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Fertility Tests for Men

In this Article

In this Article
In this Article
  • Get an Evaluation
  • Sperm and Semen Analysis
  • Physical Exam
  • Hormone Evaluation
  • Genetic Testing
  • Anti-Sperm Antibodies

If you’re a guy and your partner isn’t getting pregnant — even though it’s something you both want — take charge with a visit to your doctor. There are lots of tests you can take to find out if you’re infertile — and learn what kind of treatment you can get.

Get an Evaluation

Start out with a visit to a doctor called a urologist. They’ll give you a physical exam and ask you questions about your lifestyle and medical history, such as:

  • Surgeries you’ve had
  • Medications you take
  • Your exercise habits
  • Whether you smoke or take recreational drugs

They may also have a frank discussion with you about your sex life, including any problems you’ve had or whether you have or ever had any STDs (sexually transmitted diseases). You’ll probably be asked to give a sample of semen for analysis.

Finding out the cause of your infertilityВ can be challenging.В Male infertility specialists have different ways of doing that, but here are some of the tests you can expect:

Sperm and Semen Analysis

A trained expert checks your sperm count, their shape, movement, and other characteristics. In general, if you have a higher number of normal-shaped sperm, it means you have higher fertility. But there are plenty of exceptions to this. A lot of guys with low sperm counts or abnormal semen are still fertile. And about 15% of infertile men have normal semen and plenty of normal sperm.

If the first semen analysis is normal, your doctor may order a second test to confirm the results. Two normal tests usually mean you don’t have any significant infertility problems. If something in the results looks unusual, your doctor might order more tests to pinpoint the problem.

If you don’t have any semen or sperm at all, it might be because of a blockage in your “plumbing” that can be corrected with surgery.

Physical Exam

It can find varicoceles — abnormal formations of veins above the testicle. You can get it corrected with surgery.

Hormone Evaluation

Testosterone and other hormones control the making of sperm. Keep in mind, though, that hormones aren’t the main problem in about 97% of infertile men. Experts disagree as to how big a search should be done for hormonalВ causes of infertility.

Continued

Genetic Testing

It can identify specific obstacles to fertility and problems with your sperm. Experts differ on when genetic tests should be done.

Anti-Sperm Antibodies

Some men make abnormal antibodies that attack the sperm on the way to the egg, which keeps your partner from getting pregnant.

For other guys, making sperm isn’t the problem: It’s getting the sperm where they need to go. Men with these conditions have normal sperm in their testicles, but the sperm in semen are either missing, in low numbers, or abnormal.

There are several reasons you might have low sperm in your semen even if your body makes enough of it:

Retrograde ejaculation. In this condition, your sperm ejaculates backward, into yourВ bladder. It’s usually caused by an earlier surgery.

You’re missing the main sperm pipeline (theВ vas deferens). It’s a genetic problem. Some men are born without a main pipeline for sperm.

Obstruction. There can be a blockageВ anywhere between the testicles and theВ penis.

Anti-sperm antibodies. As mentioned, they attack your sperm on the way to the egg.

Idiopathic” infertility. It’s a fancy way of saying there isn’t any cause your doctor can identify for your abnormal or low sperm count.

Don’t hesitate to get tests to check your fertility. When you and your partner do this, it will help you figure out what’s going on, and let you learn about treatment.

Sources

SOURCES:
American College of Obstetricians and Gynecologists web site: “Evaluating Infertility.”
American Academy of Family Physicians web site: “Male Infertility.”
American Urological Association: “Male Infertility: The Optimal Evaluation of the Infertile Male: Best Practice Statement,” 2011.

Walsh, P.В Campbell’s Urology, 8th Ed., 2002, Elsevier.

Quaas, A.В Rev Obstet Gynecol, 2008.

Find out what kinds of tests men need to get to find out why they may have some fertility concerns, including sperm analysis and genetic testing.

Erection Self-Test

An erection self-test is a procedure a man can do by himself to determine if the cause of his erectile dysfunction (ED) is physical or psychological.

It’s also known as the nocturnal penile tumescence (NPT) stamp test.

The test is done to confirm that you experience erections at night. Men who have a normal physiological erectile function experience an erection during normal sleep.

According to the University of California, San Francisco Medical Center, the average healthy pubescent male will have between three to five spontaneous erections a night, lasting 30 to 60 minutes each.

Physical, emotional, or mental problems can lead to ED. This test helps determine if your ED is caused by physical problems.

The test is considered outdated. There are a variety of ways that it can be conducted. More reliable tests, such as NPT testing using a RigiScan, are now available.

A RigiScan is a portable home device used to evaluate the quality of nocturnal penile erections. The portable battery-powered unit is strapped around the thigh. It’s equipped with two loops that are connected to a direct-current torque motor.

One loop goes around the base of the penis, and the other is placed below the corona, the area of the penis before the glans penis. Throughout the night, the machine repeatedly measures how much blood is in your penis (tumescence) and how well it can resist bending or buckling (rigidity).

This test can be repeated several nights in a row. The results from each night are stored on the machine so your doctor can download and analyze it.

The penile plethysmograph is another test that’s sometimes used to distinguish between physical and psychological ED. This device measures the erection of your penis as you view or listen to sexual material. This can include viewing pictures, watching pornographic slides or movies, or listening to sexually stimulating audiotapes. During the test, penile cuffs are attached to a pulse volume recorder (plethysmograph) that displays and records waves of blood to the penis.

These are just a couple tests that are used in place of the well-known stamp test, and they’re often more accurate. It’s also becoming increasingly difficult to find postage stamps (which are used in the test) that aren’t already sticky on the back.

The biggest benefit of the erection self-test is that it allows you to test yourself if you’re embarrassed to discuss the subject with your doctor.

You’ll need to buy four to six postage stamps. The denomination of the stamps doesn’t matter, but they should have dry glue on the back.

Stamps are the most convenient option, but there are other alternatives. If you don’t have stamps, you can use a strip of paper. The strip of paper should be 1 inch wide and long enough to go around the penis with a little overlap. The paper can be secured with a 1-inch piece of tape.

Abstain from alcohol or any chemical sleep aids for two nights before the test. These can prevent erections. You should also avoid caffeine to make sure you have a good night’s sleep.

Steps

Change into briefs or boxer brief underwear before you go to bed. Take enough stamps to circle the shaft of your penis.

Pull your flaccid penis through the fly in your underwear. Moisten one of the stamps on the roll and wrap the stamps around your penis. Overlap the stamps in the roll to ensure they’ll stay securely in place. It should be snug enough so the stamps break apart if you have an erection. Place your penis back inside your shorts and go to bed.

For best results, sleep on your back so the stamps aren’t disturbed by your movement.

Do this three nights in a row.

Results

Check to see if the roll of stamps is broken when you wake up in the morning. You could have had an erection in your sleep if the stamps are broken. This could indicate that your penis physically functions properly.

Risks

There are no risks associated with an erection self-test.

An erection self-test is a procedure a man can do by himself to determine if the cause of his erectile dysfunction is physical or psychological.