Male vs. Female Fertility Evaluation: Key Differences

When it comes to natural family building, it is quite common for both men and women to experience infertility. The reasons for this may vary on a case by case basis, therefore fertility evaluations are crucial in getting to the bottom of the issue in each case. For women, ovulation is central to fertility, while sperm production is central to male fertility. Therefore fertility evaluations for both men and women help professional healthcare providers to determine the best course of treatment, in order to enable these people to realize their family building goals.

Male Fertility Testing

Male fertility testing includes an evaluation of hormone production, a semen analysis (also known as a sperm analysis), as well, DNA fragmentation testing. These tests are detailed in the section:

Semen Analysis

Healthy sperm are vital in reproduction, without which a person may experience challenges in building their family. Semen analyses evaluate the health of the semen as well as the sperms in a sperm sample. There are several factors that are put into consideration to determine how likely a person is to reproduce naturally. So let us get started on each aspect of a semen analysis.We shall begin with the semen itself. Semen is the fluid that carries sperm from the testicles and through the penis during ejaculation.

The quantity of semen in a single ejaculation varies from one person to another and is evaluated on viscosity (how fluid it is), how many white blood cells can be seen (a high number indicates an infection), and its pH (how acidic or alkali it is). The sperm cells themselves are evaluated for their quality and quantity. The quantity of sperm in a normal sample is in the millions and a low sperm count lowers the odds of natural conception. The quality of sperm is evaluated as a metric of several factors: how the sperm cells are formed, having proper structure; as well, how they move independently and in a forward direction. If sperm cells have all their parts well formed and move well, they are likely to achieve natural conception.  

Hormone Testing

The hormones that are tested for fertility are those that are key to the development, maintenance and regulation of sperm production. Hormones are released into the blood stream and therefore a hormone test would be done using a blood sample. While testosterone is more commonly known for its function in the development of sexual characteristics, it is also vital to sperm production. In addition, follicle stimulating hormone (FSH) is responsible for the development of sperm cells, while luteinizing hormone (LH) works as a regulator in the production of testosterone. Fertility can be impacted negatively when the hormonal levels are found to be either low or high in the blood.

DNA Fragmentation Test

At the core of reproduction is the bonding of DNA from both the male and female. When the DNA is fractured or damaged in any way, it can result in pregnancy loss, malformation of the embryo or birth defects. A DNA fragmentation test therefore evaluates the health of the chromosomes contained in the sperm head. The cause of DNA fragmentation is attributed to illness, and in other cases, as a side effect of previous treatments. When sperm DNA is fragmented, it does not bond properly with the DNA of the egg during fertilization, resulting in undesirable outcomes. 

Female Fertility Testing

Female fertility testing is an evaluation that is similar to male fertility evaluation, in that it evaluates the reproductive system. In women, the uterus, ovaries, fallopian tubes, and hormonal levels are examined. The most crucial part of a female’s reproductive organ are the ovaries, where her eggs are stored from birth. While her eggs remain available, there are many factors that could influence a woman’s ability to become pregnant as well, carry the pregnancy to term. Let us see how a woman’s fertility can be impacted as we discuss the tests conducted to determine the causes of infertility.

Ovarian Reserve Testing

As previously mentioned, a woman's ovaries contain all the eggs she will use during her reproductive years. This is known as the ovarian reserve. It is within the ovaries that the hormone estrogen is produced by the immature eggs, called oocytes. Since a woman’s ovaries have a limited amount of eggs, as they are used up in her menstrual cycle, they diminish, lowering the amount of estrogen in her body and impacting her ability to reproduce naturally.

There are two ways that ovarian testing is done, the first is testing the hormones that regulate the ovarian reserve, the second is counting the number of antral follicles in the ovaries themselves. As in male hormone testing, female hormone testing is also done using a blood sample. Estrogen, progesterone, LH, FSH and anti-mullerian hormone are the hormones that regulate fertility, high or low levels point to reproductive challenges.

HSG (hysterosalpingogram)

This is a specialized test used to determine if a woman has blocked fallopian tubes. Blockage can occur due to illness, infection, surgeries, or other treatments. It is possible for a woman to still have a regular menstrual cycle because as long as the egg has not been fertilized, menstruation occurs. Blocked fallopian tubes prevent the sperm from reaching the egg for fertilization. 

As such, while they may not present much of an issue in a person’s daily routine, they will present a challenge when one is trying to conceive. An HSG is done using a contrast fluid that is inserted into the uterus, and an x-ray is used to view the uterus. If there is any blockage in any of the fallopian tubes, the contrast fluid can be seen pooling at the site of blockage. 

Antral Follicle Count (AFC)

As earlier mentioned the ovarian reserve contains the eggs a female requires for reproduction. The oocytes (immature eggs) typically develop in tiny fluid filled sacs known as antral follicles. The antral follicle count is measured by the level of hormones as well, the number of oocytes in the ovaries. As the oocytes diminish due to the menstrual cycle, so does the level of estrogen. However, illness and treatments can sometimes impact the ovarian reserve, diminishing the number of oocytes in the ovaries. As well, a person’s lifestyle and diet can impact the quality of oocytes, presenting challenges in becoming pregnant.

Comparing Male & Female Fertility Test Procedures

Timeframe and Accuracy

Fertility evaluation consists of several tests, therefore the time it takes to complete the evaluation depends on the number of tests being done. On their own, a semen analysis takes about 20 to 30 minutes, as do ultrasounds. Blood tests take a few minutes to draw, while HSGs can take up to an hour. A basic fertility evaluation could take a few hours in total, while a more investigative comprehensive evaluation could take several days. Fertility evaluations are very accurate in pointing out what the cause of a person’s infertility is.

Common Misconceptions

On one hand fertility testing is accurate in determining the cause of a person’s infertility. Even so, there are those who doubt the efficacy and may have concerns regarding the side-effects of testing. One misconception is that regular menstruation is a guarantee for fertility. As we have seen, this is not the case. Since menstruation occurs as a result of an unfertilized egg, then a blocked fallopian tube repeatedly prevents the egg from being fertilized, it equally causes a person to experience menstruation regularly.

Again, there are those who presuppose that fertility evaluation is only for females. This is perhaps based on human history, where a lack of children in a family was presumed to be because the woman was barren. As well, reproductive medicine has primarily been focused on female reproduction.  Additionally, medical technology has come a long way in diagnostics, and we now know that in all infertility cases, male infertility contributes to 50 percent of the issues. Only recently have new discoveries in male infertility shifted the narrative, providing the opportunity for treatments and remedies to be found and applied.

Finally, it is said that only couples who have been trying to build their families naturally should go for fertility testing when they cannot have children. Anyone who would like to have children can benefit from fertility testing, regardless of whether they are actively trying, or planning on doing so in the future. For those who desire to build their families in the future, early fertility evaluation can catch potential challenges early enough for treatment.

FAQs

Is male fertility testing less common than female testing?

As a matter of fact it is. However it has been understood that in the same way male fertility is vital to conception, male infertility equally presents challenges in family building. Therefore both female and male testing are crucial in resolving infertility issues.  

Can male fertility be improved after testing?

After testing the causes of male infertility can be known. With this knowledge, doctors have found that supplements, improved diets and lifestyles, some medications, and surgical treatments result in improved fertility. 

Do fertility tests determine if I need IVF?

They could, depending on what the results of fertility testing reveal. This course of treatment can be determined by your doctor, once they evaluate the results.