Check your fertility status

Fertility Tests for Men

Everyone’s fertility journey is different. Ask your doctor or fertility team in the clinic about their roles and how they will be supporting you.
Your fertility and sex life can be sensitive topics, and it’s important that you feel comfortable addressing any concerns or questions that you might have. Make sure that you choose a specialist you feel at ease having these conversations with.

What Do Fertility
Doctors Test For?

Your fertility doctor will check that you have:

The right balance of hormones for
sperm to develop

Good quality and quantity of sperm

A healthy, functioning reproductive
tract

Unblocked sperm ducts

Your fertility team will perform any tests that you require. This team is made up of a range of doctors and fertility nurses, which may change depending on the support and treatments that you need. Sometimes, they’ll work together in the same fertility clinic. Other times, you may need to visit specialists at other clinics or hospitals.

When first seeking fertility help, you will typically begin with your family doctor who can perform some basic examinations and blood or urine tests. You may then be referred to a male reproductive specialist (urologist or andrologist), or directly to a fertility clinic, for further tests or treatments.
Check your fertility status

Preliminary Tests

Personal history

You will be asked about your medical history and sex life in detail13. If you feel uncomfortable discussing certain subjects in front of your partner, you can speak with your doctor in private.

Physical exam

Your doctor will usually examine your penis, testicles and prostate gland (via your rectum) to check for any abnormalities14. They will also be looking for varicose veins around your scrotum (varicoceles) which can affect your fertility. They will also check that your sperm ducts (epididymis and vas deferens) are present and intact.

Blood and urine tests

You may be tested for rubella (German measles), hepatitis B and C and human immunodeficiency virus (HIV)15. Depending on your heritage, you may also be tested for diseases or disorders that are more common amongst certain ethnic groups, such as sickle cell anaemia or thalassaemia.

Semen analysis

You may be asked by your doctor to provide a semen sample. This sample can be collected either by masturbating at home or at your clinic. The quality and volume of semen will be tested, including sperm count, concentration, movement (motility), size and shape (morphology) of your sperm16.

Testicular biopsy

A testicular biopsy may be performed if no sperm have been seen in your semen sample17. You will be given an anaesthetic and your doctor will remove a small sample of tissue from one of your testicles. This sample will be tested to see if it contains any sperm that can be used in fertility treatment.

More Advanced
Fertility Tests

Ultrasound scan (transscrotal ultrasound)

This scan will show any blockages or varicoceles around your testicles or sperm ducts that may be causing fertility issues18. Your doctor will pass a small device back and forth over your scrotum to pick up soundwaves, which are converted into an image. The transscrotal ultrasound is non-invasive and painless.

Transrectal ultrasound

This scan shows a more thorough overview of your prostate, the glands which produce your semen (seminal vesicles), and the sperm duct which carries sperm from your testicles to your urethra (vas deferens)19. Your doctor will insert a thin probe into your rectum while you lie on your side. Most men find this painless, although you may experience some mild discomfort.

Further semen analysis

If your initial semen analysis results are abnormal, you may need to provide another semen sample. Your doctor will check that enough sperm are alive, and that there are no antibodies or infections present in your semen20.

Antral follicle count (AFC)

This test uses an internal ultrasound scan to show the number and size of follicles present in your ovaries8.

Anti-Mullerian Hormone (AMH)9

The anti-mullerian hormone (AMH) is a substance produced by granulosa cells in the ovarian follicles. Blood levels of this substance have been used in fertility tests to attempt to measure the size of the pool of growing ovarian follicles in women, since AMH is produced only in small ovarian follicles. AMH blood levels are thought to reflect the size of the remaining egg supply, also known as the “ovarian reserve”.

Temperature

Your temperature may also be taken throughout the menstrual cycle to identify when you are ovulating10.

Hysterosalpingogram (HSG)

This test applies a coloured dye inside the uterus to check the shape and size of the uterus and fallopian tubes. It will also show your doctor if there are any tubal blockages or cysts11.

Laparoscopy12

This test involves insertion of a small surgical telescope into the abdomen, under general anaesthetic. This allows your doctor to check for any blockages, growths or signs of endometriosis around the uterus and fallopian tubes.

While it is natural to want answers as to what may be causing your fertility issues straight away, fertility testing can take some time. It can sometimes take months for you and your partner to perform all the necessary tests. In some cases, even after testing, some couples find that the reasons for their fertility difficulties remain unknown and they will be diagnosed with unexplained infertility.


It’s important to try to remain positive during this time. Getting a diagnosis is an important step forward in defining the right treatment to help you conceive.

What are the fertility interventions available?

References:

  1. Assessment of female fertility in the general practice setting 2020 Sarah Hunt, Beverley Vollenhoven 10.31128/ajgp-01-20-5205 Australian Journal of General Practice.
  2. National Institute for Health and Care Excellence (NICE). Fertility problems: assessment and treatment: CG156. 2016. Available at: https://www.nice.org.uk/guidance/cg156. Accessed: September 2016.
  3. Broer SL, Broekmans FJ, Laven JS, Fauser BC. Anti-Müllerian hormone: ovarian reserve testing and its potential clinical implications. Hum Reprod Update. 2014 Sep-Oct;20(5):688-701. doi:
  4. 1093/humupd/dmu020. Epub 2014 May 12. PMID: 24821925. Manders M, et al. Cochrane Database Syst Rev 2015;(3):CD011345.
  5. Khalaf Y. BMJ 2003;327(7415):610–613.
  6. Khalaf Y. BMJ 2003;327(7415):610–613.
  7. National Institute for Health and Care Excellence (NICE). Fertility problems: assessment and treatment: CG156. August 2016. Available at: https://www.nice.org.uk/guidance/cg156. Accessed: September 2016.
  8. European Association of Urology (EAU). Guidelines on Male Infertility 2015. Available at: uroweb.org/wp-content/uploads/17-Male-Infertility_LR1.pdf. Accessed: September 2016.
  9. National Institute for Health and Care Excellence (NICE). Fertility problems: assessment and treatment: CG156. August 2016. Available at: https://www.nice.org.uk/guidance/cg156. Accessed: September 2016.
  10. European Association of Urology (EAU). Guidelines on Male Infertility 2015. Available at: uroweb.org/wp-content/uploads/17-Male-Infertility_LR1.pdf. Accessed: September 2016.
  11. European Association of Urology (EAU). Guidelines on Male Infertility 2015. Available at: uroweb.org/wp-content/uploads/17-Male-Infertility_LR1.pdf. Accessed: September 2016.
  12. Kliesch S. Euro Uro Suppl 2014; 13(4):73–83. 19. Kliesch S. Euro Uro Suppl 2014; 13(4):73–83.
  13. European Association of Urology (EAU). Guidelines on Male Infertility 2015. Available at: uroweb.org/wp-content/uploads/17-Male-Infertility_LR1.pdf. Accessed: September 2016.
  14. American Society for Reproductive Medicine (ASRM). Medications for inducing ovulation. A guide for patients. 2016. Available at: http://www.reproductivefacts.org/globalassets/rf/news-and-publications/bookletsfact-sheets/english-fact-sheets-and-info-booklets/booklet_medications_for_inducing_ovulation.pdf. Accessed: January 2018.
  15. Fritz M and Speroff L. Chapter 31. Assisted Reproduction. In: Clinical Gynecologic Endocrinology and Infertility. 6th ed. Lippincott Williams & Wilkins, 1999.
  16. Rowell P, Braude P. BMJ 2003;327(7418):799–801.
  17. Braude P and Rowell P. BMJ 2003;327(7419):852–855. 25. Fritz M and Speroff L. Chapter
  18. Assisted Reproduction. In: Clinical Gynecologic Endocrinology and Infertility. 6th ed. Lippincott Williams & Wilkins, 1999.
  19. Braude P and Rowell P. BMJ 2003;327(7419):852–855.
  20. Rowell P and Braude P. BMJ 2003;327(7418):799–801. 28. Levran D, et al. Fertil Steril 1998;69(1):26–30. 

Disclaimer : The information provided by Merck is not a substitute for professional medical care or advice and intended for educational purposes only and should be used only as an aid in understanding the medical condition and treatment. A physician or another healthcare professional should always be consulted for any health problem or medical condition.

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