a drop going into a lab vial

Lab Test That Can Detect Infertility in Men

Diagnosing male infertility involves conducting comprehensive laboratory tests to accurately identify the issue. It is essential to conduct tests for testosterone, estradiol, and prolactin, among others, to evaluate hormone balance, sperm quality, and reproductive function. By identifying hormone imbalances, sperm abnormalities, and other factors through these tests, healthcare providers can create effective treatment plans. Recognizing the significance of these lab tests is crucial for couples on the journey to becoming parents.

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Dealing with infertility can be challenging and disheartening for numerous couples globally, with male factors being responsible for more than half of all infertility cases. It is crucial to conduct laboratory tests to diagnose male infertility as they offer valuable insights into hormone levels, sperm health, and overall reproductive function. Identifying specific irregularities through these tests allows for the identification of the root causes of infertility and the development of appropriate treatment strategies.

a drop going into a lab vial

Male Hormone Test

Checking testosterone levels is a very important part of assessing male fertility because testosterone plays a key role in the development and upkeep of male reproductive organs like the testes and prostate. It also impacts various biological functions like muscle mass, bone density, and the production of red blood cells. Discover how testosterone tests can aid in identifying infertility in men:

Sperm production

The production of sperm in the testes (spermatogenesis) relies on testosterone. Low testosterone levels (also known as hypogonadism) can lead to reduced sperm production, a significant factor in male infertility.

Hormonal Imbalance

The HPG axis is responsible for regulating testosterone levels.2 If there is any disturbance in this axis, it could lead to hormonal imbalances that affect fertility. For instance, elevated luteinizing hormone (LH) and decreased testosterone levels could indicate primary testicular failure.

Sexual Function

Testosterone plays an essential role for maintaining libido (sexual drive) and erectile function.1 Insufficient levels may result in decreased sexual interest and erectile problems, which can impact reproductive health.

Testicular Health

Irregular testosterone levels could suggest potential testicular problems like varicocele, infections, or tumors that may affect fertility.3

Treatment Planning

It becomes essential to measure testosterone levels for planning effective therapy. For instance, if low testosterone is due to hypogonadism, hormone replacement therapy might be suggested to enhance fertility.

Understanding that testosterone is not the sole factor affecting male fertility is very important. A comprehensive evaluation, which involves additional hormone testing and sperm analysis, is necessary to accurately identify the cause of infertility

Hormonal balance

When it comes to males, estradiol is mainly produced through the conversion of testosterone and androstenedione by an enzyme called aromatase.4 It is essential to maintain a balance between estradiol and testosterone levels to support normal reproductive function. A hormonal imbalance could potentially affect fertility.

Testicular Function

If estradiol levels are unusually high, it could be a sign of testicular cancers or other issues impacting testicular function. These conditions may lead to decreased testosterone levels and reduced fertility.

Sperm Health

Excessive estradiol levels in males can negatively impact sperm count, morphology, and motility, which are crucial fertility indicators.5 High estradiol levels can lead to estrogen dominance, a condition that can hinder sperm production.

Hormonal Feedback

Estradiol influences the brain by controlling the production of gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), and luteinizing hormone.6 Disruptions in this feedback loop may lead to hormonal imbalances, impacting sperm production and fertility.


Excessive levels of estradiol in males can lead to the development of breast tissue, resulting in a condition called gynecomastia. Although gynecomastia is not directly linked to fertility, it could indicate hormonal imbalances that may affect reproductive health.

Hormonal Balance

The pituitary gland secretes a hormone known as prolactin. Although typically associated with female milk production, it also plays a role in male reproductive health.7 High levels of prolactin (hyperprolactinemia) can lead to decreased testosterone levels and sperm production, resulting in infertility.

Sexual Function

Elevated prolactin levels may result in sexual issues in men, including decreased sex drive and difficulties with erections.8 These factors may lead to challenges in achieving conception.

Pituitary Gland Disorders

Hyperprolactinemia could suggest pituitary gland problems, like a prolactinoma (a noncancerous growth that produces prolactin). These conditions may disrupt the body’s typical hormonal equilibrium, impacting fertility.


Identifying the root cause of male infertility requires a comprehensive approach, with laboratory testing being crucial. Testing for testosterone, estradiol, prolactin, and other crucial hormones, along with semen analysis, can offer valuable insights into a man’s reproductive health. These tests assist healthcare providers in tailoring effective treatment plans by accurately identifying hormone imbalances, sperm abnormalities, and other factors contributing to infertility. Knowing the essential lab tests for identifying male infertility is crucial for couples on the journey to parenthood.

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If you need a lab test but want to avoid traveling to the doctor’s office, consider Concierge MD as an option. We are a licensed mobile healthcare provider with a wide range of services, including lab testing. You can make an appointment online or over the phone for one of our healthcare specialists to visit you in your home and collect samples for one of our many accessible lab tests:

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[2] Corradi PF, Corradi RB, Greene LW. Physiology of the Hypothalamic Pituitary Gonadal Axis in the Male. Urol Clin North Am. 2016 May;43(2):151-62. doi: 10.1016/j.ucl.2016.01.001. Epub 2016 Mar 18. PMID: 27132572.

[1] Travison TG, Morley JE, Araujo AB, O'Donnell AB, McKinlay JB. The relationship between libido and testosterone levels in aging men. J Clin Endocrinol Metab. 2006 Jul;91(7):2509-13. doi: 10.1210/jc.2005-2508. Epub 2006 May 2. PMID: 16670164.

[3] Sharma A, Minhas S, Dhillo WS, Jayasena CN. Male infertility due to testicular disorders. J Clin Endocrinol Metab. 2021 Jan 23;106(2):e442-e459. doi: 10.1210/clinem/dgaa781. PMID: 33295608; PMCID: PMC7823320.

[4] Chan HJ, Petrossian K, Chen S. Structural and functional characterization of aromatase, estrogen receptor, and their genes in endocrine-responsive and -resistant breast cancer cells. J Steroid Biochem Mol Biol. 2016 Jul;161:73-83. doi: 10.1016/j.jsbmb.2015.07.018. Epub 2015 Aug 13. PMID: 26277097; PMCID: PMC4752924.

[5] Lübbert H, Leo-Rossberg I, Hammerstein J. Effects of ethinyl estradiol on semen quality and various hormonal parameters in a eugonadal male. Fertil Steril. 1992 Sep;58(3):603-8. doi: 10.1016/s0015-0282(16)55271-6. PMID: 1387850.

[6] Kenealy BP, Terasawa E. Rapid direct action of estradiol in GnRH neurons: findings and implications. Front Endocrinol (Lausanne). 2012 Jan 3;2:106. doi: 10.3389/fendo.2011.00106. PMID: 22654841; PMCID: PMC3356072.

[7] Gill-Sharma MK. Prolactin and male fertility: the long and short feedback regulation. Int J Endocrinol. 2009;2009:687259. doi: 10.1155/2009/687259. PMID: 20011060; PMCID: PMC2778443.

[8] Zeitlin SI, Rajfer J. Hyperprolactinemia and erectile dysfunction. Rev Urol. 2000 Winter;2(1):39-42. PMID: 16985734; PMCID: PMC1476085.

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