Male Fertility Test: Semen Analysis, Normal Sperm Count and Causes of Male Infertility

Short answer: The main male fertility test is a semen analysis, a lab check of semen volume, sperm count, movement (motility) and shape (morphology). Mayo Clinic advises seeing a doctor if you have not caused a pregnancy after one year of regular unprotected sex, or after six months if your partner is older than 35. A single abnormal result is not a diagnosis: the test is usually repeated, and a urologist or fertility specialist adds a physical exam and hormone blood tests to find the cause, many of which are treatable.

Key Takeaways

• Nearly 1 in 7 couples is infertile, and a male factor is at least part of the reason in up to half of them, according to Mayo Clinic.^[1]
• Get evaluated after 12 months of trying without a pregnancy, or after 6 months if your partner is over 35. Men with known risk factors (past testicular surgery, undescended testicles, cancer treatment) can ask sooner.
• The semen analysis is the core test. Because results vary from one sample to the next, doctors usually want 2 or 3 samples before drawing conclusions.^[3]
• Mayo Clinic defines a low sperm count as fewer than 15 million sperm per milliliter, or fewer than 39 million per ejaculate.^[1]
• Common, findable causes include varicocele, infections, hormone problems, blockages, genetic conditions and medicines such as testosterone or anabolic steroids.
• No supplement replaces this workup. If conception is taking longer than expected, start with a clinician, not a product.

What Is Male Infertility?

Infertility means a couple has not achieved a pregnancy after a year or more of regular sex without protection. Male infertility is when a problem on the man’s side contributes: too few sperm, sperm that do not move or function well, or a blockage that stops sperm from getting where they need to go.^[1] The Urology Care Foundation notes that male factors are involved in over a third of infertility cases.^[5]

The frustrating part is that most men with a fertility problem feel completely normal. Mayo Clinic lists the inability to start a pregnancy as the main sign, and there may be no other symptoms at all.^[1] That is why testing, not guessing, is the only way to know. It also explains why it makes sense to test both partners at the same time instead of evaluating the woman first and the man months later.

How sperm are made and delivered

Fertility depends on a chain of steps. The testicles must produce sperm, which requires testosterone and pituitary hormones (FSH and LH, explained in our guide to the roles of FSH and LH). The sperm must then travel through the tubes of the reproductive tract, mix into semen, be present in sufficient numbers and be able to move and function. A problem at any point in that chain can reduce fertility.^[1]

Male Infertility Causes

Doctors usually group the causes into medical, environmental and lifestyle factors. In some men no clear cause is found even after a full workup.

Medical causes

• Varicocele: swollen veins that drain the testicle. Mayo Clinic calls it the most common fixable cause, and the Urology Care Foundation calls it the leading cause of impaired sperm production in the United States.^[1][5] Our article on varicocele symptoms and testosterone covers it in detail.
• Infections: epididymitis, orchitis and some sexually transmitted infections such as gonorrhea or HIV.
• Ejaculation problems: for example retrograde ejaculation, where semen goes back into the bladder.
• Hormone imbalances: including low testosterone (hypogonadism) and pituitary problems. Testing your testosterone levels is part of the workup.
• Blockages in the tubes that carry sperm, from infection, injury, surgery or abnormal development.
• Genetic conditions such as Klinefelter syndrome and cystic fibrosis.
• Undescended testicles, tumors, cancer and cancer treatment (surgery, radiation, chemotherapy).
• Antibodies that attack sperm.
• Medicines: testosterone replacement, long-term anabolic steroid use, some chemotherapy drugs and some ulcer and arthritis medicines.^[1]

Environmental and lifestyle causes

Mayo Clinic lists exposure to industrial chemicals, pesticides, herbicides, solvents, heavy metals such as lead, and radiation. Heat on the testicles (saunas, hot tubs) can lower sperm production, while prolonged sitting, laptops on the lap and tight clothing are possible factors that need more research. Drug use (anabolic steroids, cocaine, marijuana), alcohol, tobacco smoke including secondhand smoke, and obesity also play a role.^[1]

These are the factors you can change yourself. We cover diet, weight, alcohol, heat and other daily habits in a separate guide on how to improve sperm quality naturally, so this page focuses on testing and medical care.

When to Get a Male Fertility Test

Mayo Clinic’s guidance is simple: see a doctor if you have not caused a pregnancy after one year of regular unprotected sex, or after six months if your partner is older than 35.^[1] Do not wait the full year if any of the following applies to you:

• Erection or ejaculation problems, low sex drive or other signs of a hormone problem.
• Pain, a lump or swelling in the scrotum, or a known varicocele.
• A history of undescended testicles, testicular injury, groin, scrotal or prostate surgery, or a previous vasectomy.
• Past cancer treatment, or current or past use of testosterone or anabolic steroids.
• A known fertility problem in yourself or a blood relative.

The right specialist for the man is a urologist, ideally one with training in male reproductive medicine (andrology). Many fertility clinics coordinate the evaluation of both partners.

Semen Analysis: How the Test Works

A semen analysis measures how much semen you produce, how many sperm it contains, how well they move, what they look like and whether there are signs of infection.^[2] The sample is usually collected by masturbation into a sterile container at the clinic, or at home with a special collection condom your provider supplies.^[2][4]

How to prepare

• Abstinence: MedlinePlus advises avoiding ejaculation for about 2 to 3 days before the test, noting that more than 5 days can reduce sample quality.^[2] Other sources give a window of 2 to 7 days (Cleveland Clinic) or 3 to 7 days (StatPearls).^[3][4] Follow your own lab’s instructions.
• Timing: if you collect at home, the sample should reach the lab within 30 minutes per MedlinePlus (StatPearls allows up to 1 hour), kept near body temperature, for example in an inside coat pocket.^[2][3]
• Collect everything: tell the lab if any part of the sample was lost.
• Bring your list: medications, supplements, recent fever or illness can all affect results.

Semen analysis normal values (WHO reference limits)

Most labs compare results with reference limits from the World Health Organization laboratory manual. The figures below are the 2010 WHO values (the 5th percentile of fertile men) as summarized by StatPearls, plus the concentration threshold Mayo Clinic uses for a low sperm count.^[1][3] A value below a limit is not proof of infertility, and a value above it does not guarantee fertility.

Do not be surprised if your lab report uses slightly different ranges. MedlinePlus, for example, lists a normal volume of 1.5 to 5.0 mL and a concentration of 20 to 150 million per mL, while Cleveland Clinic lists 15 to 259 million per mL and 4% to 48% normal forms.^[2][4] Labs and manual editions differ, so read your numbers against the range printed on your own report and have your doctor interpret them. Cleveland Clinic also notes that more than 1 million white blood cells per mL (pyospermia) can signal infection or inflammation.^[4]

Why one test is not enough

Sperm counts naturally swing from one sample to the next. StatPearls advises 2 or 3 samples for more accurate data, and if a result is abnormal, repeating the analysis about 3 months later, after a full new cycle of sperm production.^[3] The Urology Care Foundation notes that the test is most often done at least twice when sperm numbers are abnormal.^[5] A recent fever, illness or new medicine can temporarily lower a result.

The Rest of the Workup

A semen analysis tells you that something is off, not why. A urologist or fertility specialist builds the full picture with the following steps.^[3][5][6]

History and physical exam

Expect questions about childhood illnesses, puberty, surgeries, medicines, alcohol, tobacco and drug use, chemical or radiation exposure, sexual function and how long you have been trying. The exam checks the testicles, epididymis and vas deferens, and looks for a varicocele.^[5][6]

Hormone blood tests

StatPearls recommends starting with a morning total testosterone (8 to 10 AM) and FSH. If testosterone is low, a repeat test with free testosterone, LH and prolactin follows.^[3] These results help separate a problem in the testicles from a problem in the pituitary or hypothalamus. Our pages on high prolactin in men and free vs total testosterone explain those markers.

Other tests your doctor may order

• Scrotal ultrasound to look for a varicocele or other changes in or around the testicles.
• Transrectal ultrasound to check the prostate and look for blocked ejaculatory ducts or seminal vesicles.
• Post-ejaculation urinalysis to detect retrograde ejaculation.
• Genetic tests such as a karyotype or Y chromosome microdeletion testing when the count is very low or zero.
• Testicular biopsy in selected men with very low or no sperm, to tell a production problem from a blockage and sometimes to retrieve sperm.^[3][5][6]

Treatment Options

Treatment depends on the cause, which is why the workup matters. Options listed by Mayo Clinic and the Urology Care Foundation include:^[5][6]

• Surgery: varicocele repair, repair of a blocked vas deferens, vasectomy reversal, or surgery to open blocked ejaculatory ducts. After varicocele repair, Urology Care Foundation advises a semen test about every three months for at least a year, or until pregnancy.
• Sperm retrieval: when there are no sperm in the ejaculate, sperm can sometimes be collected directly from the testicle or epididymis.
• Treating infections with antibiotics, although fertility does not always return.
• Medicines or counseling for erection or ejaculation problems.
• Hormone treatment when hormone levels are too high or too low.
• Assisted reproduction: intrauterine insemination (IUI), in vitro fertilization (IVF), or intracytoplasmic sperm injection (ICSI), where a single sperm is injected into an egg.

One important warning: men who are trying to conceive should not start testosterone on their own. Mayo Clinic lists testosterone replacement and anabolic steroids among the medicines that can impair fertility.^[1] If you already use them, tell your doctor before you stop or change anything.

Where Supplements Fit

Many products are marketed for sperm health, but none of them diagnoses or fixes a varicocele, a blockage, an infection or a hormone disorder. Start with the medical evaluation above and discuss any supplement with the specialist handling your case. Ultra Bann, a natural male vitality supplement by DL Bioproducts taken as one capsule every 2 days, is not a fertility product and has not been studied for sperm or conception outcomes. If you are curious about what is in it, the full label with all seven botanicals and their amounts is on the Ultra Bann ingredients page.

Frequently Asked Questions

What is a normal sperm count?

Mayo Clinic considers a count low when it is under 15 million sperm per milliliter of semen or under 39 million per ejaculate.^[1] Many fertile men have counts well above this, and a count below it lowers the odds of conception rather than making it impossible.

Can I do a male fertility test at home?

Home kits can estimate sperm concentration and sometimes motility, but they do not assess morphology, volume, vitality or signs of infection the way a lab semen analysis does. A home result can be a starting point, but a lab test ordered by a doctor is what guides diagnosis and treatment.

How long does a semen analysis take to come back?

The sample itself must be analyzed quickly, within about 2 hours according to MedlinePlus, but the written report often takes a few days depending on the lab.^[2] Your doctor will usually review it with you and decide whether a repeat test is needed.

Does an abnormal semen analysis mean I am infertile?

No. MedlinePlus notes that an abnormal result does not always mean a man cannot have children, and many causes of male infertility are treatable.^[2] Results vary between samples, so a repeat test and a specialist workup come before any conclusion.

What doctor should a man see for fertility problems?

A urologist, preferably one who specializes in male reproductive health. Your primary care doctor can order a first semen analysis and refer you, and fertility clinics usually coordinate testing for both partners.

References

1. Mayo Clinic. Male infertility: Symptoms and causes. mayoclinic.org
2. MedlinePlus Medical Encyclopedia. Semen analysis. U.S. National Library of Medicine, reviewed January 2026. medlineplus.gov
3. Sunder M, Leslie SW. Semen Analysis. StatPearls, NCBI Bookshelf, updated October 2022. ncbi.nlm.nih.gov
4. Cleveland Clinic. Semen Analysis: Purpose, Procedure and Results. clevelandclinic.org
5. Urology Care Foundation. Male Infertility. Updated May 2024. urologyhealth.org
6. Mayo Clinic. Male infertility: Diagnosis and treatment. mayoclinic.org

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. This article is for information only and is not medical advice.