Fertility Test for Men

Male fertility testing evaluates sperm quality and the hormones that control sperm production. Because causes of infertility are often multi-factorial—sperm factors, hormones, cardiometabolic health, infections, or genetics—a structured lab work-up helps you and your clinician identify what’s most actionable.

A proactive plan begins with a semen analysis to measure sperm count, movement, shape, and sample quality. Add sperm DNA fragmentation or oxidative stress tests when indicated. Pair semen testing with reproductive hormones(testosterone, LH/FSH, prolactin ± estradiol/SHBG), thyroid tests, and metabolic labs (A1c, lipids) to uncover systemic contributors. In selected cases, infectious or genetic tests (e.g., CFTR, karyotype, Y-chromosome microdeletions) are ordered by clinicians. Labs support screening, diagnostic triage, and monitoring, but they do not replace a clinician’s exam, imaging, or specialist care.

Signs, Symptoms & Related Situations

• Fertility clues

  • ≥12 months trying to conceive (≥6 months if partner ≥35), prior reproductive challenges, recurrent pregnancy loss

• Hormonal/sexual

  • Low libido, fatigue, low morning erections, reduced shaving frequency, gynecomastia

• Urogenital

  • Testicular pain/swelling, varicocele history, hernia or pelvic surgery, STIs, prostatitis symptoms

• Cardiometabolic

  • Central weight gain, high blood pressure, abnormal lipids, prediabetes/diabetes

• When to seek urgent care

  • Sudden severe testicular pain or high-riding testis (possible torsion), fever with scrotal swelling, priapism, new neurologic deficits

All symptoms and risks should be reviewed by a qualified clinician.

Why These Tests Matter

What testing can do

• Characterize semen quality (count, motility, morphology) and sample integrity

• Identify endocrine causes (low/abnormal testosterone, LH/FSH, prolactin; thyroid dysfunction)

• Reveal systemic contributors (insulin resistance, dyslipidemia, inflammation) that can impair fertility

• Track trends after risk-factor changes or clinical treatment

What testing cannot do

• Guarantee conception—results estimate probabilities, not outcomes

• Replace a full urologic evaluation, imaging (e.g., varicocele), or genetic counseling when indicated

• Provide treatment or dosing advice—use results to plan with your clinician

What These Tests Measure (at a glance)

• Semen Analysis (core): volume, pH, viscosity/liquefaction, sperm concentration, total motile count, progressive motility, morphology, vitality; reports leukocytes and agglutination. Pre-analytical factors (abstinence window, timing, temperature) strongly affect results.

• Sperm DNA Fragmentation Index (DFI): % of sperm with DNA breaks; helps explain unexplained infertility, IUI/IVF failures, or recurrent loss.

• Oxidative Stress / ROS (select labs): evaluates redox balance that can damage sperm membranes and DNA.

• Antisperm Antibodies (ASA): considered when agglutination, trauma/vasectomy reversal, or unexplained poor motility.

• Semen Culture (as indicated): for suspected infection/prostatitis.

• Hormones:

  • Total Testosterone (morning) with Free T/SHBG when borderline or SHBG is abnormal

  • LH & FSH to localize primary testicular vs. central (pituitary/hypothalamic) causes

  • Prolactin (hyperprolactinemia suppresses gonadotropins)

  • Estradiol (select cases: obesity/gynecomastia)

• Thyroid Panel: TSH ± free T4; thyroid imbalance affects libido, energy, and semen parameters.

• Metabolic Health: A1c/fasting glucose, lipid panel (± ApoB, Lp(a)), CMP, CBC—cardiometabolic disease often coexists with male factor infertility.

• Genetic (clinician-directed): karyotype, Y-chromosome microdeletions (AZF), CFTR (congenital absence of vas deferens).

Quick Build Guide

How the Testing Process Works

1. Plan the semen collection: follow written instructions. Abstinence 2–7 days is commonly recommended; collect by masturbation into a sterile cup; deliver within 1 hour at room/body temperature unless your kit says otherwise.

2. Schedule blood draws (morning for testosterone): fasting only if your order includes fasting lipids or glucose.

3. Confirm variability: semen parameters fluctuate; most clinicians request two analyses several weeks apart.

4. Review together: combine lab results with a urologic exam; add targeted tests (DFI, genetics, culture) as indicated.

5. Monitor: repeat selected labs to track changes over time or after clinical interventions.

Interpreting Results (General Guidance)

• Semen analysis: look at the pattern, not one number—total motile count (TMC) synthesizes concentration × volume × motility. Morphology adds context for fertilization potential.

• High leukocytes, positive culture, or high ROS: consider infection/inflammation context with your clinician.

• Low or borderline testosterone: repeat on a morning sample; use LH/FSH to distinguish primary vs. central causes.

• Elevated prolactin or abnormal TSH: can impair spermatogenesis and sexual function; requires clinician evaluation.

• Normal hormones with poor semen: consider structural, genetic, or oxidative factors and review with a specialist.
  Always interpret results with a qualified healthcare professional; timing, technique, and trends matter.

Choosing Panels vs. Individual Tests

• Foundational male fertility panel: Semen analysis • Morning total T • LH/FSH • Prolactin • TSH • A1c • Lipid panel • CMP • CBC

• Semen-focused add-ons: DFI • ROS • ASA • Semen culture

• Hormone refinement: Free T/SHBG • Estradiol

• Advanced/clinical add-ons: Genetic testing (karyotype, Y-microdeletions, CFTR) per clinician

FAQs

How long should I abstain before semen testing?
Most labs recommend 2–7 days. Use the same window for repeat tests to compare results.

Can fever or hot tubs affect results?
Yes. Heat and febrile illness can lower counts for weeks, since sperm production takes time.

Do I need two semen tests?
Often yes—semen quality varies, and decisions are better with two results.

What if my semen analysis is normal but we’re not conceiving?
Semen results estimate probability; consider female partner evaluation and timing with your clinician.

Do I have to fast?
Only for fasting lipids or glucose. Hormone tests don’t usually require fasting.

Is DNA fragmentation always needed?
Not always. It’s most useful for unexplained infertility, recurrent pregnancy loss, or ART planning.

When are genetics tested?
Usually when counts are very low/absent, or when anatomy/history suggests it—ordered by your clinician.

Related Categories & Key Tests

• Men’s Health Tests Hub

• Erectile Dysfunction (ED) Tests • Hormone Tests for Men • Thyroid Tests • Diabetes Health • Infection STD Tests • Genetic Disorder Tests

• Key Tests: Semen Analysis • Sperm DNA Fragmentation (DFI) • Oxidative Stress/ROS • Antisperm Antibodies • Semen Culture • Total Testosterone (AM) • Free Testosterone • SHBG • LH • FSH • Prolactin • Estradiol • TSH • Free T4 • A1c • Lipid Panel (± ApoB, Lp(a)) • CMP • CBC • CFTR • Karyotype • Y-Chromosome Microdeletions

References

• World Health Organization. Laboratory Manual for the Examination and Processing of Human Semen (latest edition).
• American Urological Association and American Society for Reproductive Medicine. Male Infertility Best Practice/Guideline.
• Endocrine Society. Testosterone Therapy in Men with Hypogonadism: Clinical Practice Guideline.
• American Thyroid Association. Thyroid Function Testing Guidance.
• American College of Cardiology/American Heart Association. Cholesterol Guideline—Risk Evaluation.
• Clinical reviews on sperm DNA fragmentation, oxidative stress, and male infertility evaluation.

Available Tests & Panels

Your Fertility Test for Men menu is pre-populated in the Ulta Lab Tests system. Start with a semen analysis and a core hormone/metabolic panel (morning testosterone, LH/FSH, prolactin, TSH, A1c, lipids, CMP, CBC). Use filters to add DFI, oxidative stress, antisperm antibodies, semen culture, or genetic tests when indicated. Follow collection instructions carefully and review results with your clinician to plan next steps.