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Male Fertility Tests: How Semen Analysis Works and What It Shows

If you produce sperm, a male fertility test is one of the clearest ways to understand your reproductive health. Whether you’re trying to conceive now or thinking ahead, it can highlight any issues with sperm quality that might affect your chances of pregnancy — and help guide your next step.

Author

Tassia O’Callaghan

Reviewed by

Kayleigh Hartigan

17 min read

Updated 21 August 2025

Spotlight:

A sperm test checks sperm count, movement (motility), and shape (morphology). It’s a simple, non-invasive way to get insight into your reproductive health.
Testing is usually recommended after a year of trying to conceive (or 6 months if your partner is 36 or older).
Some sperm tests can be done at home — offering a quick snapshot of things like count or motility. But follow-up with a clinician is key, as these tests don’t show the full picture. A specialist can interpret your results properly, check for anything that might be missed, and guide your next steps.
Male factor fertility issues play a role in around 50% of couples struggling to conceive — but are often overlooked in the early stages of testing. [1]
You’ll need to abstain from ejaculation for 2–7 days before the test.
The sample is produced by masturbation and analysed in a lab.
Results are usually ready within 7–10 days and sent to your GP or referring clinician.
You may need more than one test to confirm results or assess changes over time.

How can men check their fertility?

The most common way to check male fertility is with a semen analysis — a lab test that looks at key factors like sperm count, movement (motility), and shape (morphology). It’s often the first test recommended in heterosexual relationships where pregnancy hasn’t happened after a year of regular, unprotected sex (or six months if the partner with ovaries is 36 or over). But anyone who produces sperm — regardless of relationship set-up — can benefit from getting checked earlier, especially if they’re planning ahead or have concerns about their fertility. [2,3]

But an initial semen analysis is just one part of the picture — and sperm quality can vary, and a full fertility work-up may give a more complete picture. Here’s what might be included:

Comprehensive semen analysis: In addition to count, motility, and morphology, advanced semen testing may include:
- Volume – the amount of semen produced
- Vitality – whether sperm are alive
- pH – to assess the chemical environment
- Antibodies – which may interfere with sperm movement
- Photo or video of sperm – sometimes included as part of a visual report
Second semen analysis: Sperm quality can vary over time, so your doctor may request two separate samples — if the first test flags a potential issue (like low sperm count), a second test is usually done 12 weeks later to confirm. [2]
Medical history and physical exam: Your doctor will ask about any previous illnesses, surgeries, medications, or lifestyle factors that might affect fertility. They may also examine your testicles to check for things like varicoceles (enlarged veins), which can impact sperm quality. [4,5]
Hormone testing: A blood test may be used to check your levels of testosterone and other hormones that control sperm production, like FSH and LH. Imbalances here can sometimes be treated with medication. [1,6]
DNA fragmentation testing: This checks the integrity of the sperm’s genetic material. While it’s not routinely offered — and some UK clinics use it less than they used to — it may be helpful in specific situations. For example, it might be considered if you’ve had multiple pregnancy losses, unexplained infertility, or failed IVF cycles. Higher levels of fragmentation have been linked to poorer outcomes, and may be caused by oxidative stress, viral infections, or lifestyle factors like smoking. If you’re unsure, speak to a fertility specialist about whether this test could add insight in your case. [7]
Scrotal ultrasound: This painless imaging test can help spot structural problems in the testicles or surrounding area. [8]
Post-ejaculation urinalysis: This checks for sperm in your urine. If present, it may suggest retrograde ejaculation — when sperm travels backward into the bladder. [9,10]
Genetic testing: If sperm count is extremely low or zero, your clinician may suggest tests for Y chromosome microdeletions, karyotype analysis, or cystic fibrosis gene mutations — all of which can help explain why sperm aren’t being produced or released properly. [1,11]
Semen culture and virology testing: These may be recommended to screen for infections (e.g. chlamydia, HIV, hepatitis B or C) that could impact sperm health. [7]
Testicular biopsy: In rare cases, if other tests can’t explain the issue, a small tissue sample may be taken from the testicles to check for sperm production issues. [12]

Some private clinics — like Acorn Andrology — may offer same-day results, a video clip or photo of your sperm, a post-analysis consultation, and even a free male fertility coaching session to help you explore next steps.

Alongside medical treatment, there are also lifestyle changes that may help improve sperm health — including drinking less alcohol, quitting smoking, maintaining a healthy weight, wearing looser underwear, and limiting exposure to high heat or harmful chemicals. Every small step can make a difference. [2]

How to check if your sperm is fertile at home?

At-home sperm tests can offer a starting point if you’re curious about your fertility, but they only tell part of the story. Most at-home male fertility tests only measure sperm count — the number of sperm in your semen — which is just one piece of what makes sperm “fertile.” Fertility also depends on how well the sperm move (motility) and whether they’re the right shape (morphology), which most home kits can’t accurately assess.

The process usually involves collecting a semen sample and using a test strip or digital device to estimate whether your sperm count is within a typical range. Some app-connected kits might also give a rough sense of movement, but none can give a full picture of your reproductive health.

If an at-home test suggests your sperm count is low — or even if it looks normal but you’ve been trying to conceive for a while without success — it’s best to follow up with a full semen analysis at a clinic. That’s the only way to get a reliable, medically reviewed insight into how fertile your sperm actually are. [13]

And even if your at-home test suggests everything looks typical, it may miss important details like vitality, morphology, or DNA fragmentation — which can still affect your fertility or the chance of miscarriage.

Home sperm tests can be a helpful first step, but they aren’t definitive. For answers you can act on, a lab-based test can get you the most accurate results.

Who are sperm tests for?

If you produce sperm, a fertility test is for you — whether you’re cis, trans, non-binary, or somewhere else on the spectrum. These tests are often recommended in heterosexual relationships after 6–12 months of trying, but they’re just as valid if you’re planning solo parenthood, pursuing fertility preservation, or starting treatment with a partner of any gender.

When should a man get a fertility test?

If you’ve been having regular unprotected sex with a partner for over a year (or six months if they’re 36 or older), it’s time to start exploring testing — for both of you. [2,3]

That said, you don’t need to wait a year. If you have a medical history that might affect sperm production, or just want to understand your fertility earlier, you can speak to your GP or a private clinic anytime.

For men, a fertility test isn’t something you wait to be offered — it’s something you can and should ask for, especially if:

You haven’t conceived after a year of trying.
Your partner has had multiple early losses or fertility treatment that hasn’t worked.
You’ve had health issues that could affect sperm production — like a history of undescended testicles, testicular injury, or infections such as mumps or chlamydia. [14]
You’ve previously had chemotherapy, radiotherapy, or major abdominal or pelvic surgery.
You’ve taken anabolic steroids or certain medications known to affect sperm quality. [14]
You have symptoms of hormonal imbalance, such as low libido, erectile dysfunction, or unexplained fatigue. [14]
You’re planning to try to conceive soon and want to understand your baseline fertility.

In many cases, there aren’t obvious signs of an issue. You won’t necessarily notice symptoms if you have a low sperm count or poor sperm motility — which is why testing is so important. A semen analysis can pick up on issues that might otherwise go undetected and help you decide whether lifestyle changes, further tests, or treatment could support your chances of conceiving. [2]

Can you get a male fertility test on NHS?

Yes — male fertility testing is available on the NHS, but access can depend on where you live. That’s because eligibility for fertility investigations and treatment is set by your local Integrated Care Board (ICB) — the NHS bodies that decide what services are funded in your area.

In most cases, if you and your partner have been trying to conceive for over a year (or six months if your partner is 36 or older), your GP can refer you both for initial fertility tests. These usually happen at the same time to avoid unnecessary delays. For men, the first step is a semen analysis — a lab test that checks sperm count, motility (movement), and morphology (shape). [2,3]

If both tests show a potential issue, your GP can refer you to an NHS fertility clinic for further investigation. This may include hormone tests, an ultrasound of your testicles, a physical exam, or other follow-up checks.

While the testing process itself is often covered by the NHS, your access to further support or treatment (like IVF or ICSI) depends on your ICB’s criteria — which can vary widely across the UK. Some ICBs may have stricter age or relationship requirements, and others may only fund treatment after a specific number of failed attempts or confirmed diagnoses.

That’s why understanding your local ICB’s guidelines can be key. You can use our NHS eligibility tool to check what’s available in your area, or explore clinics near you if you’re considering private options or want faster access.

Do I need a referral for a sperm test?

You’ll usually need a referral from your GP to access a sperm test through the NHS. Your GP will assess your overall reproductive health, ask about any relevant symptoms or medical history, and if appropriate, refer you for a semen analysis at an NHS fertility unit. Availability may vary slightly depending on your local Integrated Care Board (ICB), as they set specific criteria for fertility investigations and treatment in your area.

Your NHS Eligibility

Use our NHS IVF Eligibility Calculator to discover if you can access free IVF and IUI.

How much does a sperm test cost?

The cost of testing sperm in the UK varies depending on the setting and how detailed the assessment is. A basic semen analysis carried out in a fertility clinic typically ranges from £100 to £210, with the median cost around £175. Some clinics also offer broader male fertility packages, often as part of a “Fertility MOT” for heterosexual couples. These include additional elements such as advanced testing, consultations, or fertility coaching, and usually cost between £449 and £1,150, with the median price sitting at £475.

Another option is to use an andrology centre or specialist clinic, where prices for semen analysis generally fall between £139 and £199, with a median of £189. Home sperm tests are also available, usually costing between £84.99 and £320 (median £98), but we recommend testing through a medical professional wherever possible. This way, the results can be interpreted in the context of your wider fertility health, with a consultation to guide any next steps.

Preparing for a male fertility test

Getting ready for a sperm test (semen analysis) is simple, but following the instructions closely is essential — even small things can affect your results. Here’s how to prepare: [3,15,16,17]

Abstain from ejaculation for at least 2 days, but no longer than 7: The quality of your sperm can be affected if this window isn’t followed. [3]
Collect the sample by masturbation only: Condoms, lubricants, or withdrawal methods are not suitable as they can damage the sample.
Use the container provided by your clinic or lab: Other containers, including those from home, won’t be accepted.
Wash your hands and genitals thoroughly before collecting the sample: Then dry completely to avoid contamination.
Avoid recreational drugs or drink heavily in the days leading up to your test, as both can affect sperm function. It’s generally recommended to avoid recreational drugs altogether while trying to conceive, and to limit alcohol consumption. [18,19,20]
If needed, label the container clearly with your full name, date of birth, and hospital or NHS number (if known), and check that the lid is secured tightly to prevent leakage.
Deliver the sample within the timeframe advised (if providing a sample out of the clinic): Usually within 50–60 minutes of production. Keep it close to your body (like in an inside pocket) to protect it from cold or overheating.
If you’re producing the sample at the clinic, let them know when booking your appointment — some units offer private rooms, but you’ll need to bring your own materials if needed, as clinics don’t provide stimulation aids.

If anything goes off-plan — like spillage, delay, or recent illness — contact the clinic to reschedule.

Understanding male fertility test results

Most results are ready within 7–10 days, but how long it takes to review them can depend on your clinic or GP. Your doctor will talk through what they mean and whether further tests or support are needed. [21]

Here’s a quick explainer of what the most common results look like — though keep in mind that a full picture of your fertility often includes more than just one number.

Sperm count (concentration per millilitre)

Low: Fewer than 15 million sperm/mL (classed as oligozoospermia). If you do find out you have a low sperm count, you’re not without options. You may still be able to conceive naturally, and fertility treatments like IVF, IUI, or ICSI can help many people go on to have children, even with very low sperm numbers.)[13]
Normal: 15–200 million sperm/mL. This is the typical range for fertile men, though count alone doesn’t confirm fertility.
Very high: Over 200 million sperm/mL (classed as hyperspermia). This is usually not a concern, quite rare, and there isn’t much research on it, but extremely high counts may point to an issue with sperm function. [22]

Sperm motility (how well the sperm move)

Low: Less than 40% of sperm are moving, or under 32% are moving progressively (in a straight line). Poor motility can make it harder for sperm to reach and fertilise the egg. [23,24,25,26]
Normal: At least 40% moving, with good forward progression.

Sperm morphology (shape of the sperm)

Low: Less than 4% of sperm are considered “normal” in shape. While this may reduce fertility, many people still conceive naturally or with treatment.
Normal: 4% or more normal-shaped sperm (this may seem low, but even a small percentage of correctly shaped sperm can be enough). [26]

FSH (follicle-stimulating hormone)

High: Over 12.4 IU/L. May indicate your body is trying to compensate for impaired sperm production. [6]
Normal: Generally between 1.5 to 12.4 IU/L, although the specific definition of ‘normal’ can vary slightly depending on your clinic and your other results. [27,28]
Low: Less than 1.5 IU/L. Can be seen in cases of obstruction or low hormone output. [6]

Scrotal ultrasound

Normal: No obvious physical abnormalities.
Varicocele found: May impact sperm production and quality. In some cases, surgery may improve fertility. [29]
Obstruction or mass: May require further urological assessment or treatment.

Find the right clinic for you

Choosing a clinic is one of the biggest decisions you’ll make. We’ll find the best options for you and arrange your pre-treatment tests, empowering you from this point onwards.

Next steps after a male fertility test

After your test, the results are usually sent to the clinician who arranged it — either your GP (for NHS referrals) or your consultant at a private fertility clinic. If anything unusual is found, you may be asked to repeat the test in about 6 to 12 weeks, as sperm quality can fluctuate and a second sample helps confirm any patterns. From there, your next steps could include a referral for further testing — such as hormone blood tests, a testicular ultrasound, or a consultation with a specialist in male fertility. [2,16,30]

On the NHS, these referrals go through your GP and may be subject to local eligibility criteria set by your Integrated Care Board (ICB). If you’re going through a private clinic, these investigations can usually be arranged more quickly, though there may be added costs. Depending on the findings, you may be offered support to improve your sperm health, or be guided toward assisted fertility treatments like IVF, IUI, or ICSI. If results are normal and pregnancy still hasn’t happened, further testing will likely be recommended for your partner, and next steps will focus on a more complete picture of your shared fertility path.

Choosing a clinic for your male fertility test

Male fertility test FAQs

Should you pee before sperm test?

In most cases, you don’t need to urinate before providing a sperm sample — and your clinic may not ask you to. However, there are specific exceptions, such as if you’re being tested for retrograde ejaculation (a condition where semen enters the bladder instead of exiting through the penis). In those situations, the clinic may instruct you to partially empty your bladder first, collect any semen you can, then urinate into a second container so the lab can retrieve sperm from the urine. Unless you’ve been given instructions for this type of test, it’s best to follow your clinic’s specific guidance. If you’re unsure, just ask when you book your appointment. [9]

Why wait at least 2 days before sperm test?

Waiting around three days (typically 2 to 5 days) before your sperm test gives your body enough time to build up a healthy supply of mature sperm. This window helps ensure the sample reflects your sperm at their best — in both count and quality. Testing too soon after ejaculation can lower your sperm count, while waiting too long (more than 7 days) can lead to sperm ageing or dying off, which can affect motility and skew the results. [3,30,31]

Does alcohol affect sperm test?

Yes, alcohol can affect the results of a sperm test — especially if consumed heavily in the days leading up to it. Research shows that alcohol may reduce sperm count, motility (how well they move), and morphology (their shape), and may also alter hormone levels like testosterone and oestradiol. While occasional or moderate drinking might not have a drastic impact, high or frequent alcohol intake can lead to measurable changes in semen quality. To get the most accurate results, it’s best to follow NHS guidelines: limit alcohol to no more than 14 units per week, and consider avoiding it altogether in the days before your test. If you’re unsure, your GP or fertility clinic can offer personalised advice. [2,32,33,34,35]

Is a sperm test painful?

No, a sperm test isn’t painful. Semen analysis is non-invasive and simply involves providing a sample through masturbation. Some people may feel a bit awkward or embarrassed about the process, especially if asked to produce the sample in a clinic, but there’s no physical pain involved.

Sources

NHS IVF Eligibility Calculator

Find my Match

Fertility Testing

Fertility Treatments

Fertility Costs

NHS Fertility