6. Post-Ejaculatory Urinalysis: This test checks for the presence of sperm in the urine after ejaculation, which may suggest retrograde ejaculation, a condition where sperm travels into the bladder instead of exiting the body.
  7. Sperm Function Tests: These tests evaluate the sperm’s ability to penetrate an egg, which is crucial for fertilization.
  8. Anti-Sperm Antibody Testing: This test determines if antibodies are attacking sperm, reducing their ability to fertilize an egg.
  9. Testicular Biopsy: In certain cases, a small sample of testicular tissue may be examined to assess sperm production and quality directly.


What is a Hormonal Test for Male Infertility?

Hormonal tests for male infertility involve measuring hormone levels in the blood to assess the endocrine system’s functioning. Hormones are essential for the development of sperm, and imbalances can significantly impact fertility.

  • Testosterone: This male sex hormone is vital for sperm production and sexual function. Low testosterone levels can lead to reduced sperm production and sexual dysfunction.
  • Follicle-Stimulating Hormone (FSH): FSH is responsible for stimulating the testicles to produce sperm. Elevated FSH levels can indicate that the body is attempting to compensate for decreased sperm production.
  • Luteinizing Hormone (LH): LH plays a role in regulating testosterone production. Abnormal LH levels can suggest issues with testosterone production.
  • Prolactin: Elevated prolactin levels can suppress testosterone production and reduce sperm count.

A hormonal test for male infertility typically involves a blood sample. Abnormal results may indicate hormonal imbalances that can be addressed through medical interventions such as hormone replacement therapy or lifestyle modifications.


Hormones Evaluated in Fertility Blood Tests for Men

Fertility blood tests for men primarily focus on evaluating several key hormones that are essential for normal reproductive function:

  • Testosterone: This male sex hormone is produced by the testes and plays a crucial role in sperm production, sexual function, and overall reproductive health. Low testosterone levels can indicate potential issues with fertility.
  • Follicle-Stimulating Hormone (FSH): FSH is produced by the pituitary gland and stimulates the testes to produce sperm. Elevated FSH levels can suggest that the body is attempting to compensate for decreased sperm production. High FSH levels may indicate testicular dysfunction.
  • Luteinizing Hormone (LH): LH also comes from the pituitary gland and regulates testosterone production in the testes. Abnormal LH levels can indicate problems with testosterone production and can affect fertility.
  • Prolactin: Prolactin is produced by the pituitary gland and is involved in various bodily functions. Elevated prolactin levels can suppress testosterone production and reduce sperm count, potentially impacting fertility.


Semen Analysis and Its Significance in Fertility Assessment

Semen analysis is a critical component of male fertility evaluation, providing valuable insights into sperm quality and quantity. A semen sample is collected through ejaculation and subjected to various tests. Below is a table illustrating the World Health Organization (WHO) reference values for semen analysis:

Parameter WHO Reference Value
Volume ≥ 1.5 milliliters (mL)
Sperm Concentration ≥ 15 million per mL
Total Sperm Count ≥ 39 million per ejaculate
Sperm Motility ≥ 40% of sperm should be motile (moving)
Sperm Morphology (Normal) ≥ 4% of sperm should have normal morphology (shape)
pH Level 7.2 – 7.8
White Blood Cells < 1 million per mL


  • Volume: A sufficient volume of ejaculate is necessary to transport sperm effectively. A low volume can indicate a blockage or other issues in the reproductive tract.
  • Sperm Concentration: This measures the number of sperm in a given volume of semen. A low sperm count can hinder fertility, making it more challenging to fertilize an egg.
  • Total Sperm Count: Total sperm count is the product of sperm concentration and ejaculate volume. It’s a crucial factor in assessing fertility potential.
  • Sperm Motility: Sperm motility indicates the percentage of sperm that can move effectively. Higher motility enhances the chances of sperm reaching and fertilizing an egg.
  • Sperm Morphology (Normal): This parameter assesses the percentage of sperm with a normal shape. Abnormal morphology can impair sperm’s ability to penetrate and fertilize an egg.
  • pH Level: The pH of semen should be within a specific range to support sperm function. Abnormal pH levels can affect sperm viability.
  • White Blood Cells: Elevated white blood cell counts in semen can indicate infection or inflammation, which can harm sperm.


Insights from Urinalysis in Male Fertility Assessment

Urinalysis can provide additional information about fertility, especially in cases where certain issues are suspected. Specifically, urinalysis can reveal:

  • Retrograde Ejaculation: Urinalysis can show whether sperm is present in the urine after ejaculation. In retrograde ejaculation, sperm travels backward into the bladder instead of exiting the body. This condition can result from issues with the muscles or nerves that control ejaculation and may lead to fertility problems.
  • Infections or Inflammation: Elevated white blood cell counts in the urine may indicate the presence of infection or inflammation in the reproductive or urinary tract. Infections can harm sperm and affect fertility.


Can You Do a Male Fertility Test at Home?

Yes, there are several at-home male fertility test kits available that allow individuals to assess their fertility without visiting a healthcare facility. These tests typically focus on measuring key parameters such as sperm count, motility, and morphology. Here’s how an at-home male fertility test typically works:

  1. Sample Collection: The kit provides instructions for collecting a semen sample. Users are required to ejaculate into a collection cup provided in the kit.
  2. Analysis: The collected sample is then analyzed using the tools and reagents provided in the kit. The analysis often involves assessing sperm concentration, motility, and morphology.
  3. Results: After analysis, the user can interpret the results based on the provided guidelines. These results can offer a basic understanding of one’s fertility status.

While at-home tests can provide some insights, they may not be as comprehensive or accurate as tests conducted by healthcare professionals. If at-home results indicate potential fertility issues, it’s advisable to consult a doctor for a more in-depth evaluation.


How Much Does a Male Fertility Test Cost in India?

The cost of a male fertility test in India can vary widely depending on several factors, including the type of test, the location of the testing facility, and whether it is conducted at home or by a medical professional. Here are some approximate cost ranges for different types of male fertility tests in India:

  1. At-Home Test Kits: At-home male fertility test kits are relatively affordable, with prices typically ranging from INR 500 to INR 2,000. These kits are readily available online and at pharmacies.
  2. Semen Analysis at a Clinic or Laboratory: A comprehensive semen analysis conducted at a medical facility may cost anywhere from INR 1,000 to INR 3,000 or more, depending on the location and the laboratory’s reputation.
  3. Advanced Fertility Tests: In cases where more specialized tests are required, such as hormone evaluations or genetic testing, the cost can be higher, ranging from INR 3,000 to INR 10,000 or more, depending on the specific tests needed.

It’s important to note that healthcare costs can vary significantly, so it’s advisable to check with local clinics or laboratories to get accurate pricing information.


How Do Doctors Test Fertility in Males?

Doctors use a combination of medical tests and evaluations to assess male fertility comprehensively. Here’s an overview of the typical steps involved in testing fertility in males:

  1. Medical History: Doctors begin by discussing the individual’s medical history, including any past illnesses, surgeries, lifestyle factors (such as smoking or drug use), and sexual history.
  2. Physical Examination: A physical examination may be conducted to check for physical abnormalities such as varicoceles (enlarged veins in the testicles) or structural issues that could affect fertility.
  3. Semen Analysis: This is a fundamental test that assesses sperm quality and quantity. It involves collecting a semen sample, which is then analyzed for parameters like sperm count, motility, and morphology.
  4. Hormonal Tests: Blood tests are conducted to measure hormone levels, including testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin. Hormonal imbalances can impact sperm production and overall reproductive health.
  5. Imaging Studies: In some cases, ultrasound or other imaging techniques may be used to visualize the reproductive organs and detect structural issues.
  6. Genetic Testing: Genetic tests may be recommended to check for conditions such as Klinefelter syndrome or Y-chromosome microdeletions, which can affect sperm production.
  7. Post-Ejaculatory Urinalysis: This test checks for the presence of sperm in the urine after ejaculation and can help diagnose retrograde ejaculation.
  8. Sperm Function Tests: Specialized tests can evaluate the sperm’s ability to penetrate an egg, an essential step in fertilization.


What Is a Day 3 Blood Test for Fertility?

A “Day 3 blood test” in the context of fertility typically refers to a test conducted on the third day of a woman’s menstrual cycle to assess her ovarian reserve and reproductive hormone levels. This test is more relevant to female fertility assessment than male fertility.

During a Day 3 blood test, a woman’s blood is drawn to measure hormone levels, including follicle-stimulating hormone (FSH), estradiol (a form of estrogen), and sometimes luteinizing hormone (LH). These hormone levels are used to evaluate ovarian function and determine a woman’s fertility potential. Abnormalities in hormone levels can provide insights into conditions like polycystic ovary syndrome (PCOS) or diminished ovarian reserve.


How Can I Check If My Sperm Is Fertile?

Checking the fertility of your sperm involves a comprehensive analysis of various parameters that influence the ability of sperm to fertilize an egg. Here are the steps to check if your sperm is fertile:

  1. Semen Analysis: The most common method to assess sperm fertility is through a semen analysis. This involves collecting a semen sample through ejaculation. A portion of the ejaculate is then examined in a laboratory. The analysis evaluates several key factors:
    • Sperm Count: This measures the number of sperm present in the sample.
    • Sperm Motility: It assesses the percentage of sperm that can move effectively. Motility is crucial for sperm to reach and fertilize an egg.
    • Sperm Morphology: This evaluates the shape and structure of sperm. Abnormalities in morphology can affect sperm’s ability to penetrate an egg.
    • Semen Volume and pH: The volume of semen and its pH level are also considered as they can impact sperm function.
  2. Hormonal Testing: In some cases, hormonal tests may be conducted to check hormone levels, such as testosterone, FSH (follicle-stimulating hormone), LH (luteinizing hormone), and prolactin. Hormonal imbalances can influence sperm production and quality.
  3. Genetic Testing: Genetic tests can identify any underlying genetic conditions that may affect sperm production or function.
  4. Post-Ejaculatory Urinalysis: This test checks for the presence of sperm in the urine after ejaculation, which can indicate retrograde ejaculation.
  5. Sperm Function Tests: Specialized tests assess the sperm’s ability to penetrate an egg, an essential step in fertilization.


Why Wait 48 Hours for a Sperm Test?

The recommendation to wait 48 hours (typically 2 to 5 days) before undergoing a sperm test is crucial for obtaining accurate and representative results. Here’s why this waiting period is essential:

  • Sperm Regeneration: Sperm production in the testes is an ongoing process, and it takes time for new sperm to mature fully. By waiting 48 hours, you allow for the accumulation of sperm that represents your baseline fertility.
  • Sperm Concentration: Waiting ensures that the semen sample contains an adequate concentration of sperm. If you ejaculate too frequently before the test, the sperm count in the sample may be lower than your actual sperm count.
  • Motility: Sperm motility is a critical factor in fertility assessment. Allowing enough time between ejaculations ensures that the sperm in the sample are viable and have good motility, providing a more accurate assessment.
  • Morphology: Sperm morphology (shape) can vary from one ejaculation to another. Waiting allows for the inclusion of sperm with normal morphology, giving a more reliable picture of sperm quality.

In summary, waiting for 48 hours before a sperm test allows for a more accurate evaluation of your baseline fertility, as it ensures that the sample contains mature and representative sperm.


What Is the Best Test for Sperm?

The best test for sperm depends on the specific information you are seeking. Generally, a comprehensive semen analysis is considered the standard test for assessing sperm quality and fertility potential. However, other tests and evaluations may be necessary in certain situations:

  1. Semen Analysis: As mentioned earlier, semen analysis is the primary test for assessing sperm count, motility, morphology, and other parameters related to fertility. It provides valuable information about overall sperm quality.
  2. Hormonal Testing: Hormonal tests can help diagnose hormonal imbalances that may be affecting sperm production. These tests are essential if there are signs of hormonal issues.
  3. Genetic Testing: Genetic tests may be recommended if there is a suspicion of genetic conditions that can impact fertility.
  4. Sperm Function Tests: Specialized tests assess the ability of sperm to perform specific functions, such as penetrating an egg. These tests can provide insights into the functional capacity of sperm.

The choice of test(s) should be made in consultation with a healthcare provider, as they will consider your medical history and specific fertility concerns.


Is 70 Sperm Motility Good?

Sperm motility refers to the percentage of sperm in a semen sample that exhibits forward movement. It is a crucial factor for successful fertilization because motile sperm can swim toward and penetrate the egg. The World Health Organization (WHO) provides guidelines for assessing sperm motility:

  • Progressive Motility: Sperm that exhibit forward movement is categorized as having “progressive motility.” This category includes both rapid and slow progressive motility.
  • Non-Progressive Motility: Sperm with movement but no forward progression falls into this category. They may exhibit twitching or erratic movement.
  • Immotile: Sperm that show no movement at all are considered immotile.

A sperm motility of 70% is generally considered excellent. It suggests that a high percentage of sperm in the sample are actively swimming forward, which is a positive indicator of fertility. However, it’s important to note that fertility is influenced by multiple factors, including sperm count, morphology, and the overall health of both partners. Therefore, while high sperm motility is favorable, it’s just one aspect of fertility, and a comprehensive semen analysis is necessary to assess fertility accurately.

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    Dr Mona Dahiya

    Dr Mona Dahiya

    IVF Specialist & Consultant

    Dr Mona Dahiya has performed over 5,000+ IVF cycles and is considered a global expert in IVF, ICSI, IUI and male fertility treatment. She is an eminent writer on Infertility Treatment and has over 100 Publications in both International and National Journals. Dr Mona Dahiya has immensely contributed to the field of infertility through her Research and articles.

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