What to test, when to test
Advanced male fertility testing can provide valuable insights beyond a standard semen analysis, particularly for individuals facing challenges with conception or recurrent IVF failures.
When should you consider male fertility tests, and what tests could be required?
When it comes to fertility there is no one size fits all approach and deciding when to pursue additional male fertility testing can pose a significant challenge. Yet, the more comprehensive your understanding of both partners' reproductive health, the better equipped you'll be to make informed decisions regarding treatment options.
Difficulty Conceiving
If a couple has been actively trying to conceive for at least a year (or six months if the woman is over 35) without success, it may be time to explore potential fertility issues, including those related to male factors.
Recurrent pregnancy loss
If a couple has experienced two or more miscarriages, it's important to investigate potential causes, including male factor through advanced testing.
Abnormal semen analysis results
If a standard semen analysis reveals abnormalities in sperm count, motility, or morphology, further testing may be warranted to identify underlying issues contributing to these abnormalities. However, it must not be forgotten that men with a normal semen analysis can still have other abnormalities in their sperm that are impacting fertility.
Prior failed IVF cycles
If a couple has undergone multiple failed IVF cycles despite apparently normal semen parameters, advanced male fertility testing can help uncover potential factors contributing to treatment failure.
History of testicular trauma / surgery
Men with a history of testicular trauma, surgery (such as vasectomy reversal), or medical conditions affecting the reproductive organs may benefit from advanced testing to assess sperm quality and fertility potential.
Exposure to environmental toxins
Occupational exposures to toxins, chemicals, heat or radiation can negatively impact sperm quality and fertility. If a man has been exposed to such factors, it may be advisable to undergo advanced fertility testing to assess any potential effects on reproductive health.
Age
While female age is often emphasized in discussions of fertility, advanced paternal age can also affect sperm quality and fertility. Men over the age of 40 may consider advanced fertility testing, especially if they are attempting to conceive with a partner of similar age.
Underlying medical conditions
Certain medical conditions, such as diabetes, hormonal imbalances, or genetic disorders, can affect male fertility. Men with such conditions may benefit from advanced testing to assess their reproductive health and identify any potential barriers to fertility.
Got Questions?
In general, if a couple are having trouble conceiving or have concerns about male fertility, consulting with a fertility specialist or reproductive endocrinologist can help determine if further testing is necessary and which specific tests may be most appropriate based on the individual's medical history and circumstances.
Sperm DNA fragmentation analysis
This test evaluates the integrity of the DNA within the sperm. High levels of DNA fragmentation can impair fertility and increase the risk of miscarriage and IVF / ICSI failure. It's especially indicated for couples experiencing unexplained infertility, recurrent pregnancy loss or repeated IVF / ICSI failure.
Oxidative stress
Oxidative stress plays a pivotal role in male fertility, serving as a significant factor affecting both health and reproductive capabilities. It arises from an imbalance between the production of reactive oxygen species (ROS) and the body's capacity to counteract them with antioxidants.
Varicocele
Varicocele is a common condition characterised by the enlargement of veins within the scrotum. It is more common on the left side but can affect both sides. Varicoceles develop when the valves within the veins that regulate blood flow become weakened or dysfunctional, causing blood to pool and the veins to swell.
Sperm Vitality Testing
This test determines the percentage of live sperm cells in a semen sample. While a standard semen analysis provides information on sperm count and motility, vitality testing can identify non-motile but still viable sperm, which may be suitable for assisted reproductive techniques.
Testicular ultrasound
This test is a non-invasive imaging test that uses sound waves to create images of the testicles and surrounding tissues. It can be a valuable tool in evaluating male fertility, as it can provide information about the size, structure, and blood flow to the testicles.
Testicular Biopsy
In cases of severe male factor infertility or suspected testicular dysfunction, a testicular biopsy may be performed to evaluate the quality and quantity of sperm production within the testes. This procedure is typically done by a urologist.
Hormonal Evaluation
Hormonal imbalances can affect sperm production and function. Blood tests to measure hormone levels, such as testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin, may provide insights into potential underlying causes of male infertility.
Genetic Testing
Genetic abnormalities, such as chromosomal anomalies or mutations in genes related to sperm production or function, can contribute to male infertility. Genetic testing may be recommended, especially if there is a family history of genetic disorders or if other fertility tests are inconclusive.
Semen culture
Used to identify infections in the male reproductive system by detecting the presence of bacteria, fungi, or other microorganisms in a semen sample. This test is performed when a man exhibits symptoms of genital infections, such as pain, inflammation, or abnormal discharge, or in cases of infertility where an infection may be suspected. Not all men with an infection will have symptoms but it may still impact their fertility through oxidative stress and DNA fragmentation.
Debunking fertility myths
True or false?
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False – Obesity plays a significant role in a man’s fertility through oxidative stress, heat stress, DNA fragmentation and hormonal imbalances.
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False – Evidence has shown that although the true mechanism isn’t understood exposure to electromagnetic fields can impact sperm quality
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True – Sitting for long periods of time will negatively affect your sperm health through a number of mechanisms.
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True – It is now well researched that plastics in our environment and food chain are impacting men’s hormones and their fertility.
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True – The testicles are outside the body for a reason, that is to keep them a bit cooler than core body temperature. High temperatures damage sperm.
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True and false – Some caffeine is ok for you but too much can be detrimental to your fertility.
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True – Although men produce millions of sperm per ejaculation only around 200 will make it all the way to the egg. This is why it’s about numbers as well as quality
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False – Whilst it may increase your semen volume the quality of sperm will decline if it is stored up for too long. Men should be ejaculating every 2 -3 days.
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False – Men experience changes in many aspects of their health as they age including their fertility.
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Fertility does decline faster in women due to the aging of eggs, while men may retain fertility longer, though quality can decline.
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While genetics play a role in fertility, environmental factors, lifestyle choices, and health conditions also significantly impact fertility.
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While men can father children later in life, advanced age can affect sperm quality and fertility.
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Fertility treatments can increase the chances of conception in some cases, but they do not guarantee pregnancy, as success rates vary.
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Moderate exercise is beneficial for overall health and can support fertility. However, excessive exercise may have the opposite effect.
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Excessive heat exposure, such as from hot baths or saunas, can negatively affect male fertility by impacting sperm production.
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Infertility can affect both men and women. Male factors contribute to infertility in about 30-40% of cases.
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Stress can indeed affect fertility. High levels of stress may disrupt hormonal balance and sperm production
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FAQ
Still have questions about further testing? Check out the FAQ’s.
Further tests should be considered if any of the above situations apply to you. However, it's worth considering them even before embarking on fertility treatment. While it's typical for advanced tests to be considered only after experiencing multiple treatment setbacks or losses, we believe they should be considered even before commencing fertility treatments, especially if you've encountered delays along the way.
The cost of additional male fertility tests can vary widely depending on several factors, including the specific tests ordered, the location and type of healthcare provider performing the tests, whether the tests are covered by insurance, and any associated consultation fees. In general, advanced male fertility tests range from a few hundred pounds to around one thousand pounds per test. It's important to check with your healthcare provider or fertility clinic to get an accurate estimate of the costs involved, including any potential additional fees for consultations or interpretation of test results.
IVF / ICSI can certainly be effective for many couples facing infertility and can bypass certain fertility issues, but it doesn't address the underlying causes especially when it comes to male infertility. Advanced male fertility tests can help identify specific issues with sperm quality or other factors that may impact your chances of success and they may help you identify a treatable cause. Many causes of male infertility can be treated to improve sperm quality ahead of fertility treatment or even allow for conception to occur naturally so it is something that should be strongly considered before going ahead with fertility treatments.
You can get additional male fertility tests done at various healthcare facilities such as urology clinics, fertility clinics, reproductive endocrinology clinics, hospitals, and diagnostic imaging centres. These facilities offer comprehensive testing services, including advanced tests like testicular ultrasound, to evaluate male fertility issues. It's important to choose a reputable provider with expertise in male infertility evaluation and treatment. We have a network of clinics and clinicians where you can access some if not all of these tests.
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