For men, the main diagnostic test that will be performed is a semen analysis. Even though the problem may not be the sperm itself, learning what is wrong with the sperm, whether it has low motility or a low sperm count, can lead your fertility specialist to perform further tests to find the exact cause.
Some of these tests will include blood work to evaluate the levels of FSH, testosterone and prolactin in your body. Your doctor may also choose to do a post-ejaculation urinalysis to see if there are any infections or disorders that could be affecting your fertility.
If you suspect there may be a problem, there is a test to measure sperm concentration that can be done at home. If you receive two results with a concentration below 20 million/mL, there could be a fertility issue. You should then speak to a specialist regarding further testing.
Some of the tests your specialist may choose to perform include:
- Hypo-osmotic Swelling (HOS) Test: This test involves placing the sperm in a solution to see how much the sperm will swell. The HOS test provides information on the cell membrane of the sperm’s tail.
- Zona-free Hamster Oocyte Test: Because of its similarity to a human egg, this test uses a hamster egg with your sperm to see if you sperm is able to fertilize the egg. This procedure gives insight into the head of the sperm and whether or not assisted reproductive technologies may be best for you and your partner. However, this test can provide false positives, therefore it is not always reliable.
- Reactive Oxygen Species and Male Fertility: A laboratory test that evaluates the level of chemicals and enzymes in the sperm. An excess of both suggests that the sperm is damaged, immature or abnormal in some way.
- Zona Pellucida Binding Tests: For this test, specialists expose your sperm to half of a dissected, non-fertilized human egg and compare the results with a known healthy sperm sample that has been exposed to the other half. This test evaluates your sperm’s ability to bind to the egg and therefore fertilize the egg.