Did you know that approximately 40–50% of infertility is due to male factor infertility (MFI)? Or, even if your partner has a normal semen analysis, his sperm could still be making trying to conceive (TTC) harder? What if there was a way to reduce your chances of having a miscarriage? Innovations in reproductive technology now offer more testing options for couples trying to answer their infertility questions. The two most significant innovations are the availability of at-home DIY semen analysis kits and sperm DNA fragmentation testing.
How do the at-home tests work?
There are now numerous home fertility testing options available in the UK and the US. Some of the brand names are Dadi, Legacy, MyLabBox, and Sperm Check. Most guys agree that the convenience and the confidentiality of at-home testing are infinitely better than having to “make love to a cup” at a doctor’s office.
The commercially available providers all offer overnight shipping from your home and analyze your sample according to WHO standards for semen analysis: sperm count, motility, morphology, volume, and concentration. Remember that the at-home sperm tests cannot diagnose many common causes of male infertility. Home sperm tests only determine whether your sperm count is normal but do not accurately tell you whether you’re fertile or not.
If a home sperm test indicates that your sperm concentration is low, you’ll want to consult your doctor for a complete evaluation. Even if your result is normal, it may still be worth further testing, especially if you have been trying to conceive for some time or your partner has had multiple miscarriages.
Today men should worry about their sperm’s health.
Newer research tells us that male fertility has decreased by 50% since 1973. Environmental (pollution), lifestyle (alcohol, obesity), and age-related factors (men waiting longer to become fathers) negatively impact sperm health over time. Research shows sperm quality peaks between ages 30-35. If you are older and worried about your future fertility prospects, an at-home test could be a convenient option for you.
Also, some men with lower sperm counts or those gearing up for expensive assisted reproductive procedures like IVF make lifestyle changes to improve their sperm count. Doing at-home testing to measure their progress is an exciting option for many men who feel powerless in the infertility journey.
How much do at-home sperm tests cost?
There are a variety of testing packages available, with some offering sperm storage and testing, but costs range between $70-$200. In addition, some of the home tests are eligible to be counted in your Flexible Spending Account (FSA) or Health Savings Account (HSA) if your insurance company or employer offers this benefit.
Newer sperm tests are now available at your doctor’s office.
The latest technology tests for something called Sperm DNA fragmentation (SDF). One such kind of test is the Sperm Comet test. These tests measure the amount of damage to sperm’s DNA (the genetic code directing the reproduction of cells). Sperm with lots of broken or fragmented DNA have a more challenging time successfully fertilizing an egg. Damaged sperm are more likely to result in an unsuccessful pregnancy (no conception or miscarriage).
For those couples facing expensive and unfavorable odds for complicated procedures such as IVF, IUI, or intracytoplasmic sperm injection (ICSI, pronounced ”ick-see”), choosing sperm with a low DNA fragmentation index (DFI) increases their chances of a successful cycle. It also reduces the chances of having to go through the painful loss of a miscarriage. The higher the DNA fragmentation index of the sperm, the more errors can happen in the early cellular divisions of the embryo, resulting in miscarriage.
Where can you find sperm DNA fragmentation tests, and how much do they cost?
Sperm DNA fragmentation tests are available at many urologists, fertility centers and can be ordered by your primary care doctor or OBGYN in some cases.
Medicare and most private insurers in the US do not cover the cost of sperm DNA fragmentation tests. Test cost ranges from $290-$580 in the US. The test can be run on a sperm sample you leave at your doctor’s office, and results are usually available within 1-3 weeks.
Why don’t more men have fertility testing?
Stigma and embarrassment keep many men out of their doctor’s offices. Men with health concerns related to their infertility report being scared to talk about these concerns, even with their partners.
Unfortunately, many primary care doctors do not discuss male fertility during routine men’s health visits. OBGYNs don’t always suggest male partners pursue fertility testing until months and even years of unsuccessfully trying to conceive (TTC) or miscarriages.
Other barriers to better-evaluating male fertility are:
- Many health care consumers and health care providers don’t know that new kinds of tests exist
- Not all insurance companies cover the newer tests
- Tests can be hard to find outside of reproductive specialists’ offices
- Women are more likely to undergo infertility-related procedures and testing before men after having a miscarriage because they are already connected with an OBGYN or reproductive endocrinologist.
How you can learn more about more advanced sperm testing options
If you and your partner are already patients at fertility center like and trust, ask about what kind of testing they offer for men. Your partner should ask his primary care physician (PCP) about having a basic semen analysis as a first step. His PCP can then refer him to either a urologist (a doctor who focuses on male reproductive health) or a reproductive endocrinologist if needed.
New sperm testing options make the infertility journey less daunting for men and women.
There are many male fertility tests currently being invented, tested, and evaluated in clinical research settings. The good news is that over time there will be more tests available to examine sperm health. Hopefully, these tests will make “unexplained fertility” even less likely of a diagnosis. These tests will also allow couples to have “bespoke” fertility treatment plans tailored to their needs.
Not every couple needs sperm testing. If your partner (male or female) is over age 35, you already have been trying unsuccessfully for longer than six months to a year, or if you have experienced a pregnancy loss, then you might want to consider going beyond the basic testing and asking your doctor about newer sperm testing options.