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November 28, 2019/Living Healthy/Men's Health

At-Home Sperm Tests Can Be Useful, But They Don’t Replace a Fertility Doctor

New consumer-friendly devices have limitations for assessing male fertility

Illustration of sperm swimming

If you and your partner are having trouble getting pregnant, you might be tempted to try one of those at-home sperm testing kits you’ve heard about. It’s cheaper and easier than seeing a doctor, right?

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Proper male fertility testing should include evaluation by a physician and a semen sample analyzed in a professional andrology laboratory — and the release of at-home testing kits hasn’t changed that, says Sarah Vij, MD, Director of the Center for Male Fertility at Cleveland Clinic.

But there is a role for these home test kits — particularly for men who don’t have a fertility specialist nearby or are hesitant to go to one. Currently, most men aren’t checked for infertility until couples have been unsuccessful at pregnancy for 12 months, so a home test may also help reveal potential problems sooner.

“At-home semen analysis gives preliminary information to men, wherever they are,” Dr. Vij says. “It can be useful for men who are self-conscious about giving a semen sample in an office setting, or who don’t do it for cultural or religious reasons.”

Male fertility test kits: What do they do?

The FDA approved the first home fertility test for men in 2012. Today, several FDA-approved test kits are available.

Each uses a different mechanism of testing and delivers different information. Some only report whether sperm are present or absent. Others measure the concentration of a man’s sperm (the number of sperm per millimeter of semen). This information is only a fraction of what’s reported on a formal semen analysis, and it doesn’t tell the whole story.

“Even if you have 100 million sperm, if none are moving, you won’t be fertile,” Dr. Vij notes.

Smartphone-based kits are more advanced. They use a smartphone’s light and camera to record a close-up video of a sperm sample. Most kits require attaching the phone to another device to evaluate sperm concentration and motility — similar to what computer equipment in an andrology lab does.

For example, the first smartphone-based sperm-testing kit to be approved by the FDA, called Yo, comes with a device that attaches to a smartphone app and acts as a tiny microscope. Men use a dropper to apply a sample of ejaculate onto a slide, which is inserted into the device. The Yo app calculates concentration of motile sperm.

Homes test kits vs. lab testing

Home test kits differ significantly from testing done in an andrology laboratory, Dr. Vij points out.

“Laboratory testing gives a much more thorough assessment,” she says.

In an andrology lab, semen is evaluated both under a microscope and by a computer to determine:

  • Exact sperm concentration.
  • Vitality (the percentage of your sperm that is healthy).
  • Motility (the percentage of your sperm that is moving).
  • Ejaculate volume.
  • Acidity (pH).
  • Morphology (the size and shape of your sperm).

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When to use home testing

Home testing will not replace a professional fertility workup, Dr. Vij says.

“If home test results show a man has low sperm count, he’ll need to see a fertility specialist,” she says. “But even if the results are normal, there could still be male-factor infertility. He could still need a fertility assessment.”

However, there may be some situations where home testing can stand alone, she adds. Men who have certain risk factors for infertility (if they’ve had chemotherapy, for example) can get a quick check to be reassured they’re fertile.

Home test kits also may be valuable in the future for testing men post-vasectomy, Dr. Vij suggests. Surgeons often recommend that patient verify that they’re sterile a few months after having a vasectomy before having unprotected sex. Most men don’t do this, she says, but compliance might improve if men could test themselves at home. (It’s worth noting, though, these tests have not yet been validated in the post-vasectomy population.)

“Home testing, even with more advanced smartphone-based methods, is a complement to the services offered by fertility specialists,” Dr. Vij says. “Most of us who do this for a living are excited about its potential, but we still believe the in-office assessment is critical.”

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