Male Fertility Testing & Evaluation

  1. Home
  2. Fertility Services
  3. Fertility Services
  4. Male Fertility Testing & Evaluation

Male Fertility Testing in Orlando, FL

Male factor infertility is involved in approximately half of all infertility cases, yet it is often the last thing evaluated. Fertility testing for men is straightforward, non-invasive in most cases, and can provide answers quickly.

The sooner potential issues are identified, the sooner your care team can develop a plan that gives you the best chance of success — whether that means lifestyle changes, medical treatment, or assisted reproductive technology. At CRM Orlando, we take a proactive approach to male fertility evaluation, taking the time to understand your health history, order the right tests, and make sure you leave with a clear picture of where things stand and what comes next.

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. Unlike some health conditions that announce themselves with pain, discomfort, or visible changes, most causes of male infertility are completely silent.

This is why testing matters even when nothing seems wrong. Clinically, a fertility evaluation is typically recommended after 12 months of unprotected intercourse without pregnancy, or after 6 months if the female partner is over 35. However, earlier testing is often warranted for men with a history of testicular injury, surgery (including hernia repair or vasectomy), sexually transmitted infections, or a known genetic condition. Men who have been exposed to chemotherapy, radiation, or prolonged heat (such as in certain occupational settings) may also benefit from evaluation before actively trying to conceive.

The bottom line: there’s no downside to knowing. A semen analysis is simple, accessible, and provides invaluable information at any stage of the fertility journey.

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 the hormonal systems that regulate all of the above. In some cases, a single identifiable cause is found; in others, multiple contributing factors are present. Common conditions and contributing factors include:

  • Varicocele: An enlargement of the veins within the scrotum that can raise testicular temperature and impair sperm production and quality. It is one of the most common and treatable causes of male infertility.
  • Azoospermia (obstructive or non-obstructive): The complete absence of sperm in the ejaculate. Obstructive azoospermia results from a blockage in the reproductive tract; non-obstructive azoospermia results from impaired sperm production in the testes.
  • Low sperm count (oligospermia): A sperm concentration below the normal threshold, which reduces the likelihood that a sperm will successfully reach and fertilize an egg.
  • Poor sperm motility or morphology: Sperm that do not move efficiently (motility) or that have abnormal shape and structure (morphology) may be unable to penetrate and fertilize an egg, even when the sperm count is normal.
  • Hormonal imbalances (e.g., low testosterone): Disruptions to the hormonal axis that governs sperm production, involving testosterone, FSH, LH, and other hormones, can significantly impair fertility.
  • Genetic or chromosomal conditions: Conditions such as Y-chromosome microdeletions or cystic fibrosis gene variants can directly affect sperm production or delivery.
  • Infections or structural blockages: Past or present infections, including sexually transmitted infections, can cause scarring that blocks sperm transport. 
  • Lifestyle or environmental factors: Smoking, excessive alcohol use, anabolic steroid use, obesity, heat exposure, and certain occupational chemical exposures can all negatively affect sperm health.
  • Unexplained infertility: In some cases, sperm parameters appear normal, but conception remains elusive. Advanced testing, such as sperm DNA fragmentation analysis, may help identify underlying issues not captured by a standard semen analysis.

What is a semen analysis, and why does it matter?

The semen analysis is the cornerstone of male fertility evaluation. It is a non-invasive, relatively simple test that provides a comprehensive look at the key parameters of sperm health. For most men, it is the first and most important piece of diagnostic information their care team will need.

A standard semen analysis measures the following:

  • Sperm count (concentration): The number of sperm per milliliter of semen. Normal is generally considered 16 million sperm per milliliter or more.
  • Total motility: The percentage of sperm that are moving. Progressive motility, or sperm moving in a forward direction, is especially important for natural conception.
  • Morphology: The percentage of sperm with a normal shape. Even in fertile men, only a fraction of sperm have ideal morphology, but very low rates can indicate a problem.
  • Semen volume: The total amount of fluid produced per ejaculation. Too little or too much can both be clinically significant.
  • pH and other parameters: Additional markers such as pH, liquefaction time, and the presence of white blood cells may also be assessed to provide a fuller picture.

Results are interpreted against established reference ranges from the World Health Organization (WHO). A single semen analysis is a starting point, not a verdict — sperm parameters can vary from sample to sample, and a follow-up test is often recommended to confirm findings before any diagnosis is made.

Preparing for a semen analysis is straightforward. You will be asked to abstain from ejaculation for 2 to 5 days before providing a sample, long enough to allow sperm to replenish, but not so long that quality begins to decline. Samples are typically collected on-site in a private collection room, though home collection with prompt delivery may be allowed. Avoid alcohol and any new medications or supplements in the days before your test, and let your care team know about any current prescriptions. The process is simple, confidential, and an essential step in understanding your fertility.

What other male fertility tests might be recommended?

Depending on the results of your semen analysis and your overall clinical picture, your fertility specialist may recommend one or more additional evaluations. These tests help identify the underlying cause of any abnormalities found and guide the most effective treatment approach.

Medical History and Physical Examination

A thorough medical history is always part of a male fertility evaluation. Your provider will ask about your reproductive history, any prior pregnancies (with a current or previous partner), past surgeries, infections, medications, and lifestyle factors. This conversation helps identify risk factors that may not show up on lab work alone.

A physical examination, typically performed by a urologist or reproductive specialist, allows the provider to assess the testicles, epididymis, and vas deferens for size, consistency, and any structural abnormalities. The combination of a detailed history and hands-on examination is essential context for interpreting any lab or imaging results.

Microsurgical Testicular Sperm Extraction (microTESE)

For men diagnosed with non-obstructive azoospermia, meaning no sperm are present in the ejaculate due to a problem with sperm production rather than a blockage, microsurgical testicular sperm extraction (microTESE) may offer a path to biological parenthood. This highly specialized procedure uses an operating microscope to identify and retrieve sperm directly from the testicular tissue.

microTESE is typically performed by a reproductive urologist in a surgical setting and is often coordinated with an IVF cycle, so that any retrieved sperm can be used immediately for fertilization. Not all men with azoospermia will have retrievable sperm, but microTESE offers the highest sperm retrieval rates of any surgical sperm extraction technique. Your care team will discuss whether you are a candidate based on your diagnosis, hormone levels, and genetic testing results.

Hormone Testing

The hormonal system plays a central role in regulating sperm production, and imbalances can be a significant yet often treatable cause of male infertility. A blood panel measuring key reproductive hormones is commonly ordered when semen analysis results are abnormal or when a hormonal cause is suspected.

Key hormones evaluated include:

  • Testosterone: The primary male sex hormone, essential for sperm production and overall reproductive function.
  • Follicle-Stimulating Hormone (FSH): Stimulates sperm production in the testes. Elevated FSH can indicate impaired testicular function; very low levels may suggest a problem with the pituitary gland.
  • Luteinizing Hormone (LH): Works alongside FSH to regulate testosterone production and support spermatogenesis.
  • Prolactin: Elevated prolactin levels can suppress testosterone and impair fertility. High prolactin is sometimes associated with a pituitary adenoma.
  • Estradiol: Excess estrogen can disrupt the hormonal balance needed for optimal sperm production, particularly in men with obesity or certain medical conditions.

Hormone testing is a simple blood draw and can provide critical diagnostic clarity, especially in cases where sperm count or production appears significantly impaired.

Genetic Testing

In certain clinical scenarios, genetic testing is an important part of the male fertility workup. It is most commonly recommended for men with azoospermia, severely low sperm counts, or a history of recurrent IVF failure without an obvious explanation.

Testing may include karyotype analysis (to detect chromosomal abnormalities such as Klinefelter syndrome), Y-chromosome microdeletion testing (to identify missing genetic regions on the Y chromosome that are critical for sperm production), and cystic fibrosis gene mutation testing (particularly relevant for men with congenital absence of the vas deferens). Genetic results can influence treatment decisions, help estimate the likelihood of successful sperm retrieval, and provide important information for family planning. Your care team will explain what tests are appropriate for your situation and what the results may mean for you and your partner.

How much does male fertility testing cost?

The cost of male fertility testing varies depending on which evaluations are recommended and your individual insurance coverage. A basic semen analysis is among the more affordable fertility diagnostics, while hormone panels, genetic testing, and surgical procedures like microTESE involve additional costs.

Florida does not currently mandate insurance coverage for fertility treatments, but many health plans do cover diagnostic testing, including semen analysis and hormone bloodwork, when ordered for a medical indication. Our financial counselors at CRM Orlando are available to review your coverage, walk you through anticipated costs, and discuss flexible financing options so that cost is never a barrier to getting the answers you need.

Male Fertility Testing FAQ

  • A semen analysis is a laboratory test that evaluates the health and quality of a man’s sperm. It measures key parameters, including sperm count (concentration per milliliter), total motility (percentage of moving sperm), progressive motility (sperm moving in a forward direction), morphology (the percentage with normal shape and structure), and semen volume. It is typically the first test ordered in a male fertility evaluation.

  • Preparation for a semen analysis is simple. You will be asked to abstain from ejaculation for 2 to 5 days before your appointment. This window allows adequate sperm to accumulate without quality beginning to decline from prolonged abstinence. In the days leading up to your test, avoid alcohol and recreational drugs, and let your provider know about any current medications or supplements. Samples are typically collected on-site in a private room, though some providers allow home collection if the sample can be delivered to the lab within 30 to 60 minutes.

  • A low sperm count (i.e., oligospermia) means there are fewer sperm per milliliter of semen than the normal reference threshold (generally below 16 million/mL). While a low count reduces the statistical likelihood of natural conception, it does not mean conception is impossible. Many men with low sperm counts father children naturally or with minimal assistance. The significance of the finding depends on how low the count is, as well as the motility and morphology of the sperm present. Your fertility specialist will interpret results in the context of your full clinical picture.

  • Yes, many causes of male infertility are treatable or manageable. Varicoceles can be surgically repaired, hormonal imbalances can often be corrected with medication, and lifestyle changes (such as quitting smoking, reducing alcohol, or addressing obesity) can meaningfully improve sperm parameters. For men with more severe infertility, procedures such as intrauterine insemination (IUI) or in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) can bypass many sperm-related barriers to conception. Even men with azoospermia may have viable sperm retrieved surgically. Early evaluation opens the door to a broader range of options.

  • Yes, though the decline is more gradual than in women. As men age, sperm count, motility, and morphology can decrease, and sperm DNA fragmentation tends to increase. Studies have also associated advanced paternal age with a higher risk of certain genetic conditions in offspring. While men can remain fertile well into later life, age-related changes in sperm quality can contribute to longer time-to-conception and a higher risk of miscarriage. Men over 40 who are trying to conceive may benefit from a fertility evaluation, particularly if conception has not occurred after several months of trying.

  • Abnormal sperm motility (asthenospermia) or morphology (teratospermia) can result from a wide range of factors, including varicocele, infections, hormonal imbalances, heat exposure, and certain medications. Lifestyle factors such as smoking, alcohol use, and poor diet have also been linked to reduced sperm quality. In some cases, the cause is idiopathic, meaning no specific underlying reason can be identified despite thorough evaluation. Your fertility specialist will review your history and recommend targeted testing to identify any correctable contributing factors and determine the best path forward.

  • Yes. Several medications are known to affect sperm production or function, including anabolic steroids (which can suppress natural testosterone and shut down sperm production), certain antidepressants, antihypertensives, and chemotherapy drugs. Testosterone replacement therapy (TRT) is a particularly common culprit, as testosterone suppresses the body’s natural signaling for sperm production and can cause azoospermia. Some supplements may also interfere with fertility. Always give your fertility specialist a complete list of all medications, supplements, and herbal products you are currently taking before your evaluation begins.

  • Most semen analysis results are available within 24 to 48 hours of sample collection, though turnaround time may vary depending on the laboratory. Your fertility specialist or care coordinator will typically review the results with you at a follow-up appointment or via a patient portal message, explaining what each parameter means and whether any further evaluation is recommended. If results are abnormal, a repeat semen analysis is usually ordered two to four weeks later to confirm findings before a diagnosis is made or a treatment plan is initiated, since sperm parameters can naturally vary between samples.

  • Not at all. Many cases of male infertility are temporary or reversible, particularly when caused by lifestyle factors, hormonal imbalances, infections, or correctable structural issues like varicocele. Even men who have been on testosterone therapy, which can suppress sperm production, may recover fertility after discontinuing treatment, though recovery timelines vary. More severe conditions, such as non-obstructive azoospermia due to testicular failure, may be less reversible, but assisted reproductive technologies still offer meaningful options. The first step is always a thorough evaluation to understand the underlying cause and explore all available solutions.

Comprehensive Male Fertility Testing in Orlando, FL

If you’re ready to take the next step, whether you’ve been trying to conceive for a while or simply want to understand your reproductive health, our team at the Center for Reproductive Medicine is here to help. We offer comprehensive male fertility evaluations for individuals and couples at our locations across Orlando, Winter Park, and Celebration.

You don’t have to navigate this alone. Our specialists bring expertise, compassion, and a full suite of diagnostic tools to every evaluation, and we’re committed to giving you the clarity and support you deserve. Reach out today to schedule your male fertility consultation.