Male Infertility Tests

Today’s advanced male infertility tests allow us to pinpoint the medical problem that is causing infertility, and also to recommend the best treatment for it.

In this article, we will look at how male fertility tests are done and what these tests reveal about your fertility problem.

The information is drawn from a recent video entitled Male Factor Infertility – The Sperm Test by Dr Lizle Oosthuizen, one of our highly qualified and impressively experienced fertility specialists at Cape Fertility. You can watch the video here

There are many factors that can cause male infertility. There might be an obvious reason for male factor infertility, such as a vasectomy or a spinal cord injury. There could be medical conditions or medication that is affecting sexual performance and fertility, as well as a range of lifestyle factors and the use of steroids or testosterone.

Male fertility levels can also decline due to several causes such as age, stress, a compromised immune system, environmental factors like working with chemicals and heat.

Problems with sperm production or the quality of the sperm are, however, a top cause of infertility in men. In fact, male fertility is defined by the “sperm quality”, which refers to semen volume, sperm count, sperm motility (movement) and sperm morphology (shape).

For this reason, after a thorough medical review, the first male infertility test that is done is a sperm test. This requires a sperm sample to be collected for testing.

The sample required for a male infertility test

A sperm sample can be collected in different ways. Men can produce the sample in the clinic at Cape Fertility, where we have facilities available. For those who are not comfortable with masturbation, a partner is welcome to assist to produce a sample via intercourse.

The sample can also be produced at home and brought to the clinic. The time duration between production of sample and arriving at the clinic should be ideally less than one hour.

Whichever method you are comfortable with, the sperm sample must be produced after 2 to 5 days of abstinence.

When the sperm sample is produced, it is very important that there are no disinfectants, soaps, or any lubricants used as this can kill the sperm and give an inaccurate reading. A normal condom can also not be used, because these contain spermicide. We will provide you with laboratory grade condoms without spermicide as well as a sterile container. If you are bringing the sperm sample from home to the clinic, keep it body temperature. Putting it in a freezer or a cooler bag will kill the sperm.

When you arrive at the clinic with your sample, we will ask you to check all of your information with the lab before you hand it over. We triple check everything – making sure all the requirements have been adhered to, such as the time of abstinence and the time that lapsed before it arrived at the clinic, and that the details match so we give you the correct information – and never somebody else’s results.

Based on what the parameters in the sperm test tell us, we can decide whether and where we need to investigate further, or which treatment options are suitable.

Before we look at what a sperm test tells us, it is important to understand two important issues: firstly, the sperm ejaculated today is not produced today, and secondly, how the male infertility test parameters are set.

The sperm ejaculated today is not produced today. In fact, the process of producing sperm takes on average about 80 days. So, the quality of the sperm ejaculated today is affected by whatever happened three months ago.

How are the male infertility test parameters set?

It is also important to understand how are the sperm test parameters set – in other words, how is it decided what is normal and what is cause for concern?

Many studies have been done to establish guidelines and criteria and these have been updated and tightened as time and technology progresses. Essentially, we looked at a big sample of men and especially at those men whose partners fell pregnant within one year of trying to conceive, to determine what is compatible with fertility and what should cause concern.

So, remember that a sperm test is not a diagnosis of fertility or infertility. It shows if the sperm sample is compatible with fertility, so a pregnancy can be expected. If your test values do not fall completely with a normal, this doesn’t mean that you are infertile, nor does it mean that your partner will never fall pregnant.

What does a male infertility test show?

Here are some of the factors we look at on the semen analysis report that our lab generates.

The first thing that we look at is what is the volume of the sperm. A normal volume is at least 1.5ml. If the volume is much lower than this, it raises the concern that there is an obstruction at some point between where the sperm is produced and ejaculation.

Next, we consider the concentration of the sperm. One measurement of this is to look at how much sperm there is per millilitre of sample. So, for example, if the sample is 3ml, we will look at 1ml of that sample and determine how many sperm are in that 1ml sample. The testes make millions of sperm, and what we would usually regard as normal is around 15 million sperm. We also look at how much sperm is in the entire sample.

We then move on to motility. General motility refers to what percentage of the sperm are moving, even if they are just twitching around or swimming in circles. Progressive motility refers to the percentage of the sperm that are not just moving, but also actually making progress in its movement, moving from point A to point B. We consider 42% for total motility to be within normal range and 32% for rapidly progressive sperm or sperm that is moving from point A to point B.

The next thing we look at is morphology, which refers to how the sperm looks. Men are often appalled to hear they have only got 4% or 5% normal-looking sperm. However, the testicles make millions and millions of sperm, so there is likely to be quite a few errors. We only expect 4% of the sperm to actually look normal, because that is what is usually the case.

We also look at the pH of the sperm. This can give us information about what’s happening with the ejaculatory ducts – the ducts that make the fluid to support the sperm. We also look at the vitality, so how many of the sperm are alive. We might also check for antibodies, because if you have had a previous vasectomy and a reversal, there can sometimes be antibodies that might hinder the sperm from moving normally.

The tests above describe the routine sperm tests that we do at Cape Fertility. But thanks to our advanced facilities and technology, we are also able to do more advanced male infertility tests.

Advanced male infertility tests

There are more advanced tests we can do at Cape Fertility when necessary.

One example is DNA fragmentation, which looks at the DNA integrity of the sperm. We might recommend doing this test when the semen analysis parameters are normal, but we suspect an underlying cause of infertility. A DNA fragmentation test it is a bit more involved and it tells us how much of the sperm has intact DNA.

There is also a whole spectrum of sperm function tests that can also be done to see, for example, whether the sperm can penetrate an egg. These tests are a bit more expensive to do, and don’t necessarily change the treatment recommended.

Fortunately, there are as many male infertility treatments as there are fertility challenges that could be revealed by a sperm test. You can read more about male infertility treatments here

If you are concerned about your fertility, we would like to invite you to set up an initial consultation with one of our fertility experts at Cape Fertility. It is as simple as contacting us here

At Cape Fertility, we value each individual patient and we look forward to providing you with individualised and personalised care, affordable quality fertility treatment, and higher success rates at our purpose-built premises in the beautiful city of Cape Town.