Fertility Tests for Men
However, a man’s fertility health should not purely be based on a semen analysis as this is only one aspect and level of testing.
The following tests are most of the available fertility tests for men.
I have grouped them into 7 categories to make reading and deciding on them easier. From this list you can pick the most appropriate ones for your situation.
I suggest starting with Level 1 + 4 to get a foundational view.
If there are any issues in either of these you can continue testing through the other options as needed.
The 7 levels of mens fertility tests are:
Level 1. Semen Analysis
Level 2. Nutrient Profile
Level 3. Thyroid Panel
Level 4. Genetic Testing
Level 5. Physical Examination and/or Ultrasound Scan
Level 6. Hormone Panel
Level 7. Immunological Testing
Let’s look at each one in more detail.
A semen analysis is the most basic male fertility test that can be carried out.
Sperm health should be tested via a semen analysis every 3-6 months, and sometimes more regularly if there is a specific issue that is being treated.
It is advisable to produce the sample at the clinic where the test is being carried out, so that the sperm are as fresh and as healthy as possible before testing.
If you have a cold or other temporary illness, please postpone the test until you have fully recovered. The results may not be a true and accurate reflection of your fertility health if you have been unwell for several weeks before, or at the time of the test.
Prior to testing it is advisable to abstain from ejaculating for a period of 2-3 days. Abstaining for more than 3 days can, in many men, cause deterioration of the sperm and produce poor results.
You should also avoid drinking alcohol for at least 3-4 days in the lead up to the test.
Try to obtain as much of the following information as you can:
- Semen volume
- Semen pH
- Sperm count / concentration
- Sperm motility
- Sperm vitality % (not always recorded)
- Sperm morphology (not always provided but please request as very important)
- Sperm liquefaction time
- White blood cells or Round cells (not always carried out but better if it is)
- Antisperm antibodies
This is a basic panel of nutrient testing but it is a good starting point to ensure that poor sperm health is not being created by a lack of these vital nutrients.
Vitamin B6 – is a vitamin that is involved in many aspects of nutrient metabolism and helps to create proteins, blood cells and many other important compounds. It is also important for the immune system and stable hormone levels.
Vitamin B12 – is a vital nutrient for brain and nerve function, as well as being involved in the production of red blood cells. A diet low in red meat can create a deficiency of B12, as there aren’t many rich plant sources of it.
Folate – is a B vitamin that is involved in blood production and neural tube development, as well as having many other involvements in the body. Folate is often referred to as Folic Acid, which is the synthetic form of Folate. Folic acid should be avoided in supplements and the natural form of folate should be taken instead.
Vitamin D – is a fat-soluble steroid and is responsible for increasing the absorption of calcium, iron, magnesium, phosphate and zinc.
Manufactured in the skin by exposure to sunlight, Vitamin D3 is produced from existing cholesterol.
There are many other functions of Vitamin D and levels should be maintained throughout the year.
Zinc – is very important for development and the immune system, and lower levels are related to poor sperm health.
Ferritin – is a special protein that stores iron and tells you about the level of stored iron in your body. If this is low it indicates that there is an iron deficiency and further investigation can be carried out.
Selenium – belongs in the antioxidant category and is involved in a variety of functions. It is involved in the transformation of thyroid hormones and can decrease Hashimotos (Thyroid Auto-Immune Disease) in some cases.
Adrenal Health Profile – Although not a nutrient, it’s also a good test to consider if there is an increased experience of tiredness or coldness in the body, or if there have been elevated stress levels for any length of time.
Test for Cortisol and DHEA.
Both of these results will show how efficiently your adrenal glands are working.
The adrenals are small glands that sit on top of your kidneys. They are involved in the production of a variety of hormones and also have a connection to the thyroid gland. If the adrenal glands are tired and under-active, due to stress or long-term physical or emotional exhaustion, then it could affect sperm health until treatment has addressed the issue.
This test should be repeated once a year if it is healthy, or more often if it shows some disturbance in adrenal health.
If any of the above areas are out of balance then dietary changes should be made to adjust these levels, based on your individual health balance.
Any significant imbalance in sperm health should be followed up with a thyroid panel.
These tests are rarely carried out for men, but men are also susceptible to thyroid issues, which could have an impact on fertility.
These tests will reveal how balanced the thyroid levels are, and how your body is producing energy, which is vital to general and fertility health. It will also tell you whether there is an immune disturbance, which might also be impacting your sperm health.
The following Panel should be completed with a blood test:
TSH – this can be an initial indicator that shows that the thyroid is struggling.
Most GP’s only check this on it’s own, and don’t complete the other thyroid tests.
Basing your decisions only on this test is risky, and I would encourage you to have the full profile tested.
The TSH can show as healthy, but there can still be issues with it or an immune presentation.
T4 – is the inactive form of the thyroid hormone that must be converted to T3 for your body to use it
T3 – is the active form of thyroid hormone
Free T4 – this is not bound in the body and can show under-activity of the thyroid if it’s low
Thyroid Globulin – tells you whether there’s an immune issue
Thyroid Peroxidase – also tells you whether there’s an immune issue
Your GP or Chinese medicine practitioner should be able to guide you with this, as thyroid testing and interpreting the results are a little more complex.
This panel should be repeated once a year, if the result is normal, and more often if the result is abnormal.
I recommend doing a DNA Fragmentation test as a starting point, combined with a semen analysis.
DNA Sperm Fragmentation will show whether there is an issue with the genetic structure of the sperm that can’t be seen through a semen analysis.
Other genetic testing, as described under the female fertility test list can also be carried out if required.
Your practitioner should advise you further with this.
If there is an issue with sperm production and there are low levels of sperm, a high sperm mortality rate, or high levels of abnormally formed sperm (morphology), then a physical examination of the testicles may be required.
This will assess whether there are any varicoceles present, which are varicosed veins within the testicles. If this is the case, the varicocele can cause an obstruction to the sperm and cause damage to the production and health of the sperm.
An ultrasound scan may also be used to check this further.
If there are severe sperm health results, then further investigation can be carried out via biopsy too.
Your practitioner should advise further on this.
As with women, it’s good to test a man’s hormones if the sperm are showing any issues.
The following tests are the most important:
FSH – is Follicle Stimulating Hormone and helps to stimulate the production of your sperm
Estradiol (E2) – is a type of Estrogen, and should be checked as it counteracts the FSH. If you have an elevated level of Estradiol, you may have a decreased level of FSH and the sperm won’t receive the stimulation they need to be properly produced.
LH – is Luteinising hormone and this is a part of the Hypothalamic-Pituitary- Gonadal axis, and connects to the testes. It’s possible for there to be a deficiency of LH, which can also affect the health and ability of the testes to make sperm.
Prolactin – A hormone that can show over- activity of the Pituitary Gland – the gland that controls most hormone production, release and activity. Elevated levels of prolactin will show whether there is an issue here.
Testosterone – this is tested for a variety of reasons and is a good indicator of possible adrenal deficiency or fatigue. It is also linked to sexual arousal and libido levels.
Immunological testing is not commonly carried out for men.
MTHFR is the main area that I would suggest considering to be sure that there is no deeper nutrient transformation issue presenting itself. MTHFR is also connected to the amount of T-cells that we make and so is strongly connected to the immune system.
Your practitioner should advise further on this.
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