How Accurate Are At-Home Sperm Tests?

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?

Not so fast.

For proper, accurate male fertility testing, you should be evaluated by a physician and have a semen sample analyzed in a professional andrology laboratory. The availability of at-home testing kits hasn’t changed that, says urologist Neel Parekh, MD.

“Home testing, even with more advanced smartphone-based methods, is an addition to the services offered by fertility specialists,” Dr. Parekh clarifies, “not a replacement for them.”

That said, home tests can still play a helpful role in your family-planning journey. He explains what at-home sperm testing can and can’t do, why you still need to see a fertility specialist and how to get on the path to conception.

What do male fertility test kits do?

The U.S. Food and Drug Administration (FDA) approved the first at-home male fertility tests in 2012. Today, there are several types of FDA-approved test kits available for sale.

Each kind uses a different testing mechanism and provides different information. Some only report whether or not there’s sperm in your semen; others measure the number of sperm per millimeter of semen (known as sperm concentration).

There are also smartphone-based home testing kits, Dr. Parekh explains, which are more advanced, using your phone’s light and camera to record a close-up video of a sperm sample. Most kits require you to attach your phone to another device to evaluate sperm concentration and motility, or how active your sperm are. This is closer to what the computer equipment in an andrology lab does.

But they’re still not all they’re cracked up to be.

“Home test kits differ quite a bit from the kind of testing that we do in an andrology laboratory,” he adds. “Laboratory testing gives us a much more thorough assessment.”

Are home sperm tests accurate?

It’s not that home tests are inaccurate, Dr. Parekh notes. It’s that they don’t have the same capacity for testing that laboratories do, so they can’t give you a full picture of your fertility (or of the infertility issues you’re facing).

In an andrology lab, your semen will be evaluated both under a microscope and by a computer — and, of course, looked at by a healthcare provider. Lab testing can determine:

• Your exact sperm concentration.
• The percentage of your sperm that’s healthy (vitality).
• The percentage of your sperm that’s moving (motility).
• The volume of your ejaculate.
• The acidity (pH) of your semen.
• The size and shape of your sperm (morphology).

But the information you receive from home testing kits is only a fraction of what’s reported on a formal semen analysis done in a doctor’s office. It doesn’t tell the whole story about what’s going on in your body.

“You could, for example, have 100 million sperm,” he illustrates, “but if none are moving, you won’t be fertile. Only laboratory testing can show you a full picture.”

Is home testing ever the right move?

There are times when at-home semen analysis can be a good starting point.

“A home test can’t — and shouldn’t — replace a professional fertility workup,” Dr. Parekh reiterates, “but it can give you some preliminary information.”

He shares times when home fertility testing could be a worthwhile first step.

You’re just getting started

When a couple is first trying to conceive, Dr. Parekh says that men typically aren’t checked for infertility unless they’re still unsuccessful in achieving pregnancy after 12 months.

“Doing a home test may help reveal potential problems sooner,” he notes. “But if your results show any potential issues, you’ll have to follow up with a fertility specialist to address them.”

You want quick reassurance

If you have certain risk factors for infertility, like a history of chemotherapy, a home test could provide some encouragement that you’re fertile. But if your results show that you have low sperm count, you’ll need to see a fertility specialist.

“Plus, even if your results seem normal, you could still be dealing with male-factor infertility that isn’t revealed through at-home testing,” Dr. Parekh points out.

You don’t have access to a lab

Not everyone in the world lives near a high-quality andrology lab.

“In these cases, at-home semen analysis can give you some preliminary information, wherever you are,” Dr. Parekh says.

Again, though, it’s still always best to follow it up with an in-person visit to a fertility specialist who can order lab testing.

You’ve had a vasectomy

Here’s a use case you might not have considered: Home test kits can be a valuable tool for making sure you’re not fertile. If you’ve had a vasectomy, your surgeon may recommend verifying that you’re sterile before you have unprotected sex — usually about two months after your procedure.

“We know that most men don’t actually do this,” Dr. Parekh acknowledges, “so testing yourself at home could be an easy way to be sure the procedure worked.”

Final thoughts on at-home sperm tests

Even with advanced smartphone methods, home fertility testing is still best used as a complement to the services offered by fertility specialists — not as a replacement for them.

“Most of us who do this for a living are excited about its potential,” Dr. Parekh says. “But we still believe the in-office assessment is critical.”