Male Fertility Testing in the San Francisco Bay Area

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Explore How Male Infertility Is Diagnosed

Male factors contribute to infertility in nearly half of all cases, making fertility testing for men an essential part of any thorough evaluation. In fact, when applicable, male fertility testing is often one of the earliest and most efficient steps in the process, providing critical insight into sperm health and overall reproductive function.

Whether you’re just beginning to explore your options or have been trying to conceive for some time, Pacific Fertility Center (PFC) offers semen analysis as part of the fertility evaluation process. If your results indicate that additional male fertility testing or specialized care may be needed, our team can refer you to a urologist for further evaluation.

What are the signs of male infertility, and when should I get tested?

Most causes of male infertility do not present with obvious symptoms. Many men feel healthy and may not realize there is an issue until experiencing difficulties achieving pregnancy. 

In general, fertility testing is recommended if pregnancy has not occurred after 12 months of regular, unprotected intercourse, or after 6 months if a female partner is over age 35. However, earlier evaluation may be appropriate in certain situations, including a history of testicular injury, surgery, infection, or known genetic conditions. Testing is also available to those who are not currently trying to conceive but are interested in planning ahead or simply learning more about their reproductive health.  

Potential Causes of Male Infertility

Male infertility can result from a range of conditions that affect sperm production, function, or delivery. In some cases, more than one factor may be involved. Common causes of male factor infertility include: 

  • Varicocele
  • Azoospermia (obstructive or non-obstructive)
  • Low sperm count (oligospermia)
  • Poor sperm motility or morphology
  • Hormonal imbalances (e.g., low testosterone)
  • Genetic or chromosomal conditions
  • Infections or structural blockages
  • Lifestyle or environmental factors
  • Unexplained infertility

What is a semen analysis, and why does it matter?

A semen analysis is often the first step in evaluating male fertility because it's a quick,  straightforward, non-invasive test that provides meaningful insight into sperm health and reproductive function. 

The test evaluates four key dimensions of sperm health: 

  • Sperm count (how many sperm are present)
  • Motility (how well they move)
  • Morphology (their size and shape)
  • Semen volume

Results are evaluated against established reference ranges set by the World Health Organization (WHO) to help determine whether sperm parameters fall within normal limits.

When preparing for a semen analysis, patients are asked to abstain from ejaculation for two to five days before providing a sample to ensure sperm counts are at their highest levels. Sample collection is private, and your care team will walk you through every detail in advance so you know exactly what to expect.  

What other male fertility tests might be recommended?

Depending on the results from your semen analysis, additional testing with a urologist or other specialist may be recommended to better understand certain findings. Further male fertility evaluation may include:

Medical History and Physical Examination

A detailed review of your medical history is a critical aspect of the evaluation process. Your provider may ask about prior surgeries, injuries, infections, medications, and any known health conditions and lifestyle habits that could affect fertility.

A physical exam may also be performed to assess for anatomical factors, such as varicoceles, which are enlarged veins in the scrotum that can impact sperm production or function.

Microsurgical Testicular Sperm Extraction (microTESE)

Microsurgical testicular sperm extraction (microTESE) is a specialized procedure typically used when sperm is not present in the semen, a condition known as azoospermia. When appropriate, a urologist who specializes in male reproductive health may perform microTESE to retrieve sperm directly from the testes. The procedure is performed using an operating microscope, which allows the physician to carefully identify areas within the testes that are more likely to contain sperm. Sperm obtained through microTESE is often used in conjunction with intracytoplasmic sperm injection (ICSI) and in vitro fertilization (IVF). 

Hormone Testing

Levels of key male reproductive hormones such as testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin can be measured using a simple blood test.  Imbalances in these hormones can affect how sperm are produced and may point to underlying conditions that require further evaluation or treatment.

Genetic Testing

Specialists may recommend genetic testing for men with very low sperm counts, azoospermia, or a history of recurrent IVF failure. These evaluations can identify chromosomal abnormalities, such as Y-chromosome microdeletions, that may affect fertility and help guide treatment decisions.

How much does male fertility testing cost?

The cost of male fertility testing depends on the specific evaluations needed to reach a diagnosis. At PFC, testing typically begins with a semen analysis. If additional evaluation is recommended, associated costs will depend on the testing and specialist care needed. Because every fertility journey is different, there isn’t a flat rate that applies to everyone.

Out-of-pocket expenses will also vary between insurance plans. While some plans cover diagnostic testing, or at least select evaluations, others do not. However, with California’s recent fertility coverage mandate — effective January 2026 — many patients now have expanded access to fertility-related benefits, including diagnostics.

Male Fertility Testing FAQ

  • A semen analysis is a laboratory evaluation of sperm health and one of the first tests performed when male fertility is being assessed. It measures sperm count, motility (how sperm move), morphology (the size and shape of sperm), and overall semen volume. These results help fertility specialists to identify underlying causes of infertility and guide next steps accordingly.

  • Before a semen analysis, patients are typically instructed to abstain from ejaculation for two to five days before providing a sample. Your provider may also recommend avoiding drugs, excessive alcohol use, or any medications that may affect sperm quality. Your care team will provide clear instructions in advance and make sure to answer any questions you may have.

  • Low sperm count, also known as oligospermia, means there are fewer than 15 million sperm per milliliter of semen. While sperm counts can vary widely, falling below this threshold can reduce the odds of achieving pregnancy naturally.  Low sperm count is also frequently accompanied by other sperm quality issues, such as poor motility or morphology, which can further affect the ability to conceive.

  • Yes, in many cases, male infertility can be treated or managed. Treatment may involve lifestyle changes, medication, hormone therapy, or procedures for structural concerns. A urologist or other male fertility specialist can recommend treatment based on the underlying cause, while PFC can help determine whether assisted reproductive treatments such as IUI or IVF may be appropriate for family building.

  • Increasing evidence suggests that sperm quality, particularly motility and DNA integrity, can decline with age. This can make it more challenging to conceive or, in some cases, impact embryo development and increase the risk of miscarriage. Advanced paternal age has also been linked to a higher risk of passing on certain genetic conditions to offspring. That said, there is no universally agreed-upon age threshold for when these changes become clinically significant, and many men father healthy children later in life. A semen analysis is the most reliable way to assess sperm health at any age.

  • Abnormal sperm motility or morphology can result from a range of factors, including hormonal imbalances, varicoceles, infections, genetic conditions, or environmental exposures. Lifestyle factors such as smoking, alcohol, and drug use may also negatively impact sperm motility or morphology. However, in some cases, no identifiable cause is found.

  • Yes, certain prescription medications and supplements can affect your ability to conceive. Some medications that may negatively impact sperm health include testosterone therapy, anabolic steroids, antidepressants such as SSRIs, chemotherapy drugs, and some antihypertensives. While supplements such as Zinc, CoQ10, Vitamin C, and other antioxidants may support sperm health, excessive amounts can have the opposite effect. Before recommending treatment, your provider will review your current medications and supplements to determine whether any adjustments are needed.

  • No, many causes of male infertility are temporary or treatable. In cases where the underlying cause has a more lasting impact, your care team can help you explore all available options, which may include assisted reproductive technologies or alternative paths to parenthood.

Start With a Semen Analysis at Pacific Fertility Center

A semen analysis can provide valuable information about sperm health and is often an important part of a fertility evaluation. Pacific Fertility Center offers semen analysis for patients throughout San Francisco, Marin County, and the greater Bay Area. If your results suggest that additional male fertility evaluation is needed, our team can help connect you with a urologist for specialized care.

Whether you're evaluating fertility on your own or as part of a couple, our team can help you understand your results and determine the appropriate next steps.

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