Male Fertility Testing

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Explore How Male Infertility Is Diagnosed

Male infertility is more common than many people realize, contributing to roughly half of all cases where a couple has difficulty conceiving. Despite this, male fertility is often the last thing evaluated, sometimes costing couples valuable time. The good news is that male fertility testing is straightforward, non-invasive in most cases, and can provide critical answers quickly.

At the Reproductive Science Center of New Jersey (RSCNJ), we take a team-based approach to fertility care, evaluating both partners early in the process so that nothing is overlooked. If you are concerned about your fertility or simply want to understand your reproductive health, testing is a proactive and empowering step.

What are the signs of male infertility, and when should I get tested?

One of the most important things to understand about male infertility is that it usually has no obvious symptoms. There are no reliable warning signs, as sperm count, motility, and morphology cannot be assessed through observation alone. Most men only discover a potential issue when a couple has been trying to conceive without success.

Fertility testing for men is typically recommended when pregnancy has not occurred after 12 months of regular, unprotected intercourse, or after 6 months if the female partner is over age 35. That said, earlier evaluation is warranted for men with a history of:

  • Testicular injury, surgery, or undescended testicles
  • Prior infections such as mumps, sexually transmitted infections, or epididymitis
  • Known genetic or chromosomal conditions
  • Hormonal imbalances or prior cancer treatment (chemotherapy or radiation)
  • A varicocele (enlarged veins in the scrotum) or other structural concerns

If any of these apply to you, talking to a fertility specialist sooner rather than later is strongly encouraged, even if you are not yet actively trying to conceive.

Potential Causes of Male Infertility

Male infertility can stem from a wide range of factors, including issues with sperm production, sperm function, sperm delivery, or underlying hormonal and genetic conditions. Common causes and contributing factors include:

  • Varicocele: Enlarged veins in the scrotum that raise testicular temperature and impair sperm production. It is also the most common correctable cause of male infertility.
  • Azoospermia: The complete absence of sperm in the ejaculate, which may be obstructive (a blockage preventing sperm from being released) or non-obstructive (a production problem).
  • Low sperm count (oligospermia): Fewer sperm than normal in the ejaculate, reducing the likelihood of fertilization.
  • Poor sperm motility or morphology: Sperm that do not swim efficiently or are abnormally shaped may be unable to reach or penetrate an egg.
  • Hormonal imbalances: Low testosterone, elevated FSH, or other hormonal disruptions can interfere with sperm production.
  • Genetic or chromosomal conditions: Conditions such as Klinefelter syndrome or Y-chromosome microdeletions can impair sperm production at the genetic level.
  • Infections or structural blockages: Past infections or anatomical abnormalities can block the ducts that carry sperm.
  • Lifestyle or environmental factors: Tobacco use, excessive alcohol, anabolic steroids, heat exposure, and certain medications can negatively affect sperm quality.
  • Unexplained infertility: In some cases, standard testing does not identify a clear cause, and further evaluation may be needed.

What is a semen analysis and why does it matter?

A semen analysis is almost always the first test ordered when evaluating male fertility, and for good reason. It provides a comprehensive snapshot of sperm health across four key parameters:

  • Sperm count (concentration): The number of sperm per milliliter of semen. Normal is generally considered 16 million or more per milliliter.
  • Motility: The percentage of sperm that are moving, and how well they move. 
  • Morphology: The percentage of sperm with a normal shape, which affects the sperm's ability to penetrate an egg. 
  • Volume: The total amount of semen produced. Low volume may suggest a blockage or hormonal issue.

Results are compared against World Health Organization (WHO) reference values, and your physician will walk you through what your results mean in the context of your overall fertility picture.

Preparing for a semen analysis is simple. You will be asked to abstain from ejaculation for 2 to 5 days before your sample collection – long enough to ensure an adequate count, but not so long that sperm quality declines. The sample is typically collected in a private room at the clinic or, in some cases, at home using a sterile collection kit. The process is confidential, straightforward, and an essential first step in understanding your fertility.

What other male fertility tests might be recommended?

Your RSCNJ physician may recommend one or more of the following additional evaluations:

Medical History and Physical Examination

Every male fertility evaluation at RSCNJ begins with a thorough review of your medical history and a targeted physical exam. Your physician will ask about past illnesses, surgeries, medications, lifestyle habits, and family history. A physical examination can identify structural issues, such as a varicocele or epididymal obstruction, that may not appear on standard lab tests but can significantly impact fertility. This step helps contextualize all subsequent testing and guides the most appropriate diagnostic path.

Microsurgical Testicular Sperm Extraction (microTESE)

For men diagnosed with non-obstructive azoospermia where the testes produce little or no sperm, microTESE is a specialized surgical procedure that may allow sperm retrieval directly from testicular tissue. Performed under general anesthesia with an operating microscope, microTESE maximizes the chance of finding usable sperm even when ejaculated samples contain none. Sperm retrieved through microTESE can be used with IVF and ICSI to achieve fertilization. Your RSCNJ physician will discuss whether microTESE is appropriate based on your diagnosis and goals.

Hormone Testing

Hormonal blood tests are often ordered alongside or following semen analysis to evaluate the endocrine factors that regulate sperm production. Key hormones typically measured include testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin. Abnormal levels can point to conditions such as pituitary dysfunction or other endocrine disorders, many of which are treatable. Identifying a hormonal cause early can open the door to targeted interventions that may improve sperm production naturally.

Genetic Testing

In cases of severe azoospermia, very low sperm counts, or recurrent IVF failure, genetic testing may be recommended to identify chromosomal or gene-level contributors to infertility. Common evaluations include karyotyping (to detect chromosomal abnormalities such as Klinefelter syndrome), Y-chromosome microdeletion analysis, and CFTR gene testing for cystic fibrosis mutations. Genetic results have implications not only for treatment planning but also for understanding heritable conditions that may affect future children, making genetic counseling an important part of this process.

How much does male fertility testing cost?

The cost of male fertility testing at RSCNJ varies depending on which tests are recommended based on your individual evaluation. A semen analysis is generally the most affordable and commonly covered diagnostic test. Additional testing, such as hormone panels, genetic screening, or more specialized procedures, may involve additional costs depending on your insurance plan.

New Jersey's fertility insurance mandate is among the most comprehensive in the country, and many diagnostic evaluations may be covered in part or in full through your employer-sponsored plan. We encourage you to contact your insurance provider before your appointment to understand your benefits.

For any out-of-pocket costs, RSCNJ offers financing options and payment plans to help make care accessible.

Male Fertility Testing FAQ

  • A semen analysis is the primary diagnostic test used to evaluate male fertility. It measures key characteristics of the ejaculate, including sperm count (concentration), motility (how well sperm move), morphology (sperm shape), and semen volume. Results are compared against established reference ranges to identify whether a sperm factor may be contributing to difficulty conceiving. A single abnormal result does not necessarily confirm infertility – results can vary, and your physician may recommend a repeat analysis before drawing conclusions.

  • To get the most accurate results from a semen analysis, you should abstain from ejaculation for 2 to 5 days before your sample collection. Avoid alcohol, caffeine, and recreational drugs in the days leading up to the test, and let your physician know about any medications or supplements you are taking. Samples are collected in a private, comfortable setting at the clinic. Following these guidelines helps ensure your sample reflects your baseline sperm health rather than temporary fluctuations.

  • A low sperm count, clinically known as oligospermia, means there are fewer sperm in your ejaculate than the reference threshold of approximately 16 million per milliliter. While lower counts reduce the statistical likelihood of natural conception, they do not make pregnancy impossible. Many men with low sperm counts successfully father children, sometimes with the help of treatments such as IUI or IVF with ICSI. Your physician will evaluate your full semen analysis results alongside other factors to determine the most appropriate next steps.

  • In many cases, yes. Treatment depends on the underlying cause. Varicoceles can often be surgically corrected, improving sperm parameters in many men. Hormonal imbalances may respond to medication. Lifestyle changes, such as quitting smoking, reducing alcohol, or addressing heat exposure, can meaningfully improve sperm quality over time. For cases involving azoospermia or severely low counts, assisted reproductive technologies like IVF with ICSI or sperm retrieval procedures may allow conception. Your RSCNJ physician will review all available options with you based on your specific diagnosis.

  • Yes, though the relationship between age and male fertility is less dramatic than in women. Sperm quality, including motility and morphology, tends to decline gradually with age, particularly after age 40 to 45. Older men may also have higher rates of sperm DNA fragmentation, which can affect fertilization and embryo quality. While men can father children well into later decades, age-related changes in sperm are a real consideration, particularly for couples where the male partner is significantly older. Testing can help clarify whether age-related factors are relevant in your situation.

  • Abnormal sperm motility (asthenospermia) or morphology (teratospermia) can result from a variety of factors, including infections, hormonal imbalances, varicoceles, oxidative stress, genetic conditions, and lifestyle influences such as smoking, heat exposure, or anabolic steroid use. In many cases, a clear cause is not identified. Your physician will evaluate motility and morphology alongside other semen parameters and your medical history to determine whether further investigation or treatment is needed. Improving certain lifestyle factors may positively affect sperm quality.

  • Yes. Several medications are known to impair sperm production or function, including anabolic steroids, testosterone replacement therapy, certain antibiotics, chemotherapy agents, and some antidepressants or antihypertensives. Over-the-counter supplements, while generally safer, can also interact with fertility in complex ways. It is important to disclose all medications and supplements to your RSCNJ physician before testing so results can be accurately interpreted. In some cases, adjusting or discontinuing a medication under medical supervision may improve sperm health over time.

  • No, many causes of male infertility are treatable or manageable. Varicoceles can be surgically repaired, hormonal issues can be medically addressed, and lifestyle modifications can meaningfully improve sperm quality in men without a fixed anatomical cause. Even in cases of azoospermia, sperm retrieval procedures such as microTESE may allow conception through IVF. While some causes – such as certain genetic conditions or severe testicular failure – may not be reversible, there are often assisted reproductive options available. An accurate diagnosis is the essential first step toward identifying what is possible.

Comprehensive Male Fertility Testing in New Jersey

If you are concerned about your fertility, or simply want to take a proactive step toward understanding your reproductive health, the Reproductive Science Center of New Jersey is here to help. Our experienced, board-certified physicians provide thorough, compassionate male fertility evaluations at our three New Jersey locations in Eatontown, Lawrenceville, and Toms River.

Whether you are part of a couple navigating infertility together or an individual seeking answers on your own, RSCNJ offers the expertise, technology, and supportive care to guide you forward with clarity and confidence. Reach out to schedule a consultation today.