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Fertility Tests For Men: What Are The Option And Various Tests Advice For Checking Male Infertility


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Male Infertility

There is a 50/50 probability that even the men will have problems supporting the pregnancy when a couple struggles to conceive. Fertility is a mixture of sperm and eggs, so keep that in mind if you’re hoping to father a child. Therefore, the fact that 50% of infertility issues are caused by male fertility is probably not a coincidence.

In the present times, nearly one in seven couples are infertile. Many couples report that they haven’t been able to conceive a child despite engaging in frequent, unprotected sexual activity for at least a year or sometimes even longer. Almost half of these couples are impacted to some extent due to male infertility. But this is not a blame game. It’s about arming oneself with the knowledge you require to get the result you desire and help you conceive. 

Low sperm production along with poor sperm function, or obstructions that limit sperm delivery can all contribute to male infertility. Male infertility may be caused by illnesses, accidents, chronic health issues, lifestyle choices, and other circumstances.

Male infertility is a condition that can be stressful and distressing, but there are several male infertility tests available. The inability to conceive a child is the main giveaway of male infertility. There might be no other apparent and obvious symptoms or indicators.

Factors Affecting Male Fertility

According to research, up to 6% of men in North America are infertile. But why does it happen? Several elements that might lead to decreased sperm function and production are listed below:

  • Anomalies in the anatomy or genetics
  • Neurological or systemic illnesses
  • Sperm antibodies
  • Trauma
  • Infections
  • Hormone-disrupting radiation treatment

Getting The Evaluation 

It is likely that you will begin by seeing a urologist. They will conduct a physical examination on you and inquire about your personal history, including:

  • Procedures you’ve undergone and medications you take
  • Your workout routine
  • If you smoke or use drugs recreationally

They might also openly discuss your sexual history with you, including any issues you’ve had and whether you currently have or have ever had any STDs (sexually transmitted diseases). Most likely, you’ll be requested to provide a sample of semen for examination.

Male Infertility Tests

It can be difficult to identify the source of your infertility. It’s a good idea for you — both of you – to get tested if you and your spouse are struggling to conceive. Specialists in male infertility use many techniques to accomplish this. Let’s look into male fertility tests and what might (or might not) be making it difficult to conceive a kid.

Physical Examination

The physical examination happens first. Your penis and testicles will be examined by the doctor. You’ll then be asked inquiries regarding your medical background, your sex life, and your lifestyle.

  possible inquiries regarding your medical history

  • Which medications are you now taking?
  • Have you had surgery in the past?

 possible inquiries regarding your lifestyle. (Offer a truthful response!)

  • How much exercise do you get? 
  • Do you smoke or use drugs recreationally?

You can anticipate an open talk about your sexual history, including any issues you’ve encountered such as erection problems (ED), ineffective ejaculation, and retrograde ejaculation

Also, whether you now have any STDs or have ever had any (sexually transmitted diseases). Most likely, you’ll be requested to provide a sample of semen for examination.

Semen/Sperm Analysis

Men’s fertility is assessed by male sperm tests using sperm analysis or sperm count tests, which count and grade the sperm generated. Three key aspects are evaluated by this sperm fertility test: sperm shape, sperm count, and sperm motility. A male sperm test also tests the semen, the fluid that contains them. Up to 2 percent of all males have sperm parameters that aren’t ideal, according to a 2015 Indian study. What then is your doctor trying to find out? Briefly speaking:

Regarding sperm fertility test bear in mind these two points:

  • Sperm morphology and motility problems are frequently present in semen samples with low sperm concentrations.
  • The best predictor of healthy semen may be the proportion of sperm with normal morphology.

Urine Analysis

A little, spotless urine sample will be requested from you, and you will be handed a plastic cup. To stop bacteria from your penis from getting into the cup, use the cleaning wipe you were provided to clean the area surrounding your urethra. The presence of some sperm in the urine suggests that sperm are moving into the bladder rather than exiting. This aids in figuring out whether the person has retrograde ejaculation or not.

According to a 2014 study, clinicians can now check for normozoospermic infertility by monitoring the concentrations of five tiny molecules, or biomarkers, in urine. Although additional investigation is required in this area, researchers hypothesize that the varying concentrations of these biomarkers may indicate physiological issues as the cause of normozoospermic infertility.

Hormone testing

In order to produce sperm, the pituitary gland, hypothalamus, and testicles collaborate. The process is aided by testosterone, which is made in the testicles, as well as luteinizing and follicle-stimulating hormones (FSH and LH). These three crucial hormone levels in your blood can be determined by a quick blood test.


The generation of sperm is helped by this hormone. High levels could be an indication of  testicles that aren’t unhealthy or have been harmed due to disease, chemotherapy or radiation. Low levels could indicate that you aren’t sperm-producing.


This is produced in the pituitary gland. In the testes, LT binds to receptors in the Leydig cells to release testosterone, which is needed to produce sperm.After administering an injection of gonadotropin-releasing hormone, LH levels can also be assessed (GnRH). This method of testing LH has the benefit of allowing your doctor to determine whether the issue is with your pituitary gland or another organ in your body.


Healthy testosterone in fertile men should fall between a range of 300 to 1,000 nanograms per deciliter (ng/dL) of. Remember that testosterone levels typically decline by about 1% per year beyond the age of 40.

Imaging Tests

Your doctor may occasionally request imaging to make sure your anatomical structure is healthy and free of obstacles.

Scrotal Ultrasound

To see the scrotum and other organs like the testicles and epididymis, scrotal ultrasonography is employed (tubes immediately next to the testicles that collect sperm). The testicles are located in the scrotum, a flesh-covered pouch that hangs between the legs at the base of the penis. To determine whether there is any obstruction in the testicles, a scrotum ultrasound examination is helpful. 

Additionally, it can be used to screen for varicocele, testicular torsion, and other issues with the reproductive system’s supporting structures. Although many adult men have varicoceles and aren’t disturbed by them, if you’re having trouble getting pregnant, your doctor might advise surgery. You have a portable probe moved across your scrotum. High-frequency sound waves are used during the scan to look for:

  • Infections
  • Cysts 
  • Tumour
  • An accumulation of fluid inside the testicles infections
  • Testicular symmetry and size
  • Testicular lump in either or both testicles
  • Testicular torsion, which results in irregular blood flow, is 
  • Cause of pain and swelling  (if any), in the testicles.

Transrectal Ultrasound

A small, well lubricated wand is inserted into your rectum. Since the probe is wrapped in a soft gel, inserting it into the rectum is rather painless. Your doctor can examine your prostate and make sure the vas deferens is unblocked with the aid of imaging. Surgery can be used to remove obstructions. To ensure the availability of male radiologists to do transrectal ultrasounds, a previous appointment is usually made. The majority of male patients would feel at ease having a man radiologist do transrectal ultrasound.

Anti-sperm antibodies testing

Sperm typically doesn’t interact with your immune system or the rest of your body. However, this defense mechanism may be compromised by injuries, operations, or infections of the prostate gland.

Additionally, your body could develop anti-sperm antibodies when sperm comes into contact with your immune system. Male infertility is said to be caused by antibodies that can establish an auto-immunity to spermatozoa. If the cause of infertility is still unknown, your doctor might request an anti-sperm antibody test.

A sample of your semen will be required. The test uses a chemical that only binds to impacted sperm to examine your semen for antibodies that battle against your sperm.

The likelihood of a sperm fertilizing an egg decreases as the amount of sperm impacted by antibodies increases. (Since women can also have these antibodies, your doctor may suggest that your partner undergo testing.)

Genetic testing

The study of genetic reasons for infertility has grown since the invention of in vitro fertilization methods. Ten percent to twenty percent of men with significant sperm production issues have genetic abnormalities.

When a man has azoospermia (no sperm in the semen) or oligozoospermia, genetic testing on DNA can help rule out chromosomal disorders (low sperm count). The test results can: 

  • remove any uncertainty from your situation; 
  • assist you in avoiding unneeded surgical or medical procedures;
  • assist you in deciding what your best options are for your future steps

Testicular biopsy

If the other tests you’ve done don’t provide a clear answer, this test might be the last in the series. During this test, a sample is taken from the testicle using a needle or a little cut. Your infertility may be brought on by a blockage or another issue with sperm transport if the testicular biopsy results reveal that sperm production is normal. It is not frequently used to detect reproductive issues, though.

Idiopathic Infertility

Your doctor may use the term “idiopathic infertility” if you’ve undergone all the necessary testing and everything has come out normal. In essence, it’s a fancy way of expressing that the reason for your abnormally low sperm count or infertility is unknown at this time.

Although it won’t make your grief or frustration go away, remember that many people share your uncertainties. Idiopathic infertility affects both men and women equally and is one of the most frequent infertility diagnoses.

Cost of Male Fertility Tests

Cost of Semen Analysis on Average

The price of a semen analysis test varies by city in India. Tier-3 cities typically have the cheapest procedures and Tier-1 cities have the priciest ones. The price can vary from Rs. 70 to Rs. 4000 depending on the various factors that are tested.

The advanced test is also provided in conjunction with semen analysis by high-end, specialized clinics. Additional external elements that affect the cost of semen analysis include taxes, available space, material acquisition costs, and so on.

Cost of Hormone And Urine Analysis on Average

The price for a combined hormone and urine study ranges from Rs. 2750 to Rs. 4500 based on the different labs and localities.

Cost Of Scrotal ultrasound on Average

A scrotal ultrasound in India can cost anywhere around Rs. 550  to Rs.  2000 depending upon the lab machines, the city that you live in etc. 

Cost of Transrectal ultrasound on Average

Transrectal ultrasounds cost between 1800 and 2200 rupees. The price of a 4D Transrectal ultrasound will be between Rs. 2000 and 2500 depending upon the city. 

Cost Of Anti-sperm antibodies testing on Average

Depending on the various parameters that are tested the Anti-sperm antibodies testing  price can vary from anywhere between Rs. 800 to Rs. 1800

Cost of Genetic testing on Average

Depending on the region and laboratory, a DNA sperm test in India costs between 8,000 and 12,000 rupees. Sperm DNA fragmentation testing is one of the most accurate and important genetic tests offered by DNA Labs India, a top genetic testing facility.

Cost of Testicular Biopsy on Average

The price for a testicular biopsy in Delhi, NCR, starts at $30,000, and depending on the requirement, further tests may be done at an additional cost. Semen analysis evaluates your sperm’s amount and quality. Given the lack of lab alternatives and other facilities, the cost of a testicular biopsy in Delhi is lower than in other places.


  • Can I collect the semen specimen for the semen analysis test at home? 

Since semen has a limited shelf life, the sample must be examined quickly after collection. As a result, samples must be provided at a nearby diagnostic facility and must be examined very soon.

  • What precautions need to be taken before semen analysis test?

Before gathering the sample, several safety steps must be done. Three to four days before the sample collection, any sexual activity should be avoided. By doing this, the sperm count is ensured to be high. No lubricants should be applied because they reduce sperm motility. For at least a week before the test, abstain from alcohol and caffeine. Even if the samples come from the same person, it is necessary to submit 2-3 samples within a 2- to 3-week period because sperm counts can vary

  • My semen analysis test results aren’t normal, which other tests should I get done to  determine infertility?

If the findings of the semen analysis test are abnormal, your doctor can recommend additional testing or refer you to a urologist. This testing will reveal:

  • If there are enough viable sperm in the sample of semen (“vital staining” test)
  • If sperm cannot travel freely because antibodies have adhered to them (“antisperm antibodies” test)
  • If your semen is impacted by an infection or inflammation (“peroxidase staining” and “semen culture”)
  • Does it hurt to get a scrotum ultrasound ?

Scrotum ultrasonography is not a painless procedure, but you might feel the transducer’s pressure on the area being examined. Testicular swelling causes pain, which is caused by testicular inflammation rather than the procedure of ultrasound itself.


Tests to determine your fertility should not be delayed due to hesitation. By doing this together, you and your partner will be able to identify the problem and discover possible treatments.

Depending on your diagnosis, you might discover that you need to use resources you had no idea you possessed.

However, there are numerous alternatives for medically assisted conception. And keep in mind that many diagnoses of male infertility can be effectively treated.

Srujana Mohanty
She is the Managing Editor of Cogito137, one of India’s leading student-run science communication magazines. She's been working in scientific and medical writing and editing since 2018, also associated with the quality assurance team of scientific journal editing. Majored in Chemistry with a minor in Biology at IISER Kolkata, Srujana loves doodling and watching series.


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