Male vs. Female Fertility Evaluation: Key Differences

Fertility in men is based on how well the body develops and produces sperm. For women, it is based on how efficient the menstrual cycle is. Fertility testing is used to determine if there are any issues preventing people from building their families. We shall focus specifically on fertility evaluations for both men and women. 

Male Fertility Testing

Male fertility testing includes hormone testing, DNA fragmentation testing and a semen analysis:

Hormone testing

Hormone testing is done using a blood sample and the main hormones tested are follicle stimulating hormone, luteinizing hormone and testosterone. The male hormones regulate the development and function of the male reproductive system. They are also responsible for the physical appearance of men. 

DNA fragmentation test

DNA is what determines what we will look like, whether or not we inherit medical or health conditions, and whether we develop normally during the embryonic stage of our formation. When there is damage on the DNA, it is called fragmentation and fragmented sperm DNA does not bond as it should with the egg DNA. This results in birth defects and pregnancy loss. 

Semen analysis

This is the primary fertility evaluation done for men, before any other testing is done. It is used to evaluate semen and sperm health, primarily the structure, quantity and movement of sperm cells. As well, the volume of semen and quantity of sperm in the ejaculation are also evaluated. 

Female Fertility Testing

When it comes to females, fertility testing for women is structured around the menstrual cycle. The health of the uterus, the quantity of eggs in the ovarian reserve, including the menstruation itself. A woman’s uterus has to be in good health without any structural anomalies, with a regular menstrual cycle in order for her to conceive and carry a pregnancy to term. 

Ovarian reserve testing

Women do not produce their eggs regularly, rather they are born with an ovarian reserve which holds all the eggs that they will use in their reproductive years. Two aspects are evaluated in ovarian reserve testing; the actual number of eggs left in the ovaries, as well as the hormones that regulate the maintenance and development of the eggs during the follicular phase of the menstrual cycle. 

HSG (hysterosalpingogram)

Sometimes, the cause of infertility is blockage in the fallopian tubes, preventing the sperm from reaching the egg. In order to check if the fallopian tubes are blocked, a hysterosalpingogram (HSG) test is done. Using a contrast fluid the uterus is observed using an x-ray. Typically the contrast fluid would spread around the uterus and flow through the fallopian tubes. If there is any blockage, the fluid would pool around the blockage. 

Antral follicle count (AFC)

An antral follicle count checks the number of immature eggs left in the ovaries. These immature eggs are what produce estrogen in the ovaries. When they decrease, so does the amount of estrogen in the woman’s body. 

Comparing Male & Female Fertility Test Procedures

Time frame and accuracy

Fertility testing is an accurate diagnostic for the causes of infertility experienced by either men or women. In terms of timeframe, depending on how many tests are conducted, or how comprehensive the evaluation is, fertility testing can take a few hours to a few days. Specific tests such as ultrasounds or semen analyses could take 20 to 30 minutes; a hysterosalpingogram can take about an hour, while a blood test would take just a few minutes for the blood draw. 

Common misconceptions

While fertility evaluations are vital diagnostic tools used not only to determine the causes of infertility that men and women face, there is a lot of speculation and misconception regarding their purpose, who qualifies for such tests, and the general causes of infertility. So let us address some of these misconceptions by way of concluding this discussion. 

Fertility testing is only for women

When it comes to family building, the fact is that male factor infertility comprises about 50 percent of infertility cases. Therefore men too can benefit from fertility testing. In fact when both the man and woman are tested, treatment can be more accurately administered.

A regular menstrual cycle equals fertility

While this may be true, it is only true to an extent. Sometimes a person can have a regular menstrual cycle, but have a blockage in their fallopian tube. This means that while menstruation is possible because the egg has not been fertilized, pregnancy may be impossible because the sperm never reaches the egg.

Fertility testing is for couples struggling to get pregnant

Fertility testing is not just for those actively trying to build their families. Fertility testing is beneficial to sperm and egg donors, or people who would like to build their families in the future and want a comprehensive picture of their reproductive potential. Early fertility testing also opens the opportunity for early treatment of any issues that could prevent family building in the future.

FAQs:

Is male fertility testing less common than female testing?

Yes. Fertility testing is more commonly done on women than men, even if male factor infertility contributes significantly to family building challenges.

What does a semen analysis measure?

A semen analysis measures semen volume, semen viscosity, as well sperm structure, movement and count. It also evaluates the white blood cell count and how alkaline or acidic the semen is. 

Can male fertility be improved after testing?

After fertility testing, male fertility can be improved through lifestyle changes, medications, fertility supplements, medical and surgical treatments. However, the approach used can only be determined by a fertility expert, based on the fertility evaluation results. 

Do fertility tests determine if I need IVF?

It is possible for fertility tests to determine if you need IVF. This decision however can only be made under the guidance and advice of a fertility expert, depending on what the results of fertility testing indicate.