Male Fertility Tests in London: What to Expect at Your First Visit
Male Fertility Tests in London: What to Expect at Your First Appointment
A first male fertility appointment is usually a conversation, a physical examination and a semen analysis, and most men find it simpler than they expected. Knowing what will happen helps you prepare and removes much of the worry. This guide walks you through the steps in a London male fertility clinic, from preparing for your visit to understanding your results.
This article is general information and does not replace personal medical advice.
Before you book: what to prepare
A little preparation makes the first appointment more useful. Gather the following:
Your medical history. Note any past surgery, testicular injury or infection, undescended testicle, cancer treatment or long-term condition.
Medicines and supplements. Include any testosterone, steroids or bodybuilding products, because some can reduce sperm production. Read more in our guides on testosterone replacement therapy and fertility and anabolic steroids and male fertility.
Earlier test results. Bring any semen analysis, blood test or scan reports, even if they are old.
How long you have been trying. Your partner's age and fertility history also matter, so mention them.
Your questions. Write them down so you do not forget them.
What happens at the first appointment
The visit usually follows the same order:
A detailed discussion. The specialist asks about your health, lifestyle, sexual function and how long you have been trying to conceive.
A physical examination. This includes checking the testicles for lumps, size or other abnormalities, and examining the penis. A GP appointment on the NHS includes a similar examination.
Tests. You may be asked for a semen sample, and sometimes blood or urine tests.
A plan. The specialist explains what the findings may mean and which tests or treatments could come next.
You can bring your partner, but you do not have to. The appointment is about you and your results.
Semen analysis: the main test
A semen analysis checks the number of sperm, how well they move and what they look like. It is the first test for almost every man investigated for fertility.
To prepare:
Abstain from ejaculation for 2 to 7 days before giving the sample, unless your clinic tells you otherwise.
Follow the clinic's collection instructions. Samples are normally produced by masturbation into a sterile pot, and must reach the laboratory within the time the clinic gives you.
Tell the clinic about any illness, fever or medicines in the past three months.
Expect a repeat test. Results vary from one sample to another, so a second sample is common if the first is abnormal.
If you are worried about a sample you cannot produce, for example after an injury, tell the clinic. There are other options, including electroejaculation and surgical sperm retrieval.
Understanding your semen analysis results
Laboratories compare your results with the World Health Organization (WHO) 2021 reference values. These are the lower fifth-percentile values seen in fertile men, not pass or fail marks.
Measure | WHO 2021 lower reference value |
Semen volume | 1.4 mL |
Sperm concentration | 16 million per mL |
Total sperm number | 39 million per ejaculate |
Total motility | 42% |
Progressive motility | 30% |
Vitality (live sperm) | 54% |
Normal forms (morphology) | 4% |
A result below a value does not mean you cannot have children, and a normal result does not guarantee conception. Your specialist reads the whole picture, including repeat tests, examination and your partner's fertility. Ask your specialist to go through each line of your report with you.
Other tests you may be offered
If your semen analysis is abnormal, or your history suggests a cause, the specialist may recommend further tests:
Blood tests. These can check hormones that control sperm production, such as testosterone, FSH and LH.
Scrotal ultrasound. This looks for a varicocele (enlarged veins), blockages or other changes in the testicles.
Urine test. This checks for infection, such as chlamydia, which can affect fertility.
Genetic tests. These may be offered if you have very low or no sperm. They can look for conditions such as Klinefelter syndrome or missing parts of the Y chromosome.
Sperm DNA fragmentation test. This is sometimes considered after repeated treatment failure or miscarriage, and your specialist will explain whether it is useful in your case.
Not every man needs every test. Your specialist chooses tests based on your history and results.
What happens after your results
The next step depends on what the tests show. Common outcomes include:
Normal results. You may be advised to keep trying, and your partner may also be assessed.
A treatable cause. For example, a varicocele, a hormone imbalance or an infection, which can be treated with medicine or surgery.
Low sperm count or poor movement. Your specialist may suggest lifestyle changes, medical treatment or assisted conception such as IUI, IVF or ICSI.
No sperm in the semen (azoospermia). Further tests find out whether the cause is a blockage or a production problem. Sperm can sometimes be retrieved surgically. Read about micro-TESE surgery.
You should leave the appointment knowing what the results mean, what comes next and roughly how long each step will take. See the full list of our services.
Frequently asked questions
Do I need a referral to see a male fertility specialist? Not always for private care, but check with the clinic when you book.
How long should I abstain before a semen analysis? Usually 2 to 7 days, but follow your clinic's instructions.
Is one abnormal semen analysis enough for a diagnosis? No. Results vary between samples, so a repeat test is common before any conclusion.
Can I do a semen analysis at home? Home kits give only limited information, such as a sperm count. They do not replace a full laboratory analysis and a specialist assessment.
Is the examination painful? It should not be painful. Tell the specialist if anything is uncomfortable.
Book a male fertility consultation
If you want clear answers and a plan, book a consultation online with The Male Factor Fertility Clinics London, Barnby St, London NW1 1AA.
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