Understanding male fertility
Male fertility is an important part of the overall fertility picture. Sperm needs to be produced in sufficient numbers, move effectively and have the ability to reach and fertilise an egg.
If pregnancy is taking longer than expected, assessing sperm alongside female fertility factors can help build a clearer picture of what may be happening.
How does male fertility work?
Sperm are produced in the testes and mature as they move through the male reproductive system. Several factors need to come together for sperm to have the opportunity to fertilise an egg.
Sperm production
The testes need to produce sperm. Hormones, medical conditions, some medications and other factors can affect this process.
Sperm movement
Sperm need sufficient motility, meaning the ability to move, to travel through the reproductive tract towards an egg.
Fertilisation
Sperm also needs to interact successfully with the egg. Semen testing can provide useful information, but it cannot measure every step involved in fertilisation.
What does a semen analysis look at?
A semen analysis is one of the main first-line tests used to assess male fertility. Rather than relying on one number, the laboratory looks at several characteristics of the semen and sperm together.
Volume
The amount of semen in the sample. Volume is considered together with the other semen parameters rather than interpreted on its own.
Count and concentration
These measurements look at how many sperm are present, including the concentration of sperm within the semen sample.
Motility
Motility describes how sperm move. The pattern and proportion of moving sperm provide useful information about the sample.
Morphology
Morphology refers to sperm shape and structure. It is assessed alongside count, motility and the wider clinical picture.
Semen parameters can vary between samples, and results need to be interpreted together. If a result is outside the expected reference range, your doctor may recommend repeating the test or considering further assessment.
What is sperm DNA fragmentation?
Sperm DNA fragmentation testing looks at the integrity of the DNA carried within sperm. It provides different information from a standard semen analysis.
A sperm sample can have semen parameters within expected ranges while still showing a higher level of DNA fragmentation, but the test is not required routinely for every person having an initial fertility assessment.
Whether it is useful depends on the individual clinical situation and should be interpreted by a doctor alongside the relevant fertility history and other results.
DNA fragmentation testing does not replace a semen analysis and should not be interpreted as a stand-alone measure of whether pregnancy can or cannot occur.
What can influence male fertility?
Male fertility can be affected by medical, hormonal, anatomical, environmental and lifestyle factors. Sometimes more than one factor is involved, and sometimes no single explanation is identified.
Medical and hormonal factors
Hormonal conditions, previous infections, testicular conditions, surgery and some medical treatments may affect sperm production or function.
Heat exposure
The testes function at a temperature below core body temperature. Frequent or prolonged heat exposure may be relevant in some circumstances, although fertility is rarely explained by one lifestyle factor alone.
Medications and substances
Some medications and substances can affect sperm production. Testosterone treatment and anabolic steroids are particularly important to discuss with a doctor because they can suppress sperm production.
General health and lifestyle
Smoking, alcohol, weight, nutrition, sleep and general health may be relevant. Healthy habits can support overall health, but they should not be presented as a guaranteed way to improve fertility.
Changes take time
Sperm production is a continuous process that takes several weeks, followed by further maturation. This is why any change in health, treatment or lifestyle is not expected to be reflected in a semen sample immediately.
Sperm develop within the testes through a biological process that takes time.
After production, sperm undergo further maturation as they move through the reproductive system.
If repeat testing is appropriate, your doctor can advise on timing based on the original result and clinical circumstances.
When should male fertility be assessed?
Male fertility is usually best considered at the same time as female fertility rather than waiting until other investigations have been completed.
If pregnancy has not occurred after the recommended period of trying, a semen analysis may form part of the couple's initial fertility assessment. Earlier assessment may also be appropriate where there is a known history that could affect sperm production or function.
Men can also choose to have an individual fertility assessment if they have concerns about their sperm health or would like more information before making decisions about future fertility.
Finding a sperm-related factor does not necessarily mean it is the only reason pregnancy has not occurred. Results are most useful when considered alongside the other partner's fertility assessment, where applicable.
Understand your sperm health before deciding what comes next
A fertility assessment does not mean committing to IVF treatment. It provides an opportunity to understand important aspects of sperm health and discuss the findings with a fertility specialist.
IVF(SG) offers two individual male fertility assessments. Both include a semen analysis and a consultation with Dr Yeong to review the results. The second option includes sperm DNA fragmentation testing.
Men's Fertility Assessment
An initial assessment of sperm characteristics to provide information about male reproductive health.
- Semen analysis
- Consultation with Dr Yeong to review results and discuss next steps
Men's Fertility Assessment + Sperm DNA Fragmentation
A semen assessment with additional testing to evaluate the integrity of DNA within sperm.
- Semen analysis
- Sperm DNA fragmentation testing
- Consultation with Dr Yeong to review results and discuss next steps
Male fertility FAQs
Can I book a male fertility assessment without my partner?
Yes. IVF(SG) offers individual male fertility assessments, so you can have your sperm health assessed without booking a couples' package.
What is included in the Men's Fertility Assessment?
The S$196.20 assessment includes a semen analysis and consultation with Dr Yeong to review your results. The S$466.52 assessment also includes sperm DNA fragmentation testing. Both prices are inclusive of GST.
Do I need sperm DNA fragmentation testing?
Not necessarily. Sperm DNA fragmentation testing provides additional information but is not routinely recommended for every initial male fertility assessment. Your doctor can advise whether it may be useful in your circumstances.
Does an abnormal semen analysis mean natural pregnancy cannot happen?
No. A semen analysis provides information about several sperm parameters, but it does not provide a simple yes or no answer about whether pregnancy can occur. Your doctor will interpret the findings in context.
Can semen analysis results change?
Yes. Semen parameters can vary between samples. Depending on the result and your circumstances, your doctor may recommend a repeat analysis.
What is the difference between semen analysis and sperm DNA fragmentation?
A semen analysis assesses characteristics such as volume, sperm concentration, motility and morphology. DNA fragmentation testing looks at the integrity of the DNA within sperm and provides different information.
Can testosterone improve male fertility?
Testosterone treatment should not be started as a fertility treatment without appropriate medical advice. External testosterone can suppress the hormonal signals required for sperm production and may substantially reduce sperm count.
Should both partners have fertility tests?
Where appropriate, assessing both partners at the same time can provide a more complete picture and avoid focusing unnecessarily on one person.
Does a male fertility assessment mean we will need IVF?
No. Testing is about understanding your circumstances. The next step depends on the results, your history and your preferences, and treatment is only discussed where appropriate.
