When we talk about infertility and reproductive health, much of the pressure falls on the female partner. But the truth is that 30 percent of infertility is male factor, meaning the male partner has an issue with his sperm that’s making spontaneous conception, or pregnancy without medical treatment, more difficult or impossible. As with female fertility, male fertility can be tested at a doctor’s office, and results can help shed a light on his future reproductive potential.
Brian Levine, MD, founding partner and practice director at CCRM New York and medical advisor at Dandi, explains the semen analysis test for male fertility, normal results and when to see a urologist or fertility doctor.
What is a male fertility test?
A semen analysis (SA) is the most accurate test for male fertility. It tests the sperm within a semen sample that he produced either at home or in a private room at a doctor’s office. The semen analysis looks at four parameters:
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Volume, amount of semen within the sample
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Count, number of sperm within the sample
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Motility, how well they swim
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Morphology, shape of sperm
I like to say that the sperm analysis is the best worst test that we have to test male fertility. It doesn’t tell us anything about the function of the sperm, but it does help us predict the chances of getting pregnant on your own without medical intervention.
What are normal sperm analysis results?
Male fertility declines more gradually with age than women’s fertility does, so these averages aren’t by age. The numbers we’re looking for in a sperm analysis are:
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sperm volume above 1.5 mL
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sperm count above 15 million per mL
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sperm motility above 40 percent
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sperm morphology above 4 percent
Low numbers in each of the parameters could be indicative of a bigger medical issue, so your partner may be referred to a urologist because:
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Low sperm volume could mean a blockage or a medical issue that prevents sperm production
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Low count could mean a low testosterone level or that the signals from the brain to the testicles aren’t working
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Low motility could require lifestyle modifications such as stopping to drink or smoke
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Abnormal morphology could require a DNA fragmentation test, which helps determine the quality of the sperm’s genetic material
Are testosterone supplements safe?
I get asked this question a lot, and most people are shocked to learn that testosterone is a contraceptive for men. Testosterone supplements shut down sperm production because it suppresses LH and FSH, hormones required for the testes to produce semen.
To simplify the science behind it: if the body doesn’t make the right number of hormones, the brain won’t send the signal to do so. If the body senses an excess of testosterone (via supplementation), then it’s going to believe it’s making an adequate amount of sperm and won’t send the signals to the brain to make more.
So when in doubt, don't let your partner take testosterone if you’re trying to get pregnant! If he’s taking it already, its effects are usually reversible and sperm counts can return to normal, but this can take 3-6 months.
Key takeaways on fertility testing for men
When a couple is trying to conceive, it’s important to test the male partner’s fertility and the female’s, since about a third of infertility cases are due to issues with the sperm. A sperm analysis is a simple laboratory test that can reveal a lot of information about a man’s ability to conceive naturally, and help inform your fertility planning future.
People like myself at CCRM New York are trained in all of this testing and in reproductive endocrinology, and we help our patients discuss their options for fertility treatment. Check out Dandi’s guide for how to choose a fertility doctor, as well as the rest of Dandi’s helpful resources, as you begin your fertility journey.
