By Michael A. Werner, MD, FACS

A new infertility test that measures male and female infertility has just been introduced into the U.S. marketplace. This is a great first step for the one million couples facing infertility issues each year. Patients who are attempting to achieve a pregnancy can use these tests as a first step on the path to conception.

One of the greatest advantages of these tests is that it draws attention to the often ignored issue of male infertility. In addition, it helps men who are intimidated by the idea of a sperm analysis to become comfortable with the concept of fertility testing in the comfort of their own home

For many years, doctors and the public often disregarded the male issues involved with reproduction and tested the men only after completing an exhaustive evaluation of the female partner. Since as many as 60% of infertility cases have male factors, this often led to significant delays in beginning treatment of the male, and over-testing of the female. (It is important to remember that sperm production, from division through maturation to ejaculation takes 78 days. Thus almost all interventions in treating the man have at least a three month delay before taking effect.)

Since sperm takes time to develop and because many cases of infertility have male factors, the medical field has somewhat recently recognized that the safest and easiest reproductive test to perform is a semen analysis. This is usually the first step in an infertility evaluation.

The new at-home fertility tests recognize that there may be male factors as well as female factors involved in reproductive issues. The male test measures sperm count and motility.

While this is a great start for couples, sperm count and motility address a very small segment of the fertility issues that can occur. A thorough semen analysis also should include volume (amount of fluid), forward progression (how well the sperm that are moving actually move), morphology (shape), antibodies (if the man is building up an immune response to his own sperm), white blood cells (is there an infection or inflammation), and total number of moving sperm. If any of these are abnormal, the man may have decreased fertility.

The biggest concern with these new over-the-counter tests is that men will take the test, find they have normal sperm counts and motility, and the couple may falsely believe that there is not a male factor. This may delay treatment of the male, while initiating an overly aggressive evaluation of the female.

The new tests bring attention to the important issues of male infertility, but they can not be used as a substitute for an in-depth semen analysis performed by a specialty infertility laboratory.

An infertility evaluation typically starts after twelve cycles of unprotected intercourse (or six cycles in woman over 35) have not resulted in a conception. In this situation, a formal semen analysis should be performed, and if abnormal, a specialist consulted. The female should see her physician and begin an evaluation as well.

If couples would like to get a rough gauge of their fertility status at the beginning of attempting conception, these new tests can be useful. If the test results are abnormal, the couple knows to begin a formal evaluation earlier than 6-12 months. If normal, they can attempt conception for this period, with the knowledge that they have a greater chance of success than if they had not done the screen.

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Dr. Michael A. Werner has dedicated his career to the treatment of male infertility. As a fellowship-trained, board-certified urologist, Werner’s practice is limited to male infertility and sexual dysfunction.

Werner earned his undergraduate degree from Harvard University and his medical degree from the University of California, San Francisco Medical School. He did his internship at St. Luke’s Hospital in New York: his surgical residency at Beth Israel Medical Center in New York; his urology residency at Mount Sinai Medical Center; and a Fellowship in male infertility and erectile dysfunction at Boston University Medical Center. Werner lives in White Plains, NY with his wife and four sons and practices in Westchester, NY and Fairfield County, CT.