Patient Resources

The Male Fertility Workup

If you and your partner are having a hard time conceiving, know that infertility affects both men and women equally, so both of you should be tested. Once you have scheduled your appointment, here’s what you can expect:

Physical Exam

During the physical exam, your doctor will discuss your medical history, current medical status, and potential fertility problems. You can expect a general examination of the penis to look for abnormalities. An examination of the scrotum will also be performed, with careful attention to the size and firmness of the testes. You may receive a prostate exam to evaluate for enlargement or irregularity in the shape of your prostate, which can be indicative of abnormalities or cancer. Hormone testing may be done to measure FSH levels, the normal range being 4 to 10 mIU/mL. Androgen levels may also be tested, with the normal testosterone range being 300 to 1,111 ng/dL and the normal prolactin level being less than 20ng/mL.

Semen Analysis

The semen analysis is very important when it comes to male infertility. It checks for sperm count, the ability of sperm to swim, and velocity or forward progression of the sperm. The size and shape of the sperm will also be examined, as well as the liquefaction of the semen and total semen volume. 

Depending on what is discovered in the first round of testing, you may have additional tests, which may include:

Sperm Antibodies

If the sperm agglutinate, or do not move well, tests may be ordered that can localize and quantify specific antibodies in the blood and on the sperm’s surface. If antibody attachment sticks to the head of the sperm, the sperm may not be able to penetrate. If they cover the tail of the sperm, it may not be able to swim fast enough or in the right direction. 

Sperm Penetration

The sperm penetration assay (SPA) is designed to evaluate the sperm’s ability to break through the outer membrane of an egg and fuse with the egg cytoplasm.

Hemizona Assay Test

The Hemizona Assay Test evaluates the sperm’s ability to fuse with a previously frozen, but no longer viable, human egg. It a rarely performed test now that there is increased technology of ART procedures.


The North Carolina Center for Reproductive Medicine/Talbert Fertility Institute is the premiere center for reproductive health in North Carolina and the East Coast. Our team specializes in fertility testing, diagnosis, and treatment of infertility conditions. We’re experts in IVF, Tubal Ligation Reversal, Male Infertility, Intrauterine Insemination (IUI), Gestation Surrogacy, Family Balancing, and more. Contact us today.

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