Introduction and definition of male fertility tests
Table of Contents
Infertility affects approximately 15% of couples worldwide, with male factors contributing to nearly half of all cases. Male infertility can be attributed to various factors such as hormonal imbalances, genetic abnormalities, structural abnormalities, or lifestyle choices.
Male fertility tests plays a crucial role in diagnosing male infertility, providing valuable insights into the underlying causes and guiding appropriate treatment strategies. In this article, we will explore the laboratory tests commonly employed to assess male infertility.
Male fertility: Commonly done laboratory tests
A wide range of tests are available to assist in the search for the cause of male infertility. The initial tests include basic and comprehensive metabolic panels, screening for STIs and HIV, and thyroid hormones. These baseline tests help establish the general health of the patient.
In this article, however, we focus on specific tests commonly used for the assessment of male infertility. These tests are selected judiciously for an individual patient on a case-by-case basis.
The most commonly used tests are presented below:-
1. Semen Analysis
Semen analysis is the cornerstone of male infertility assessment. It evaluates the quantity, quality, and functionality of sperm. The analysis involves several parameters, including sperm count, motility, morphology, and semen volume. These parameters (discussed below)provide valuable information about the sperm’s ability to fertilize an ova successfully.
a)Semen Volume
Semen volume measures the amount of semen ejaculated. A normal semen volume ranges from 1.5 to 5 milliliters. Abnormal semen volume may indicate underlying issues such as ejaculatory duct obstruction or retrograde ejaculation.
b) Sperm Count
Sperm count, or sperm concentration, measures the number of sperm per milliliter of semen. A normal sperm count is typically considered to be above 15 million sperm per milliliter. Low sperm count, known as oligospermia, may indicate reduced fertility potential. Extremely low sperm count, called azoospermia, refers to the absence of sperm in the ejaculate and can be indicative of obstructive or non-obstructive causes of infertility.
c)Sperm Motility
Sperm motility refers to the ability of sperm to move effectively. Progressive motility, which measures the percentage of sperm with forward movement, is a crucial parameter in assessing male fertility. Poor sperm motility, known as asthenospermia, can hinder the sperm’s ability to reach and fertilize an egg.
d) Sperm Morphology
Sperm morphology evaluates the shape and structure of sperm. Abnormalities in sperm morphology, known as teratospermia, can affect fertility. The Kruger strict criteria, a widely used classification system, assesses the percentage of sperm with normal morphology. Normal morphology is typically defined as having a strict criteria score above 4%.
It should be noted these are the most commonly done seminalysis test. Other more complex tests are done in more specialized centers or in research settings
2) Hormonal Assessment
Hormonal imbalances can significantly impact male fertility. Hormonal assessment involves measuring various hormones involved in sperm production and maturation. The most commonly evaluated hormones include follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and prolactin.
i) FSH and LH levels
FSH and LH are essential for the production of sperm in the testes. Elevated levels of FSH or LH may indicate testicular dysfunction or primary hypogonadism. Conversely, low levels of FSH or LH may suggest secondary hypogonadism, which can be caused by pituitary or hypothalamic dysfunction.
ii) Testosterone level
Testosterone is a crucial male sex hormone necessary for sperm production. Low testosterone levels can negatively impact sperm production, leading to infertility. Testosterone levels are typically measured in the morning when they are at their highest. DHEAS test may also be carried out as well
iii) Prolactin level
Elevated levels of prolactin, a hormone primarily associated with lactation, can disrupt the hormonal balance necessary for sperm production. Increased prolactin levels may be indicative of a pituitary gland disorder, potentially affecting fertility.
3. Genetic Testing
Genetic abnormalities can contribute to male infertility. Genetic testing can identify chromosomal abnormalities or mutations in specific genes associated with infertility. Karyotyping, a test that examines the number and structure of chromosomes, can detect conditions like Klinefelter syndrome or structural abnormalities that may affect fertility. Additionally, specific gene mutations associated with conditions such as cystic fibrosis or Y-chromosome microdeletions can be assessed.
4. Specialized Tests
In some cases, specialized tests may be necessary to further evaluate male infertility. These tests include:
- Anti-sperm Antibody Testing: Determines the presence of antibodies that may impair sperm function.
- Seminal Fructose Analysis: Assesses the presence of fructose in semen, which is essential for sperm energy production.
- Post-Ejaculatory Urinalysis: Evaluates for the presence of sperm in urine after ejaculation, indicating retrograde ejaculation.
Interpretation of laboratory male fertility tests
The doctor or fertility expert will review your tests in the context of the clinical and radiological picture. It’s important to bear in mind about half of all cases of male infertility are idiopathic, i.e. no cause can be established despite extensive investigations. Based on these tests, the fertility doctor is able to advise you on the appropriate cause of action.
Cost of male fertility tests in Kenya
Each of the tests above is charged separately, so the total cost will depend on how many tests are ordered. For example, semen analysis costs from KES 2000 in public facilities to as high as KES 6000 in private hospitals and fertility clinics.
The cost is usually out of pocket as health insurance companies, private and NHIF typically don’t cover the cost of infertility treatment.
Please find our comprehensive guide on laboratory test prices here for more information
Where are male fertility tests done?
Most leading private and mission hospitals in Kenya provide the service. Some are also available in national hospitals like KNH, KUTRRH, and MTRH.
Fertility clinics such as Nairobi IVF Center also offer the service as part of their service package. However, they are only found in major cities like Nairobi and Mombasa.
A word of caution: There are many suspicious “sperm test kits” sold online, discuss with your doctor before purchasing.
Check out our directory for laboratories here
Summary of male fertility tests
Laboratory assessment of male infertility plays a vital role in diagnosing and understanding the underlying causes of fertility issues. Semen analysis, hormonal assessment, genetic testing, and specialized tests provide valuable information to guide appropriate treatment strategies.
By utilizing these laboratory tests, healthcare professionals can effectively evaluate male infertility and offer personalized solutions to help couples achieve their dream of parenthood.
You can read more information on male fertility tests here
♦If you found this post useful, kindly share it with your friends and register for alerts whenever we publish new posts
See you in the next post, till then, happy and healthy living!
Related Tests
Medically reviewed by Dr Mwaura J.