All About Fertility Tests

This article discusses all of the different fertility tests currently available to diagnose why patients are unable to conceive. About 35% of fertility tests reveal problems with the mail partner, and 35% reveal problems with female partner, 20% for both partners, and the remaining 10% are attributed to unknown causes.

Jump to Fertility Tests for Men.

Jump to Fertility Tests for Women.

Male Fertility Tests
Male Fertility Tests Can Reveal Why You Aren’t Conceiving

If you and your partner have been trying to conceive for a year or more without success, it may be time for a fertility test. Such tests are designed to uncover possible causes of infertility in order to determine a proper course of treatment. In our journey, we learned that males are infertile almost as often as females. Therefore, it is extremely for both parties to keep an open mind toward any fertility test that your doctor recommends. 

Fertility Tests for Men

Reluctance to take tests is a stumbling block for many couples, but many of these tests may now be done from the comfort of your home. We will provide links to some of the best home fertility tests throughout this article. The first fertility for men is a complete physical exam as well as a questionnaire regarding your medical history, drug use and personal habits. The exam likely will include visual observation of the testicles as well as physical evaluation of their overall size and structure. 

Sometimes, simple lifestyle changes may be the solution. Often, however, further testing will be needed. Each male fertility test listed below provides specific information to aid in learning whether you currently are infertile and to determine what, if anything, needs to be done. 

Sperm Fertility Test

We learned that in order for a man to impregnate his female partner, his sperm must have mobility, motility and volume. The testicles must produce large quantities of sperm. Your body transports the sperm from each testicle to the epididymis, where each sperm matures. Once sperm are mature, your body moves them through tubes known as the “vas deferens” to two reservoirs, called “ampullae.” If you are a man with normal fertility, your body combines more than 20 million mature sperm from these reservoirs with semen. This blend issues from the male reproductive tract as ejaculate. 

Fertility Tests for Men Can Reveal Issues with Sperm that are Easily Treated

Once your sperm are deposited in your partner’s vagina, they must be capable of swimming to reach an egg released by one of her ovaries. Once there, individual sperm must be able to penetrate the egg. When one of the sperm reaches the egg’s interior, the egg secretes substances that prevent other sperm from entering. 

Several tests exist to help in diagnosing sperm health and to look at environmental conditions within your body that may contribute to infertility. Here are a few: 

  • Analysis of Semen Sample 
    The usual procedure for obtaining semen for this fertility test is to ejaculate into a clean container or into a condom that is especially designed for this purpose. The sample needs to be kept warm, and it has to be delivered to the laboratory in less than 30 minutes in order for the analysis to be accurate. 

    This fertility test provides information as to the quantity and quality of your sperm. The volume of semen produced and the total quantity of sperm in the sample as well as their shapes, how active they are and how well they swim determine your current probability of fathering a child.
  • Sperm Agglutination Test 
    This fertility test may require a second semen sample. The laboratory technician uses a microscope to look for clumped sperm. Clustering keeps sperm from being able to swim forward.
  • Antisperm Antibodies Fertility Test 
    At times, men’s immune systems turn against sperm while fighting infections of the prostrate gland or testicles. If your system sees sperm as an enemy, it will produce antibodies that attack the sperm. This can greatly reduce the number of surviving sperm and affect both their motility and mobility. 

    One test requires a sample of your blood to which a sperm sample is added. If your body produces antisperm antibodies, the blood will immobilize the sperm. 

    Direct immunobead testing often is used instead of a blood test to detect antisperm antibodies. In this test, semen is mixed with latex beads that have been coated with certain antibodies. After the mixture is incubated, it is examined under a microscope. If the sperm and beads bind together, results are positive.
  • Imaging 
    The male fertility test known as “imaging” actually includes more than one method of obtaining an image. Two well-known methods are listed below. 

    • Ultrasonography makes use of ultrasound. The images it produces, known as “sonograms,” are used to locate blockages or other damage to the male reproductive system that may be affecting your fertility.
    • Vasography utilizes an x-ray exam to obtain an image of the vas deferens. This test can determine whether the tubes leak sperm or are blocked.
  • Urinalysis 
    Analyzing a sample of urine taken shortly after ejaculation can reveal whether part or all of your semen is flowing into your urinary bladder. This condition is known as “retrograde ejaculation.” It often is caused by weak muscles in the neck of the bladder. Sometimes, the problem lies with damaged nerves instead of with the muscles themselves. There are several causes, including side effects of certain medications.

See our article on vitamins that can boost fertility for men.

Genetic Testing

Once in a while, sperm from a semen specimen are analyzed to evaluate the existence of abnormal DNA. More commonly, genetic testing is performed from a blood sample. Your physician may recommend a DNA test if your sperm count is very low or nonexistent. 

You also may want to have your DNA checked if your partner has had several miscarriages. Chromosomal abnormalities cause nearly half of the total number of miscarriages that occur in the first three months of pregnancy. Although some of these abnormalities occur spontaneously, others are the result of one or more abnormal genes in either the mother or father. 

MTHFR

A specific gene that may be tested for is MTHFR, especially if you are suffering from recurrent miscarriage. MTHFR stands for methylenetetrahydrofolate reductase. This gene causes women to create less folate than necessary to carry a pregnancy to live birth. Once diagnosed all that is required is for you to take additional folic acid during your pregnancy.

Another gene that may be tested for is MTHFR, especially if you are suffering from recurrent miscarriage. MTHFR stands for methylenetetrahydrofolate reductase. This gene causes women to create less folate than necessary to carry a pregnancy to live birth. Once diagnosed all that is required is for you to take additional folic acid during your pregnancy.

Male Fertility Test to Detect Sexually Transmitted Diseases

Causes of sexually transmitted diseases, known as “STDs,” include a variety of bacteria, viruses and parasites. In men, some do not show outward signs or cause discomfort. However, untreated STDs have the potential to cause a great deal of harm. 

Fortunately, testing is easy. If your doctor has not mentioned this type of testing, request it.  You may even take this test at home
(click the image below for details) :

STD Test - Male

Here is what testing likely will involve: 

Your physician inspects your genitals for signs of warts, irritation, rashes, sores or discharge. He also may look in your mouth. Likely, you will answer questions about sexual behaviors, both past and present. This helps the doctor determine what tests to order, even if you show no signs of having an STD. 

Testing may include a urine test, a blood test and swab tests. You probably are familiar with urine tests, which simply require you to collect a sample of urine by “peeing in a cup.” 

For the blood test, a nurse will draw blood from a vein in your arm or by pricking your finger. 

A swab test makes use of a soft swab to obtain a fluid sample from the inside of your cheek or from any sores, blisters or abnormal discharge that you might have. 

Additional Blood Tests

Here are a few tests to consider: 

RH Factor


Rhesus factor, commonly known as “Rh,” is a protein located on the surface of red blood cells. If your cells contain the protein, you are Rh positive. If it is missing, you are Rh negative. Opposing RH Factors between partners require additional monitoring to prevent a miscarriage.


Male fertility tests often include tests to determine the levels in your blood of a variety of hormones, including the ones mentioned below. 


Hormone Tests

Androgens, a group of sex hormones, regulate characteristics such as hair growth, testicular development and sex drive. The most commonly tested androgen is testosterone. 

A great way to take this test from home may be found below
(click the image below for details) :

Testosterone Test

Follicle-stimulating hormone, or “FSH,” and luteinizing hormone, also called “LH,” play a role in male fertility. High levels are a cause of infertility. 

Sex hormone binding globulin, or “SHBG,” is a glycoprotein produced by your liver that binds tightly to testosterone and dihydrotestosterone to transport them throughout your bloodstream. 

Inhibin B, a hormone produced both by men and women, restricts the action of FSH. A study that was published by the American Society of Andrology in their May/June 2007 issue of “Journal of Andrology” showed the roles that this hormone and others play in male fertility. In men with increased FSH, increased levels of Inhibin B decreased the odds of low sperm counts and poor motility. 

Fertility Tests include tests for Thyroid hormone levels that are below normal parameters have a negative effect on male fertility. Possible tests include the following:

  • T4 – thyroxine, called “T4” because it has four atoms of iodine.
  • Free T4 – T4 that travels freely in the bloodstream instead of binding to protein.
  • T3 – triiodothyronine. T3 is converted by the body from T4 by removing one iodine atom.
  • TBG – thyroid binding globulin. This test measures how much protein is available to move thyroid through your body.
  • TSH – thyroid stimulating hormone. TSH is sent by the pituitary gland to the thyroid gland to tell it that the body needs more T4.

An option to take the Thyroid Test at home is
(click the image below for details) :

Thyroid Test

Fertility Tests for Women

We highly recommend the following all-in-one home fertility that will cover most of the tests that can be done in the Doctor’s office for a fraction of the price: (click the image below for details)

Women's Health and Fertility Test

When you go to your first fertility appointment with your doctor, you will be expected to answer questions about your health history, medicines and supplements, sex habits and prior birth control usage as well as drug and alcohol consumption. The doctor also will ask whether you have regular periods. 

You will have a comprehensive physical exam that includes a breast exam, pelvic exam and pap smear. You also may be scheduled for a mammogram. The exams and tests help rule out tumors, cysts, inflammation and pelvic infection. Further testing will be scheduled to follow up on abnormal results or to continue to search for causes of your infertility. 

Genetic Testing

Genetic testing checks for possible defects in your genes that contribute to infertility. To test your DNA, you simply provide a blood sample. 

In select cases, the DNA of an infertile woman’s eggs also is tested. This female fertility test requires a surgical procedure in which a needle-shaped device is inserted into an ovary to gather one or more eggs. 

Blood Tests

Fertility Tests with blood may include the following:

  • Hormone Tests 
    • Estradiol
    • Follicle Stimulating Hormone, or “FSH”
    • Luteinizing Hormone, or “LH”
    • Prolactin
    • Progesterone
    • Androstenedione
    • Dehydroepiandrosterone Sulfate, or “DHEAS”
    • Free Testosterone
    • Total Testosterone
    • Thyroid

    Unbalanced hormone levels are a major cause of infertility. Inexpensive treatment could be all that you need to become fertile.
  • RH Factor 
    As mentioned in the men’s section of this blog, it is important to know whether your blood and the blood of your partner is RH positive or RH negative. This can be determined by a simple blood test.
  • Blood Tests for Sexually Transmitted Diseases 
    In women, sexually transmitted diseases, or “STDs,” cause many problems if left untreated. Examples are pelvic inflammatory disease, permanently damaged reproductive organs and infertility. Untreated STDs also can harm the fetus. Talk with your doctor about STD blood tests and any other STD testing you might need. Keep everyone safe.
  • Blood Clotting Factors 
    Several tests exist to to examine blood clotting factors. Abnormal findings may point toward genetic disorders as well as certain illnesses. Women whose blood clots too fast are at risk of early miscarriage as well as heart attack and stroke.

Autoimmune Disease Tests

An autoimmune disease is the result of your immune system turning against its own organs or cells. It also is possible for your immune system to attack your partner’s sperm. Often, autoimmune diseases interfere with a woman’s ability to conceive. Urine tests as well a variety of blood tests have been developed to detect these diseases. 

More than one blood test exists that will identify systemic lupus erythematosus, often referred to simply as “lupus” or “SLE.” This disease occurs in nine times as many women as men. Both the disease and its treatment have been linked to infertility. 

Lupus is an Autoimmune Disease that frequently causes miscarriage and can be treated.

Fertility Tests also can identify Type I diabetes, multiple sclerosis, rheumatoid arthritis, Addison’s disease, Hashimoto’s thyroiditis, Grave’s disease, Crohn’s disease and myasthenia gravis.

Ovulation Tests

Expect several appointments.It takes time to fully evaluate whether your ovaries are releasing eggs and to determine when ovulation occurs. 

Blood samples to determine hormone levels will be taken at various stages of your monthly cycle. 

Chart your basal body temperature, or “BBT.” Use a digital thermometer to take your temperature by mouth when you first wake up each morning. There usually is a slight drop in temperature just before ovulation. Within 24 hours after you ovulate, your BBT will rise. 

Another fertility test requires at-home use of an ovulation predictor kit to detect the presence of luteinizing hormone in your urine. 

Your doctor may order an ultrasound test to confirm that you actually ovulate when you think you do. 

Post Coital Female Fertility Test

This fertility test determines how well sperm is able to travel through cervical mucus. The test is timed to be as close as possible to the time of ovulation. 

The test requires that you and your partner have intercourse no more than 18 hours before your healthcare provider, during an office visit, performs a routine pelvic exam and removes a sample of cervical mucus. By looking at the sample under a microscope, the doctor or lab technician can determine whether the mucus helps or hinders the sperm. 

A high visibility of motile sperm in this fertility test is a good indicator of the couple’s ability to get pregnant.

Pelvic Ultrasound

Pelvic ultrasounds often consist of both a transabdominal ultrasound and a transvaginal ultrasound. Images from the transabdominal ultrasound are obtained by running a probe that emits sound waves over your lower abdomen after gel is applied. This procedure can detect large pelvic masses. 

The transvaginal ultrasound entails inserting a thin probe, covered with a disposable sheath, into the vagina. It produces clear images of your pelvic organs and can detect endometriosis as well as other conditions that may contribute to your infertility.  Endometriosis is a key factor in failed IVF and IUI cycles. This fertility test can allow for the clearing of scarred tissues, that significantly increases the odds of a successful pregnancy.

Hysterosalpinogram

Also known as “HSG,” a hysterosalpinogram is an X-ray of the fallopian tubes to check for blockages. The test usually is performed between the sixth and thirteenth day of your cycle. This fertility test is usually done in an outpatient visit. There will be some discomfort as a liquid is introduced into the womb.

Hysteroscopy

This female fertility test, often done on an outpatient basis under general anesthesia, utilizes a small tube containing a lighted telescope. This instrument, inserted through the cervix into the uterus, allows the technician to inspect the inside walls of the uterus to check for defects. Physical abnormalities such as scar tissue, polyps and fibroid tumors are easily detected, and often they can be taken care of without requiring a second procedure. 

Laparoscopy

By making a small incision in or near your navel and inserting a tiny camera while you are under general anesthesia, the doctor can inspect several areas of your abdomen. Problems in the uterus, ovaries and fallopian tubes often are spotted this way. 

Endometrial Biopsy

An endometrial biopsy, usually performed in the doctor’s office, requires removing a small amount of tissue from your uterus’s inner lining, known as the “endometrium.” This test helps to determine whether the lining of your uterus is responding normally to cyclic levels of estrogen and progesterone. 

Reference and Resource Links about Fertility Tests

Male Infertility Guide: Maximizing Fertility 
https://www.maleinfertilityguide.com/home

Science, Encyclopedia Britannica: Semen 
https://www.britannica.com/science/semen

Centers for Disease Control and Prevention: Sexually Transmitted Diseases – STDs and Infertility 
https://www.cdc.gov/std/infertility/default.htm

National Institute of Child Health and Human Development: Link Between Sexually Transmitted Diseases or Sexually Transmitted Infections and Infertility 
https://www.nichd.nih.gov/health/topics/stds/conditioninfo/infertility

My Fertility: Fertility Testing and Diagnosis 
http://www.myfertility.ca/testing_and_diagnosis/

University of California San Francisco: Conception – How It Works 
https://www.ucsfhealth.org/education/conception_how_it_works/

Mayo Clinic: Retrograde Ejaculation 
https://www.mayoclinic.org/diseases-conditions/retrograde-ejaculation/symptoms-causes/syc-20354890

Science, Encyclopedia Britannica: Ductus Deferens 
https://www.britannica.com/science/ductus-deferens#ref45805

Cleveland Clinic: Genetic Testing and Male Factor Infertility 
https://my.clevelandclinic.org/health/diseases/15217-genetic-testing-and-male-factor-infertility

Centers for Disease Control and Prevention: Sexually Transmitted Diseases – STDs and Infertility 
https://www.cdc.gov/std/infertility/default.htm

Centers for Disease Control and Prevention: National HIV, STD, and Hepatitis Testing – Frequently Asked Questions 
https://gettested.cdc.gov/faq-page 

Virtual Medical Center: How Sexually Transmitted Infections Affect Sperm Health 
https://www.myvmc.com/pregnancy/how-sexually-transmitted-infections-affect-sperm-health/

National Institute of Child Health and Human Development: Types of and Treatments for Sexually Transmitted Diseases or Sexually Transmitted Infections 
https://www.nichd.nih.gov/health/topics/stds/conditioninfo/types

The American College of Obstetricians and Gynecologists: The Rh Factor – How It Can Affect Your Pregnancy 
https://www.acog.org/patients/faqs/the-rh-factor-how-it-can-affect-your-pregnancy

Thyroid Week: How Thyroid Hormones Impact Male Fertility 
http://thyroidweek.org/en/thyroind-and-fertility-html-html/how-thyroid-hormones-impact-male-infertility-html/

American Thyroid Association: Thyroid Function Tests 
https://www.thyroid.org/thyroid-function-tests/

Healthy Women: Androgen 
https://www.healthywomen.org/condition/androgen

Advanced Women’s Imaging: Pelvic or Gynaecologic Ultrasound 
http://advancedwomensimaging.com.au/pelvic-gynaecologic-ultrasound

University of Rochester Medical Center: Health Encyclopedia – Sex Hormone Binding Globulin Blood Test 
https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=shbg_blood 

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