The Hype, Hope and Possible Harm of Home Sperm Tests

Last updated March 8, 2022

At home sperm testing is a step – a half-step – to finding out if pregnancy problems are due to male infertility

In half of all infertility cases, the male is a contributing cause – and what he is probably contributing is poor quality sperm or no sperm. No one wants to be shooting blanks, as they say. But how do you know?

In the past decade since I first wrote here about home sperm testing, a lot has changed and yet some things have not. In 2007, after hearing a story about home fertility testing on NPR’s “All Things Considered,” I sent a letter describing some of the pitfalls of such testing, writing, “I’m a practicing reproductive endocrinologist and I have concerns regarding this test because it can be falsely reassuring to couples.”

Fourteen years later, I am saying the same thing. Let me give some background.

The idea of home testing fits a definite need among consumers. It’s nice to be able to learn that you’re pregnant without making a doctor’s appointment. It’s also nice to identify problems early, if that leads to evaluation and effective treatment.

The problem with a lot of tests on the market is that they can be falsely reassuring and may cause some people to delay proper evaluation. There is no good evidence that performing such tests actually improves a couple’s chance of conception. A patient without a history of infertility is most likely wasting his or her money.

On the other hand, if a couple has not conceived within one to two years of unprotected intercourse, I’m not sure that any home test is particularly reassuring. A mistakenly reassured patient may delay treatment and therefore is at risk for not meeting their reproductive dreams.

Many at home tests claim to be as accurate as a professional lab. While this statement may be true, what does that matter if they are only checking one of several important factors?

What sperm test kits are good for

• The most positive thing about sperm test kits is that they can generally show some issue with sperm.
• If a sperm test kit shows no sperm in a semen sample, that is good information to have and should get the gentleman moving to see a fertility specialist.
• If it shows low sperm count, that’s useful info and another reason to consider seeing a fertility specialist.
• The tests can provide an idea that there might be a problem sooner than waiting the usual 12 months before seeking help from a fertility specialist.
• Home sperm tests are useful for men with a family history of male infertility, or for those who have a cause for concern about infertility, such as an injury or having received chemotherapy. Negative results for these men could push them to seek help.
• The home sperm tests can be helpful for men in rural areas where a fertility doctor is not located close by.
• Self-testing can also remove anxiety some men have in producing a sample in a doctor’s office.

At home fertility testing for men vs. laboratory semen analysis

If a man uses one of the above tests and gets a positive result, he might feel pretty confident in his fertility. He shouldn’t be so confident: a normal test does not mean that all is well. A person without infertility may find this test reassuring; however, this person probably doesn’t need the test in the first place.

The positives to the tests listed above all lead to the same conclusion: you don’t get enough information to really know anything with certainty (same goes for home pregnancy tests). For that certainty in a male test, you need a professional semen analysis with strict Kruger morphology assessment that identifies minute abnormalities.

This is the gold standard of male infertility testing – and the professional evaluation at home sperm tests are related to. Professional semen analysis can involve three types of assessment: antisperm antibody tests, sperm penetration tests and sperm DNA fragmentation testing.

Male infertility is most often caused by one aspect or a combination of aspects. These include semen volume, sperm count, sperm concentration in the semen, motility (movement), velocity and morphology (shape). Each of these factors can have a huge impact on male fertility. The parameter that most affects fertility, assuming normal volume, is morphology.

Guess what parameter home sperm kits don’t evaluate for? Morphology. An Andrology journal research article that evaluated 12 home sperm tests shows that only one, ReproSource, evaluates for morphology. But ReproSource is really a professional semen analysis where the sample is collected at home and mailed to the lab, which works with fertility practices to provide results.

So, none of the true DIY sperm testing available evaluate for the all-important morphology, partly because it’s too complicated.

 Related reading: Wendy’s story (and Jon’s game-changing diagnosis)

Comparing popular home sperm test kits

In my review of home sperm tests in 2011, I wrote about the Fertell sperm test. The advantage of this test is that it determines the motile concentration, which is the percentage of sperm moving in one semen sample and is fairly predictive of normal fertility. A reassuring Fertell test should correlate well with two of the World Health Organization’s three parameters (concentration, percent progressively motile and morphology). If abnormal, the test should lead a man to have further testing performed.

Other tests that check motile concentration include SwimCount and YO, which works in conjunction with a smartphone.

Other home semen tests such as Trak, which uses a centrifugal motion, and SpermCheck purport to evaluate sperm concentration. Because each tests only a single parameter (concentration), they tell nothing about motility or morphology. A man with few or no moving sperm may be falsely reassured. And an abnormal result should be followed up with a visit to a physician’s office.

There are also small microscopes available, such as Micra that tests sperm count, volume and motility. The disadvantage of this test is that interpretation is left up to the patient. As with all home testing, the disadvantage to the home microscope is that there is no one with clinical experience to interpret the test in the context of the couple.

The ultimate test and real value: answers

A full semen analysis gives significantly more information than any of the above home tests. You also have to compare value. A semen analysis in our clinic costs around $295. That’s not a whole lot more than some of the better at home sperm tests. For example, YO costs about $80 on Amazon. With our semen analysis, it is reviewed by a physician who can interpret the results in the context of the couple.

A couple with infertility is probably better off having a medical evaluation by a knowledgeable physician. However, if the only way to get a man to get tested is with at an at home test, I would pick one that evaluates motile concentration and appears the easiest to use.