Most men only think about getting the quality of their sperm checked when they have tried unsuccessfully with a partner to start a family.
But should all men instead be regularly monitoring their sperm from their late teens onwards?
It’s an idea suggested by a leading UK expert, who believes it could help to identify thousands of hidden cases of male infertility at an earlier stage – and in time for treatment that could avoid problems for them fathering children later on.
And whereas testing traditionally involves having a semen sample sent to a lab by a GP or fertility clinic for analysis, which can take weeks for results, in recent years home-testing kits have been launched by high street retailers such as Boots and Superdrug for as little as £29.99.
These tests involve placing a semen sample in a solution and applying it to a test pad. The Boots test, for example, claims to be ’98 per cent’ accurate and gives a result in just ten minutes, with a red line appearing on the test strip for a ‘normal’ sperm count.
Research suggests male infertility is a factor in about half of all cases where couples fail to conceive. Anything less than 15 million sperm per millilitre of fluid lowers the chances of successfully fertilising an egg
Meanwhile, a private clinic claiming to be the first in the UK to offer free same-day sperm testing was opened last year near Manchester city centre, by Danish sperm bank Cryos International.
Both the home checks and private tests look at sperm count (the number of sperm in a millilitre of semen), sperm motility (how well they move) and sperm morphology (i.e. shape – they need to have oval heads and long tails to ‘swim’ properly).
Anything less than 15 million sperm per millilitre of fluid lowers the chances of successfully fertilising an egg (a healthy reading can be up to 200 million), and at least a third of them need to be able to move properly in order to travel smoothly through the woman’s reproductive system.
Research suggests male infertility is a factor in about half of all cases where couples fail to conceive.
Yet many cases could be identified and potentially treated early if every man had a semen analysis when they turned 18 and again a couple of years later to monitor changes in sperm count and motility, argues Tet Yap, a consultant andrological surgeon at Guy’s and St Thomas’ NHS Foundation Trust and the private Princess Grace Hospital, both in London.
One major benefit of this, he argues, would be an increase in the detection of varicoceles, a fertility-damaging problem that affects up to 20 per cent of men.
This is where blood pools in the veins in the scrotum, often during puberty and, in many cases, with no pain or complications.
Yet a varicocele can significantly reduce sperm count (possibly because pooling of warm blood raises the temperature in the testicles, which reduces sperm production).
Most men often only discover they have a varicocele when they and their partner experience fertility problems.
But semen checks at 18 and again in the man’s early to mid-20s could highlight if sperm count is low due to an undiagnosed varicocele, says Mr Yap.
‘It’s a big health issue in young men, yet most are not told to look out for it,’ he told Good Health.
‘Some kind of screening starting at 18 is not a bad idea, as semen analysis could help us to pick it up and treat it.’
A varicocele is usually treated with embolisation – a procedure where doctors inject tiny metal coils or foam to stop blood flow to the affected veins, causing the varicocele to shrink.
A 2014 study in Japan found sperm counts in men treated for varicocele increased from an average of 2.4 million per millilitre to almost 12 million – still lower than normal but potentially making them more fertile, reported the journal Urology.
Another cause of hidden damage to a young man’s sperm is mumps, which is not uncommon in teenagers. It can trigger inflammation in the testicles that damages the tiny tubes where sperm are produced.
If a problem is identified ‘that may continue or get worse, it might be an idea to freeze some of their sperm as soon as they can just in case’, adds Mr Yap.
It’s not just about fertility – there’s a growing body of evidence that sperm count in young males is also a marker for other serious health problems, too.
A 2018 study by the University of Brescia in Italy found that men with low sperm counts were also 20 per cent more likely to have more body fat, higher blood pressure and raised levels of ‘bad’ LDL cholesterol.
A private clinic claiming to be the first in the UK to offer free same-day sperm testing was opened last year near Manchester city centre, by Danish sperm bank Cryos International
The analysis of more than 5,000 men showed they also had lower testosterone levels, which can reduce libido, muscle mass and bone density.
The researchers stressed sperm problems do not cause ill-health but are a useful marker for underlying ailments that may have no symptoms – and so monitoring levels can stop men developing heart disease or certain cancers, for instance.
Indeed studies have found low sperm count in young men may double their risk of prostate cancer later in life, possibly because, some evidence suggests, both conditions are connected to faulty DNA repair mechanisms.
But not everyone agrees that routine checks on sperm would be a good idea – especially as in around 40 per cent of male infertility cases there is no obvious cause, which means it may be largely untreatable.
‘This is a big consideration because, apart from living a healthy lifestyle, often there is little you can do about it and it will just be an added worry for these men,’ says Allan Pacey, a professor of andrology at the University of Manchester.
‘I know guys who test themselves as often as once a fortnight because they are so worried about their sperm count.’
He says a more important message to all men is that, despite well-publicised examples of ageing rock stars or actors fathering children in their 70s and 80s, ageing is the biggest danger to male fertility.
Even though men may have a respectable sperm count in their 30s or 40s, he warns, the quality of that sperm will have deteriorated.
‘As you get older, it’s not about sperm count or how well they swim – it’s the difference in quality that makes you less fertile,’ Professor Pacey told Good Health.
‘Men in their 40s are half as fertile as men under 25.
‘They need to try for a family much earlier than they probably think they should.’
