Infertility for Men

Male infertility testing evaluates sperm quality and the hormones and health factors that control sperm production and delivery. Because male factor contributes to about half of infertility cases in couples, a structured, lab-first approachhelps you and your clinician find what’s most actionable—often within weeks.

Start with a semen analysis to measure sperm count, movement, and shape, then layer sperm DNA fragmentation(DFI) or oxidative stress if prior tests are borderline or unexplained infertility persists. Add reproductive hormones(total testosterone, free T/SHBG, LH/FSH, prolactin ± estradiol), thyroid (TSH), and metabolic labs (A1c, lipids, CMP, CBC) to uncover systemic contributors. In selected cases, infection or genetic tests (e.g., CFTR, karyotype, Y-chromosome microdeletions) are appropriate.

Testing supports screeningdiagnostic triage, and monitoring, but it does not replace a clinician’s exam, imaging (e.g., scrotal ultrasound for varicocele), or genetic counseling. If you are trying to conceive, note that testosterone therapy (TRT) can suppress sperm production—discuss alternatives before starting.

Signs, Symptoms & Related Situations

  • Fertility clues

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

  • Sexual/hormonal

    • Low libido, fewer morning erections, erectile difficulties, gynecomastia, fatigue, depressed mood

  • Urologic history

    • Testicular trauma, undescended testis, hernia/inguinal surgery, infections (epididymitis/prostatitis), known or suspected varicocele

  • Lifestyle/medical factors

    • Central weight gain, diabetes/prediabetes, abnormal lipids, heat exposure (hot tubs/saunas), febrile illness, tobacco/cannabis, heavy alcohol, anabolic steroids, opioids, chemo/radiation

  • When to seek urgent care

    • Sudden severe testicular pain or a 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, total motile count) and sample integrity

  • Identify endocrine/systemic contributors (testosterone/LH/FSH, prolactin, thyroid, insulin resistance, dyslipidemia)

  • Reveal specific causes in select cases (infection or genetic factors)

  • Track trends after lifestyle or clinical interventions

What testing cannot do

  • Diagnose infertility from one result—semen parameters vary; most pathways use two analyses

  • Replace a full urologic evaluation, imaging, or genetic counseling when indicated

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

What These Tests Measure (at a glance)

  • Semen Analysis (core): volume, pH, liquefaction/viscosity, sperm concentrationtotal motile count (TMC)progressive motilitymorphologyvitalityleukocytes/agglutinationPre-analytical factors (2–7 days abstinence, timely delivery at body temperature) strongly affect results.

  • Sperm DNA Fragmentation Index (DFI): % of sperm with DNA breaks; useful for unexplained infertility, recurrent loss, or ART decision-making.

  • Oxidative Stress / Reactive Oxygen Species (ROS): redox status that can impair membranes and DNA.

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

  • Semen Culture (as indicated): evaluates infectious contributors when prostatitis or leukocytospermia is suspected.

  • Hormones:

    • Total Testosterone (morning) and Free T/SHBG (bioavailable T context)

    • LH & FSH (primary testicular vs. central pattern)

    • Prolactin (hyperprolactinemia suppresses gonadotropins)

    • Estradiol (sensitive) in select cases (obesity/gynecomastia)

  • Thyroid & Metabolic Health: TSH ± free T4A1c/fasting glucoselipid panel (± ApoB, Lp[a])CMPCBCVitamin D

  • Infection Screens (history-based): STI NAATs (e.g., chlamydia/gonorrhea), HIV 4th-generationsyphilishepatitis B/C

  • Genetic (clinician-directed): KaryotypeY-chromosome microdeletions (AZF)CFTR (congenital absence of vas deferens)

Quick Build Guide

Clinical goal Start with Add if needed
Initial male infertility work-up Semen analysis (1–2 tests) • AM Total T • LH/FSH • Prolactin • TSH • A1c • Lipid panel • CMP • CBC Free T/SHBG • Estradiol (sensitive) • Vitamin D
Abnormal/borderline semen Repeat semen analysis (same abstinence window) DFI • ROS • ASA • Semen culture
Endocrine pattern suspected AM Total T • LH/FSH • Prolactin • TSH Free T/SHBG • Estradiol (sensitive)
Unexplained infertility or ART planning Semen analysis + DFI Genetic tests (karyotype, Y-microdeletions, CFTR) per clinician
Infection risk STI NAATs Semen culture • Urinalysis
Metabolic contributors A1c • Lipids • CMP • CBC ApoB • Lp(a) • Vitamin D

How the Testing Process Works

  1. Plan semen collection: abstain 2–7 days; collect by masturbation into a sterile cup; deliver within 1 hour at room/body temperature; avoid lubricants and condoms unless collection device is approved.

  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. Layer targeted tests: add DFI/ROS, ASA, culture, hormones, thyroid/metabolic, or genetics based on findings.

  5. Review together: combine labs with a urologic exam; consider scrotal ultrasound or referral as indicated.

Interpreting Results (General Guidance)

  • Semen analysis: emphasize TMC (concentration × volume × motility) plus progressive motility and morphology.

  • High leukocytes or positive culture: infection/inflammation context—re-test after management per clinician.

  • Low or borderline testosterone: repeat morning total T; 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 structuralgenetic, or oxidative factors and specialist review.
    Interpret all results with a qualified healthcare professional; timing, technique, and trends matter.

Choosing Panels vs. Individual Tests

  • Foundational male infertility panel: Semen analysis • AM 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 (sensitive)

  • Advanced/clinical add-ons: Genetic testing (karyotype, Y-microdeletions, CFTR) per clinician
    Choose bundled panels for efficiency and consistent trending; add individual tests to answer specific questions.

FAQs

How long should I abstain before a semen test?
Most labs recommend 2–7 days; use the same window for repeat tests.

Do I need more than one semen analysis?
Often yes—semen quality varies; decisions are better with two results.

Can fever, hot tubs, or cycling affect results?
Yes. Heat and febrile illness can lower counts for weeks; very vigorous cycling may elevate PSA/affect comfort.

Will TRT help fertility?
No—testosterone therapy can suppress sperm production. Discuss alternatives if you’re trying to conceive.

What if my semen is normal but we’re not conceiving?
Semen results estimate probability; consider female partner evaluation, timing, and DFI/genetic testing when indicated.

Do I have to fast?
Only if your order includes fasting lipids or fasting glucose.

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

Related Test Categories & Key Tests

  • Pregnancy & Fertility Tests Hub

  • Fertility Test for Men • Men’s Hormone Health Tests • Low T and Testosterone Replacement Therapy (TRT) • 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 (sensitive) • TSH • Free T4 • A1c • Lipid Panel (± ApoB, Lp[a]) • CMP • CBC • Vitamin D • STI NAATs • HIV 4th-gen • Syphilis • Hepatitis B/C • Karyotype • Y-Chromosome Microdeletions • CFTR

References

  • World Health Organization. Laboratory Manual for the Examination and Processing of Human Semen (latest edition).
  • American Urological Association & American Society for Reproductive Medicine. Male Infertility: Best Practice Statement/Guideline.
  • American Society for Reproductive Medicine. Diagnostic evaluation of the infertile male.
  • Endocrine Society. Testosterone Therapy and 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 genetic testing in severe oligospermia/azoospermia.

Available Tests & Panels

Your Male Infertility Tests menu is pre-populated in the Ulta Lab Tests system. Start with a semen analysis and a core hormone/metabolic panel (AM testosterone, LH/FSH, prolactin, TSH, A1c, lipids, CMP, CBC). Use filters to add DFIoxidative stressantisperm antibodiessemen culture, or genetic tests as indicated. Follow collection instructions carefully and review results with your clinician to plan imaging, referrals, and a monitoring schedule.

  • Page
  • 1
  • of
  • 1
  • Total Rows
  • 17
Name Matches

The 17-Hydroxyprogesterone (17-OHP) Test measures levels of 17-OHP, a hormone made by the adrenal glands, to help diagnose congenital adrenal hyperplasia (CAH) and other adrenal disorders. Elevated levels may indicate enzyme deficiencies affecting cortisol production, while low levels can suggest adrenal insufficiency. Doctors order this test for infants with ambiguous genitalia or adults with irregular periods, infertility, or abnormal androgen symptoms.

Blood
Blood Draw
Also Known As: 17-OHP Test, 17-OH Progesterone Test

The Male Anti-Mullerian Hormone (AMH) Test measures AMH levels in blood to assess testicular function, fertility, and hormone balance. In men, AMH is produced by Sertoli cells and plays a role in reproductive development. Doctors use this test to evaluate sperm production, investigate infertility, or assess disorders of sexual development. Results provide key insight into reproductive health, testicular activity, and overall endocrine function.

Blood
Blood Draw
Also Known As: Anti-Mullerian Hormone Test, Mullerian-Inhibiting Hormone Test

Blood
Blood Draw

Most Popular

The Estradiol (E2) Test measures levels of estradiol, the primary form of estrogen, to evaluate reproductive and hormonal health. It helps assess menstrual irregularities, fertility issues, menopause status, and estrogen-producing disorders. In men, it aids in diagnosing hormonal imbalances. Doctors use the estradiol test to monitor hormone therapy, ovarian function, and conditions affecting puberty, bone health, and overall endocrine balance.

Blood
Blood Draw
Also Known As: E2 Test, Estrogen 2 Test

The Estrogen Total Test measures all forms of estrogen in blood, including estradiol, estrone, and estriol, to assess reproductive and hormonal health. Abnormal levels may indicate menstrual irregularities, menopause status, infertility, or hormone-related disorders. Doctors order this test to evaluate fertility, monitor hormone therapy, and investigate symptoms such as hot flashes, irregular cycles, or abnormal bleeding. It provides key insight into endocrine and reproductive function.

Blood
Blood Draw
Also Known As: Total Estrogen Test, Estrogen Serum Test

Most Popular

The Follicle-Stimulating Hormone (FSH) Test measures FSH levels to evaluate reproductive and endocrine health in both men and women. In women, it helps assess infertility, irregular periods, menopause, or ovarian function. In men, it is used to check sperm production and testicular function. Abnormal results may indicate PCOS, pituitary disorders, or hormonal imbalance. Doctors order this test to guide fertility treatment, hormone therapy, and overall reproductive care.

Blood
Blood Draw
Also Known As: Follicle Stimulating Hormone Test, Follitropin Test

Most Popular

The FSH and LH Test measures follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to evaluate reproductive and endocrine health in both men and women. In women, it helps assess menstrual irregularities, infertility, menopause, or polycystic ovary syndrome (PCOS). In men, it aids in diagnosing low testosterone, infertility, or testicular dysfunction. Doctors also use this test to investigate puberty disorders, hormone imbalance, and pituitary function.

Also Known As: Follitropin Test, Lutropin Test, Interstitial Cell Stimulating Hormone Test, ICSH Test

Most Popular

The LH Test measures luteinizing hormone levels in blood to assess fertility, reproductive health, and endocrine function. Abnormal LH may indicate infertility, menstrual irregularities, menopause, or pituitary disorders in women, and low testosterone or testicular dysfunction in men. Doctors use this test to evaluate ovulation, investigate infertility, monitor puberty disorders, or guide hormone therapy. It provides key insight into reproductive and hormonal balance.

Blood
Blood Draw
Also Known As: Luteinizing Hormone Test, Lutropin Test, Interstitial Cell Stimulating Hormone Test, ICSH Test

The Post-Vasectomy Spermatozoa Qualitative Test checks for the presence of sperm in semen after a vasectomy to confirm the success of the procedure. This post-vasectomy semen analysis is essential to ensure sterility, verify the effectiveness of surgery, and reduce the risk of unintended pregnancy. Doctors use this sperm test to confirm no live sperm remain, providing patients confidence in their vasectomy results and long-term reproductive planning.

Varied
Phlebotomist
Also Known As: Semen Analysis, Spermatozoa Test, Post-Vasectomy Test, Semen Test

Most Popular

The Progesterone Test measures progesterone levels in blood to evaluate ovulation, fertility, and menstrual health. It helps confirm whether ovulation has occurred, assess causes of infertility, and monitor hormone therapy or high-risk pregnancies. Doctors also use it to investigate abnormal bleeding, detect ovarian or adrenal disorders, and evaluate miscarriage risk. This test provides key insight into reproductive, hormonal, and overall endocrine health.

Blood
Blood Draw
Also Known As: PGSN Test

Most Popular

The Prolactin Test measures prolactin, a hormone produced by the pituitary gland, to assess reproductive and endocrine health. High prolactin (hyperprolactinemia) may cause infertility, irregular periods, or milk production in women and low testosterone, erectile dysfunction, or infertility in men. Doctors use this test to evaluate pituitary tumors, hormonal imbalance, or unexplained symptoms such as headaches, vision changes, or abnormal lactation.

Blood
Blood Draw
Also Known As: PRL Test

The Prolactin, Dilution Study measures prolactin levels using dilution techniques to correct assay interference. This test improves accuracy when unusually high prolactin is present, distinguishing genuine hyperprolactinemia from laboratory artifact. It aids in evaluating pituitary adenomas, reproductive hormone imbalance, infertility, and endocrine-related disorders with reliable, clinically useful results.

Blood
Blood Draw
Also Known As: Prolactin Dilution Study

The Sex Hormone Binding Globulin (SHBG) Test measures SHBG, a protein that binds testosterone and estrogen, to assess how much active hormone is available in the body. Abnormal levels may indicate PCOS, infertility, low testosterone, liver disease, or thyroid disorders. Doctors order this test to investigate symptoms like low libido, irregular periods, acne, or hair loss and to evaluate hormone balance, endocrine function, and metabolic health in men and women.

Blood
Blood Draw
Also Known As: SHBG Test, TeBG Test, Testosterone-Estrogen Binding Globulin Test

The Testosterone Free and Total Test measures total testosterone and free, bioavailable testosterone in blood for both men and women. It helps diagnose hormone imbalance, infertility, low libido, erectile dysfunction in men, irregular periods, or PCOS in women. Doctors also order it to assess fatigue, mood changes, or muscle weakness and to monitor hormone therapy. This test provides key insight into reproductive, endocrine, and overall metabolic health.

Blood
Blood Draw
Also Known As: Bound and Unbound Testosterone, Uncapped Testosterone Test

The Testosterone Free, Bioavailable, and Total Test measures total testosterone, free testosterone, and bioavailable testosterone, along with sex hormone binding globulin (SHBG) and albumin. This test provides a complete evaluation of hormone balance in men and women. Doctors use it to assess infertility, erectile dysfunction, low libido, PCOS, fatigue, or muscle loss and to monitor hormone therapy. Results offer key insight into reproductive, endocrine, and metabolic health.

Blood
Blood Draw
Also Known As: Bound Unbound and Bioavailable Testosterone with SHBG Test, Uncapped Testosterone

The Testosterone Free and Total and Sex Hormone Binding Globulin (SHBG) Test measures total testosterone, free testosterone, and SHBG to assess hormone balance in men and women. It helps diagnose infertility, erectile dysfunction, low libido, irregular periods, PCOS, and abnormal puberty. Doctors also use it to evaluate fatigue, muscle weakness, or mood changes and to monitor hormone therapy. This test provides a comprehensive view of reproductive, endocrine, and metabolic health.

Also Known As: Bound and Unbound Testosterone with SHBG Test, Uncapped Testosterone Test

The Testosterone Total Male Test measures testosterone levels in men to assess reproductive, sexual, and hormonal health. It helps diagnose low testosterone (hypogonadism), infertility, and erectile dysfunction. Doctors use it to evaluate fatigue, muscle loss, or low libido and to monitor testosterone therapy, hormonal balance, bone health, and overall metabolism.

Patient must be male and 18 years of age or older.
Blood
Blood Draw
Also Known As: Total Male Testosterone Test

As they say, it takes two to tango. Fertility is a 50-50 deal. It takes an egg and a sperm. So when it comes to fertility, it should be no shock that about 50% of infertility challenges come from the man. This means it is your responsibility to familiarise yourself with male infertility tests.

This is not about placing blame, but if you and your partner are struggling to get pregnant, both of you must get infertility tests. Here are the seven things you need to know about male fertility tests. 

Factors That Can Affect Male Fertility

Research shows that male infertility affects up to 6 percent of American Men. The exact causes of any individual case of male infertility are varied;

  • genetic or anatomical abnormalities
  • neurological and systemic diseases
  • trauma
  • infection
  • sperm antibodies
  • gonadotoxic radiation therapy

Get an Evaluation From a Urologist

The first step is getting an evaluation from a urologist. A urologist is a doctor who specializes in the kidney, urinary bladder, adrenal glands, urethra, and male reproductive organs (collectively known as the genitourinary tract). This doctor is a specialist in male fertility.

Your urologist will ask you questions about your lifestyle and medical history. Common questions will be about surgeries you have had, medications you take, your exercise and diet habits, and whether or not you smoke or take drugs. 

You can also expect a frank discussion about your sex life, including if you have ever had any sexually transmitted diseases.

Finding the cause of male infertility can be challenging. Urologists have several different infertility tests for men they will use to solve the issue.

Sperm and Semen Analysis

You will be asked to provide a semen sample for analysis. An analyst will check the sample for sperm count, shape, movement, and other important characteristics. 

Normal sperm densities range from 15 million to more than 200 million sperm per milliliter of semen. If you have a sperm count in this range, with normally shaped sperm, you likely have higher fertility. 

However, there are exceptions. About 15% of infertile men have a normal sperm count. 

It is not uncommon for your doctor to order two semen tests, even if the first analysis is normal, just to confirm the results. Two normal tests most likely mean you do not have any major infertility problems.

If there is something in your test that is unusual your doctor will undertake more tests to find the issue. 

In some cases, tests may show that you have no sperm in your semen or no semen at all. This can be caused by a blockage that can be fixed with surgery. 

Physical Exam and Imaging

A sperm analysis is only one of many types of male infertility tests. Your urologist will conduct a physical exam, including both a genital exam and a digital rectal exam, to assess your prostate. Your doctor will be looking for varicoceles, abnormal formations of veins above the testicles.

Your doctor may also order imaging studies to ensure your anatomy is fine. 

Most common are the scrotal ultrasound and the transrectal ultrasound.

In a scrotal ultrasound, a handheld probe is swept across your scrotum. This scan uses high-frequency waves to identify infections, cysts, collections of fluid, and tumors. 

For a transrectal ultrasound, a small, lubricated wand is inserted into your rectum. This helps your doctor check your prostate and ensure there are no blockages in the vas deferens.

They will evaluate all elements of the genitourinary system. Any issues that are found are likely to be easily resolved with surgery.  

Hormone Evaluation

Testosterone and other hormones control the making of the sperm. However, only about 3% of infertility problems in men are caused by hormone issues. 

Your doctor may still order hormone infertility tests for males just to be sure. Hormone tests are easily done with a simple blood test. Your doctor will likely be evaluating the following hormones;

The FSH hormone contributes to sperm production. High levels could indicate that your testicles are not working correctly, likely due to being damaged by disease, chemotherapy, or x-rays. Low levels show you aren't producing any sperm.

The LH hormone is produced in the pituitary gland and binds to receptors in the testes to release testosterone, which is needed to produce sperm. Testing for LH helps the doctor identify if the issue is in your pituitary gland or another part of the body.

A healthy male will have testosterone levels between 300 and 1,000 nanograms per deciliter. If your testosterone levels are low, this could be the cause of a lower sperm count.  

Genetic Testing

Genetic testing for male fertility is relatively new, and experts differ on if genetic tests should be done. That said, genetic issues are found in between 10 and 20% of men who have sperm production disorders. 

Genetic testing helps rule out chromosomal abnormalities. This is especially important in men with either azoospermia, which is no sperm present, or oligozoospermia, a very low sperm count. 

These tests will help you avoid unnecessary surgery or medical treatments and help make an informed decision on the next step.

Anti-Sperm Antibodies

Sperm typically stays isolated from the rest of your body, and if it does come into contact with your body the immune system is likely to have an immune response, producing anti-sperm antibodies. 

Sperm is only likely to come into contact with the body due to a prior injury, surgery or trauma. 

To test for anti-sperm antibodies requires a sperm sample. The higher the level of sperm affected by antibodies, the lower the chance of a sperm fertilizing an egg.

The anti-sperm antibodies can also be found in women so, it is possible your doctor will ask your partner to get checked also.

Getting Male Infertility Tests

If you and your partner are struggling to get pregnant, you should visit your doctor and urologist to find the cause. Remember that men are responsible for about 50% of infertility challenges. Just know that finding the cause of male infertility can be a complex process and can take several male infertility tests.

Ulta Lab Tests offers tests that are highly accurate and reliable so you can make informed decisions about your health. Here are a few great things to love about Ulta Lab Tests:

- You'll get secure and confidential results
- You don't need health insurance
- You don't need a physician's referral
- You'll get affordable pricing
- We offer a 100% satisfaction guarantee

Order your lab tests for infertility today and your results will be provided to you securely and confidentially online in 24 to 48 hours for most tests.

Take control with Ulta Lab Tests today!