Male Infertility Diagnostics & Testing
Our comprehensive fertility testing guides our doctors to develop a plan unique to your infertility history and situation to help you achieve your dream of having a family. As a low-cost fertility center, we focus on doing the testing that you need to make a diagnosis to keep the cost of your fertility journey as low as possible.
At a Glance
- Semen analysis is the primary male infertility test
- How sperm moves and its shape are as important as how many sperm there are
Male Fertility Testing
Our providers at Pathways Fertility have over 60 years of combined experience in helping families in Atlanta and across the country to bring healthy babies into the world. Unfortunately, getting pregnant and having a child does not come easily for everyone.
One of the first tests to do in evaluation of an infertile couple is the sperm count. There are various parameters which determine whether a sperm count is normal.
Approximately 30-40% of infertility problems may be due to male factor infertility. The diagnosis of male problems depends primarily on the sperm count, which involves more than just counting how many sperm there are. The proper movement, called motility, and the shapes of the sperm are also important. Not only are these subject to interpretation, sometimes there is great variability in sperm counts from one week or one month to the next. Thus, more than one sperm count may be necessary.
A normal sperm count requires a certain volume of semen and refers to the number of spermatozoa cells/mL of fluid in the semen. While there are debates about exactly what should be the cut-off for normal sperm counts, the usual number cited for a normal sperm count is 20 million/mL. Some men with concentrations in the 10 to 20 million range are somewhat subfertile but still have children without any assisted reproduction or IVF treatment. However, men who have been trying to conceive with low concentration typically are subfertile.
The good news about male infertility is that if IVF is done it does not matter how low the sperm count is. IVF can still be successful. Men who have 50,000 sperm instead of 50 million can have intracytoplasmic sperm injection (ICSI) performed and be successful.
Additionally, the number of sperm which are moving, known as the motility, is assessed. Once the sperm is produced for evaluation, it is examined in the laboratory after approximately one hour. It can be longer so do not panic if you are driving to the facility. Producing a specimen at home is much more conducive to a good count than producing in a clinic environment. The number of sperm which swim and how well they swim is then observed. Normal motility means that at least half of the sperm are motile.
In an assisted reproductive technology or IVF center, sophisticated analysis of the most perfectly shaped sperm is known as the Kruger strict morphology test. A South African doctor, Dr. Kruger, discovered that only the "perfect sperm" are the ones responsible for fertilizing. Roughly 95% of sperm are typically abnormal. The shape of the sperm, primarily of the head and the tail, is assessed by looking at approximately 100 sperm to determine the characteristics. When the tails are abnormal, typically motility is also impaired. If the sperm numbers and motility are good but the sperm morphology is the single isolated abnormality, it, by itself, is probably not the cause of infertility.
Low Sperm Count
In general, if the numbers of sperm are low, the motility goes down is also low, but sometimes there are isolated defects. Typically, one sperm count is not considered to be enough evidence of a male problem. Men who have low sperm counts can be evaluated for the cause of the infertility by male specialists who have been trained in this field.
In situations where the semen analysis reveals something where the sperm cannot be used, a sperm donor may be appropriate. Another time when donor sperm is used is with single women and same-sex female couples who desire a child.
Home Testing for Sperm Count
While a sperm count is always part of an infertility evaluation, if you are not ready to start that process, you can do an at-home sperm count that we have tested. We found it to be reliable enough to give you a good idea if there may be a male-factor problem. Watch Dr. Massey’s review of the Yo Home Sperm Test results compared to in-office sperm counts.