Male Fertility Testing

It’s not uncommon to face challenges and complications when trying to conceive. This deeply personal experience can be emotionally difficult, fraught with frustration, sadness, and disappointment as you Male fertility is simply defined as the ability to impregnate his partner. To truly understand male fertility and how it's evaluated, it's important to understand how the male reproductive system works.

Male Fertility, Explained

Male fertility is defined by the ability to impregnate, which is ultimately dependent on the ability to produce a normal quantity of healthy sperm.

Unlike the female reproductive system, the male reproductive system is predominantly external. The external male sex organs are the penis, testicles, scrotum, and epididymis, which together perform the main mechanisms behind the production, storage, and ejection of sperm. The male reproductive system also consists of several important internal organs that support semen production and transportation.

The testicles are the male equivalent of the ovaries in that they are two oval-shaped glands that are responsible for producing sperm and testosterone (the primary male sex hormone). The testicles are nested in a sac-like organ called the scrotum, which not only protects the testicles, but also regulates their temperature and ensures that they are cooler than the rest of the body. After being created, sperm cells are transferred to the epididymis for storage so that they can develop, mature, and “learn” how to swim. From creation to full maturation, the entire process takes about 74 days. Every day, the testicles produce several million sperms.

When sexually stimulated, the sperm is forced out of the epididymis and into the vas deferens, which is a long tube that transports the sperm to the urethra. At this time, the sperm is mixed with seminal fluid, which is a whitish substance produced by the seminal vesicles and prostate gland. Once in the urethra, the sperm is ejaculated through the penis. 

In a traditional pregnancy, sperm ejaculated from the penis will journey from the vagina through the cervix, to the uterus, and finally, to the fallopian tubes, which is where the sperm can potentially fertilize an egg. Getting from point A to B is strenuous for the sperm – the vast majority do not survive the journey. Although men can produce about 250 million sperm in an average semen sample, only about 200 will actually ever reach the egg.

Definition of Healthy Semen Sample

For men to have a chance of successfully impregnating someone, they need to be able to produce a healthy semen sample. A healthy semen sample is defined not just by the number of sperm present in the sample, but also by the sperm’s overall motility (ability to move or swim) and morphology (the shape of the sperm). 

Ideally, a healthy semen sample will have a volume of 15 million or more sperm per milliliter of semen. The more sperm a patient has, the more likely one of them will make it to the fallopian tubes to fertilize an egg. It’s also important that at least 40% of these sperm are actively motile and able to swim effectively. Lastly, the vast majority of sperm in a given sample must have a normal shape, consisting of a rounded head and long tail. Sperm that are misshapen or have other morphological abnormalities are less likely to successfully complete the journey, much less penetrate an egg.

Although men are sometimes able to continue producing sperm well into older ages, male fertility does begin to decline after the age of 35. Not only does sperm count become lower, but the sperm themselves are also more likely to have motility problems, abnormal morphology, and DNA fragmentation (when one or both of the DNA strands contained in the sperm are fractured or broken).

Take control of your fertility journey with Prelude. Schedule a male fertility evaluation at one of our fertility clinics.

Types of Sperm Disorders

There are a number of sperm disorders that can make it difficult for a man to impregnate someone:

• Azoospermia: no sperm present in the ejaculate
• Oligospermia: a low sperm count
• Hypospermia: a low volume of semen
• Hyperspermia: an abnormally high volume of semen
• Polyzoospermia: an abnormally high concentration of sperm
• Asthenozoospermia: reduced or poor sperm motility
• Teratozoospermia: a high number of sperm with abnormal morphology
• Necrozoospermia: the presence of dead sperm in the ejaculate

Causes of Male Infertility

Just like with women, there are many factors that can cause or increase the likelihood of having male infertility. Some of these factors include:

• Hormonal imbalances
• Tumors (both benign and malignant)
• Underlying conditions that impair the function of the male reproductive system
• Varicocele, a condition in which the scrotal veins swell
• Structural abnormalities of the male reproductive organs
• Genetic conditions, such as Klinefelter’s Syndrome
• Some medical treatments (e.g. radiation, chemotherapy, etc.)
• Obesity
• Excessive or extreme physical activity
• Smoking and using other tobacco products
• Substance use, including alcohol, recreational steroids, and marijuana
• Exposure to certain pollutants and toxins
• Problems with antibodies attacking sperm
• Overheating of the testicles

How Male Fertility Is Evaluated

Male fertility is evaluated primarily through a diagnostic semen analysis, which is a simple, non-invasive procedure. 

First, before producing the sample, patients must abstain from all forms of ejaculation for two to seven days. Next, the patient collects a semen sample, either by masturbating into a sterile container or using a special condom designed specifically for semen collection. Patients often do this in a private room at their fertility clinic, but sometimes they have the option of doing it at home. In either case, it’s important that the patient provide the clinic with the fresh semen sample within an hour of producing it.

Once the clinic has the semen sample, they will prepare it for analysis using a technique known as sperm washing. Sperm washing is the process of separating the sperm from the seminal fluid to create a super-concentrated sample.

The semen sample will then be evaluated for several factors:

• Sperm volume
• Sperm concentration
• Sperm motility
• Sperm morphology
• Semen pH level
• The presence of white blood cells
• The percentage of live sperm

In addition to semen analysis, fertility doctors will sometimes also order blood tests, hormone panels, and genetic testing to fully investigate a case of male infertility. Testing for DNA fragmentation may also be recommended, especially in cases of recurrent pregnancy loss, which can sometimes be caused by high levels of DNA fragmentation in sperm.