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Diagnostic Tests for Male Fertility Assessments

male fertility tests

Approximately 1 in 6 couples struggle with infertility worldwide. But did you know that male factor infertility contributes to nearly 50% of all infertility cases? Genetics, lifestyle factors, and underlying medical conditions can all contribute to male infertility. This is why men who may have a history of testicular damage, erectile dysfunction, cancer treatments, mumps infection, or urinary tract surgery should consider getting a male fertility assessment.

Oftentimes, however, male infertility does not present any noticeable symptoms. If a couple has been struggling to conceive for over a year, it is highly recommended that both the male and female partners undergo fertility testing to determine the underlying cause of the infertility.

Below, we explore some of the most common male fertility assessments available in Ontario.

Semen Analysis

Diagnostic tests for male fertility include a semen analysis test to detect the quality, quantity, shape, and motility of the sperm. It also measures the sperm’s pH level and any signs of infection. This test is performed at least twice as levels of sperm production fluctuate over time and from person to person. The male patient produces a sperm sample for testing by masturbating and ejaculating into a cup or with use of a special condom used during sex.

Factors that may influence the results of the semen analysis involve the use of prescribed and recreational medication, supplements, steroids, marijuana, and alcohol consumption. Patients are advised to refrain from ejaculation for at least five days prior to the test to ensure active sperm are present.

Read More: Semen Analysis FAQs: Answers by Fertility Specialists

Hormone Tests

Hormone tests (via blood tests) are performed in conjunction with the semen analysis in fertility clinics in Kitchener-Waterloo. Male infertility is often linked to varying levels of the luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, and Testosterone.

The FSH level will determine sperm production capability while a specific LH level is required to release the essential testosterone for healthy sperm production. Hormone imbalances can be due to medical conditions, lifestyle choices, diet, and genetic factors.

Physical Examination

Since the medical history of the male patient is imperative when creating an infertility plan, a physical examination is often performed to rule out physical abnormalities that may be linked to difficulties with conception.

A physical examination consists of examining the testicles for undescended, neonatal, or retractile testicles. The size, shape, and appearance of the testicles and the epididymis will also be carefully checked by the doctor. The penis and scrotum will also be thoroughly examined for temperature and any signs of discharge or lumps.

Genetic Tests

Sperm quality and quantity can be affected by genetic conditions, which is why specific testing aside from a regular blood test may be needed. Abnormalities linked to genetic syndromes account for up to 20% of all sperm production issues. There are various genetic tests fertility clinics use.

The same karyotyping testing performed to analyze the structure of chromosomes can help determine if a genetic condition is causing infertility. A Y chromosome microdeletion test uncovers if any chromosome genes are missing which can explain fertility issues. As nearly 98% of men with cystic fibrosis are infertile, cystic fibrosis testing is performed.

Other Tests

Male fertility assessment testing can involve a number of other procedures and examinations as there is no one cause for male infertility. These tests may be necessary if the above-mentioned tests provide inconclusive results or require further investigation.

  • Sperm DNA Fragmentation: It has been shown that all men have a form of damage within the DNA of sperm. This can be linked to oxidative stress as seen with tobacco use, infections, pollutant exposure, age, chronic diseases, and an elevated testicular temperature. The sperm DNA fragment tests are conducted by a laboratory examination of a semen sample.
  • Antisperm Antibody Test: A sample of semen is examined to detect the presence of antibodies that can hinder the quality and amount of sperm. While it is unusual for sperm to be affected by the immune system, pre-existing conditions of prostate gland infections, an injury, or surgery can cause antibodies to be produced.
  • Post-Ejaculate Urinalysis: One possible cause of infertility is if the sperm travels in a backward flow to the bladder rather than exiting through the urethra. A post-ejaculate urinalysis test will determine if a low sperm count is due to the presence of sperm in the urine.
  • Scrotal Ultrasound: As fertility issues can stem from within the scrotum region, a non-invasive scrotal ultrasound is performed to produce high-frequency sound waves to detect obstructions. These can include varicoceles, infections, cysts, tumours, and pooling of fluids.
  • Transrectal Ultrasound: This type of ultrasound uses ultrasonic waves emitted by a wand when inserted into the rectum for image viewing of the prostate and tissues. The presence of blockages caused by calcification, dilated vessels, thickening of vesicle walls or other obstructions can be detected with this test.
  • Testicular Biopsy: Once a physical examination, semen analysis, and hormone tests are completed, a testicular biopsy may be performed. Tissue samples are collected from the testicles with a needle to check the level of sperm production.

Consult with ONE Fertility’s Specialists for Evaluation and Treatment Options

ONE Fertility Kitchener Waterloo offers exceptional and compassionate fertility care and treatments for both partners. Our state-of-the-art facility is managed by a team of fertility specialists who focus on individual fertility plans and infertility counselling in Kitchener-Waterloo.

Our fertility plans are developed using evidence-based medical advancements for the safety and quality of your care. We provide personalized female infertility and male infertility plans.
Contact us today for more information or to book a consultation to begin your journey to fertility success.


4271 King St East, Suite 200
Kitchener, ON
N2P 2X7

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Phone: 519.650.0011
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