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An at-home fertility test for men can give you a glimpse into your fertility. But you still may need to contact your doctor for a follow-up.

Fertility is a 50-50 deal: half egg, half sperm. So it probably isn’t coincidental that male fertility is a factor in 50% of fertility issues.

Male fertility testing can empower you with the knowledge you need to get the outcome you want — whether you and your partner are looking to achieve pregnancy naturally, you’re donating sperm, or you’re planning to use a surrogate.

While a urologist can offer the most comprehensive information about male fertility, you can also start your journey without leaving home with at-home male fertility tests.

Let’s take a look at male fertility testing at home and what may (or may not) be contributing to conceiving a child.

Male fertility tests generally involve a sperm analysis, which can indicate the health and viability of a person’s sperm.

A semen analysis looks at many factors. The three main ones to know about are:

  • sperm count (how many sperm there are)
  • motility (how the sperm move)
  • morphology (how the sperm are shaped)

“At-home semen analysis testing will tell you if there’s sperm in the ejaculate,” said Dr. Amanda Kallen, an associate professor in the division of reproductive endocrinology and infertility at Yale Medicine. “Many will provide sperm quantity, but most won’t tell you if the sperm are moving (motility).”

In other words, some at-home semen analyses are not usually as detailed as doctor-ordered tests. Still, they can provide information as a starting point for people concerned about sperm count and quality.

Each test on our list has been vetted by our internal team for:

  • medical credibility
  • good business practices
  • social impact

When deciding what to include on our list, we also looked for tests that provided more than just sperm count.

LegacyLabcorp OnDemandFellow
Price$295$199$189
What’s testedsperm volume, count, concentration, motility, morphologysperm volume and concentrationvolume,
concentration,
count,
motility,
total motile count,
morphology
Results48 hours6 minutes1.5 days after company receives sample

Pros

  • A home kit relieves you of the stress of providing a sperm sample in the doctor’s office.
  • Your concerns remain private.
  • The kits are quick and easy to use and are generally less expensive than in-office labs.

Cons

  • Some home kits won’t give you all the information you need. While they can tell you if your sperm count is normal or not, these numbers are only one factor in male fertility.
  • The range for low and optimal sperm counts varies between the kits.
  • Some kits don’t measure sperm counts below certain levels.
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While a home kit might be a helpful first step, you’ll need to be medically evaluated by a healthcare professional for a more complete picture of your fertility.

First comes the physical exam. They will examine your penis and testicles.

Next, they’ll ask questions about your:

  • medical history
  • lifestyle
  • sex life

Questions about your medical history may include:

Questions about your lifestyle may include:

  • How much do you exercise?
  • Do you smoke or take recreational drugs?

When it comes to your sex life, you can expect a frank discussion that includes any issues you may be experiencing, such as:

It’s best to avoid sperm tests that look only at whether sperm is present or absent.

According to Kallen, sperm testing in a credentialed laboratory by a trained andrologist gives you much more information, such as morphology, volume of the ejaculate, the pH of the ejaculate, and more.

“These are critical factors in determining whether the sperm is adequate to fertilize an egg (and identifying whether male factor infertility is an issue),” she said.

If you visit a healthcare professional to talk about fertility, they’ll likely ask you to provide a semen sample.

How semen analysis is done

Semen samples are given in two different ways.

You can ejaculate into a special container at the doctor’s office. If this isn’t an option because of your religious or cultural beliefs, you can use a special condom during intercourse.

Be prepared to possibly provide several samples, as sperm counts do fluctuate from one specimen to the next.

What semen analysis shows about fertility

You’ve done your part by providing the sample. Now it’s up to the healthcare professional to analyze it. According to a 2015 review of available research, as much as 2% of men have sperm measurements that aren’t optimal.

So what is your doctor looking for? In a nutshell:

  • Signs of infection: The presence of certain bacteria in semen can indicate infection.
  • Volume of semen: This is a measurement of how much semen in total is in your sample.
  • Sperm concentration: Normal sperm counts are typically at or above 20 million sperm per milliliter of semen.
  • Vitality: This examines what percentage of sperm are alive.
  • Motility: Are the sperm moving? Above 63% motility indicates fertility, while less than 32% of sperm with motility indicates subfertility.
  • Morphology: How are the sperm shaped? Believe it or not, the majority of sperm in your sample won’t be perfect. But if more than 12% are of normal size and shape, this indicates fertility. A sample with less than 9% normal morphology could mean sub- or infertility. (Between 9 and 12% is inconclusive.)

So much for the numbers. Now let’s crunch them.

While the numbers help distinguish between fertility, subfertility, and indeterminate fertility, none of them actually diagnoses infertility. That said, here are two things to keep in mind:

  • A semen sample with a decreased sperm concentration often shows abnormalities in sperm motility and morphology, too.
  • The percentage of sperm with normal morphology is perhaps the best indicator of healthy semen.

Sometimes, sperm cells pass all the standard medical tests for fertility, but you may still have trouble growing your family.

That could indicate a condition called normozoospermic infertility, meaning that the sperm cells themselves are infertile. Here’s where urinalysis comes in.

How urinalysis is done

At the doctor’s office or the testing facility, you’ll be given a plastic cup and asked to provide a small, clean urine sample. Use the cleaning wipe you’ve been given to wipe around your urethra to prevent bacteria on your penis from entering the cup.

What urinalysis shows about fertility

A 2014 study shows that doctors can now test for normozoospermic infertility by tracking the levels of five biomarkers (small molecules) in urine.

While standard fertility tests may capture 75% of cases, the researchers were able to correctly identify 86% of men who were infertile and 87% of men who were fertile.

What does that mean for you? While there’s still more research needed in this area, researchers suggest that the variant levels of these biomarkers may point to physiological problems as the root of normozoospermic infertility.

Making sperm is an energy-intensive process and any spoke in the production wheel could disrupt proper sperm production. The more we learn about the biomarkers, the easier it will be to fix any physiological problems.

The pituitary gland, hypothalamus, and testicles work together when it comes to sperm production.

Follicle stimulating hormone (FSH) and luteinizing hormone (LH) — acting together with testosterone, which is produced in the testicles — are involved in the process.

A simple blood test will show the level of these three important hormones in your blood.

FSH

This hormone contributes to sperm production.

High levels may indicate that your testicles aren’t functioning properly or have been damaged by disease, X-rays, or chemotherapy. Low levels may show that you aren’t producing sperm.

LH

This is produced in the pituitary gland. In the testes, LH binds to receptors in the Leydig cells to release testosterone, which is needed to produce sperm.

LH levels can also be measured after giving an injection of gonadotropin releasing hormone. The advantage of measuring LH this way is that your doctor can then pinpoint whether the problem is with your pituitary gland or another part of your body.

Testosterone

Healthy testosterone levels for men are typically above 300 nanograms per deciliter. Keep in mind that after age 40, testosterone levels decrease by an average of around 1% every year.

In some cases, your doctor may ask for imaging to check that your anatomical structure is OK and there are no obstructions.

Scrotal ultrasound

In this exam, a handheld probe is swept across your scrotum. The scan uses high frequency sound waves to check for:

  • infections
  • cysts
  • a collection of fluids inside the testicles
  • tumors

The test also checks for testicular torsion and varicoceles. Testicular torsion is generally associated with severe pain and is considered an emergency. Varicocele, a common cause of infertility, is when the temperature of the testicles is higher than normal. This causes a decrease in sperm production.

Transrectal ultrasound

A small, lubricated wand is inserted into your rectum. The imaging helps your doctor check your prostate and check that there are no blockages in the vas deferens. Blockages can be corrected with surgery.

Usually, sperm doesn’t come into contact with the rest of your body and immune system. However, injury, surgery, or prostate gland infections can interfere with this protective system.

And when sperm comes into contact with your immune system, the body may produce anti-sperm antibodies.

Your doctor may ask for an anti-sperm antibody test if the cause of infertility is unclear.

You’ll be asked to provide a sample of semen. The test checks your semen for antibodies that fight against your sperm by using a substance that binds only to affected sperm.

The higher the level of sperm affected by antibodies, the lower the chance of a sperm fertilizing an egg.

Note that these antibodies can also be found in females. So, your doctor may also recommend testing your partner for these antibodies.

Doctors are divided over whether this testing is advisable. Some say it doesn’t help set a treatment plan for infertility; others advise taking medication to lower the body’s immune response.

This test may come at the end of the line if the other tests you’ve done aren’t conclusive.

In this test, a sample is removed from the testicle, either with a needle or through a small cut. If the results of the testicular biopsy show that sperm production is normal, your fertility issues may be caused by a blockage or another problem with sperm transport.

Following the development of in vitro fertilizing techniques, research on genetic causes for infertility has expanded. Genetic abnormalities are found in 10% to 20% of men who have severe disorders with sperm production.

Genetic testing carried out on DNA can help rule out chromosomal abnormalities, especially in men with either azoospermia (no sperm present in the semen) or oligozoospermia (low sperm count).

The test results can:

  • relieve you of uncertainty
  • help you avoid unnecessary surgical or medical treatments
  • help you make informed decisions on what your next steps should be

If all the tests come back as normal, your healthcare professional may diagnose idiopathic infertility. Basically, this means that currently there’s no way to determine the cause of your infertility.

While it won’t ease your frustration and pain, know that your uncertainty is shared by many. Idiopathic infertility is an extremely common infertility diagnosis in general.

You can test your sperm for fertility at home with at-home kits, like the carefully vetted kits on our list, or you can visit a urologist for in-office testing, comprehensive results, and next steps from your doctor.

It’s best to avoid sperm tests that look only at whether sperm is present or absent.

According to Kallen, sperm testing in a credentialed laboratory by a trained healthcare professional gives you much more information, such as morphology, volume of the ejaculate, the pH of the ejaculate, and more.

“These are critical factors in determining whether the sperm is adequate to fertilize an egg (and identifying whether male factor infertility is an issue),” she said.

A few signs, including low sex drive, erectile dysfunction, testicle pain, or swelling, may signal low sperm count.

Though males can continue to create new sperm beyond 80 years old, sperm quality lowers after age 50.

At-home male fertility tests can help clue you in on the health and viability of your sperm. If an at-home test or in-office test suggests abnormalities, your healthcare professional can discuss any potential treatments with you. There are also many options available for medically assisted pregnancy.