A male is fertile when his sperm parameters are on an optimal level and he has the ability to fertilise a female’s ovum without any struggle. When a couple is struggling to conceive or a male just has questions, it is recommended to go for fertility tests to analyse where a possible problem or risk might be.
At-home fertility testing kits can be used to get an idea of where a male’s fertility is at. What’s great about the kit is that the patient wouldn’t have to go to the doctor’s room to provide a semen sample and thus his personal concerns stay private. The kit is also usually affordable making it easy for men to test their fertility.
Important to note is that some kits may not be able to supply all the information about a male’s fertility as needed. Some kits only test a male’s sperm count and not other parameters such as sperm structure or movement. Fertility can’t be assessed just based on sperm count, as the other parameters also play a vital role in determining fertility.
Doctor’s Consultation and Fertility Tests
If a male is concerned that the home kit may not provide all the information he is seeking regarding his fertility, or when the results of the home kit are not satisfactory, it is recommended to make an appointment with a doctor to evaluate the male’s health and inform him on all of his fertility concerns.
A typical consultation will include a physical examination where the doctor will take a look at the male’s reproductive organs, feeling for any abnormalities or lumps and nodules. The doctor will also check the patient's vital signs and screen for hypertension and diabetes.
The doctor may then ask questions to the patient about his medical history, if he has been diagnosed with any chronic conditions or if he has undergone any surgeries previously and if he has any sexually transmitted infections (STIs). Other questions may include if the patient is taking any medications, how often they are exercising, if they consume any alcohol or smoke and even how often the patient and his partner have sexual intercourse, especially if the patient came to the doctor with the concern of struggling to conceive.
After the physical examination, the doctor may require some fertility tests. Common fertility tests include:
This is when a semen sample is produced in an indicated medical container. The sample will then be sent to the laboratory to be analysed. The laboratory will look at specific parameters to assess fertility. These parameters are
- Semen Volume: This is the total volume of the semen sample that has been collected.
- Sperm Count: This is the amount of sperm that is present in the sample. The concentration of 15 million sperm per millilitre is seen as a healthy sperm count. They also test the amount of sperm that is alive in the semen sample.
- Sperm Motility: This is the ability of the sperm to move. A motility rate of 63% and above indicates healthy motility.
- Sperm Structure: The simple structure of a sperm consists of a head and a tail. When an amount of 12% or more is of normal structure, it is seen as a high-quality sperm structure.
- Infection: The laboratory will also test for possible microbes that can cause an infection that might have an effect on fertility.
- The pH Level: The pH of the semen is also tested and should be almost neutral to a more basic level (7.2-8.0).
A blood sample may be taken to test the hormone levels. Common hormones that are tested for are Testosterone and Follicle-Stimulating Hormone (FSH). Balanced and optimal levels of both of these hormones are necessary for optimal fertility. These hormones play a vital role in the process of spermatogenesis and if their levels are too low, the process may be disrupted and can lead to insufficient production of sperm.
The next test to be done is a scrotal and rectal ultrasound. The doctor uses these scans to test for any obstructions in the reproductive tract, infections, tumours or torsions. Most of the time, any obstruction can be surgically removed in order to repair fertility.
This test uses a semen sample to test for the presence of any antibodies that attack sperm cells. If the antibodies are present and it is known that the immune system is attacking sperm cells, it can affect sperm cells and male fertility. The antibodies can occur due to an injury or surgery or an infection, causing the sperm cells to come in contact with the immune system. The doctor will advise on each clinical case, but the option of using immunosuppressants in extreme cases, is available.
Genetic testing will determine if there are any genetic abnormalities with a male’s sperm. This will rule out or identify possible causes of male infertility.
If all the other tests have been done and the doctor is not yet satisfied with the results, they may request a testicular biopsy where a piece of testicular tissue is biopsied to test for the presence of any sperm.