SpermCheck has arrived and is filling the shelves of your neighborhood drug store as I write. What is it? It’s an over-the-counter FDA approved home male fertility test. What does it do? It tells you whether you have more than 20 million sperm per milliliter of semen.
That’s a good thing, right? Generally, yes. It’s good to know whether you have a reasonable amount of sperm, which SpermCheck says is 20 million per milliliter. The problem is in the yes-or-no nature of the test and in picking the number 20 million. As I described in this post, you can get a woman pregnant with sperm counts less than 20 million per milliliter and have problems with more than that amount. The numbers of swimmers don’t tell the whole story.
So, will SpermCheck help you? For most men, probably. Having a positive or negative result will point them in the right direction. But for the handful of guys that get the OK from the test when they have a problem or for those that get the thumbs-down from the test that are fertile, it’s not telling the whole story. According to the manufacturer, the guys that are getting it wrong is about one in twenty. If you’re OK with that, great–if not, you may want to see a doctor.
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I really like this blog.. It’s Interesting and very informative.
I was drawn to your blog site by your explanation about Clomid and Clomiphene. As
you explain, this drug is generic and “off label for males.” So the profit-motive for testing is low. Might it have undergone more testing for females? If so, what side effects and safety issues occur? Do these findings seem to offer relevant guidelines regarding safety and side effects for males?
It’s been around for a really long time for females, Roger. The safety issues are well documented, and women who are under the care of physicians prescribing clomiphene can be expected to have informed, useful conversations. Of course very unusual effects can be detected decades after a drug is approved, but it would require a large scale health program, like the Women’s Health Initiative, to detect them. I’m not sure in the case of clomiphene that is yet warranted.
disclosure: a quick personal story. i used SpermCheck when it first appeared online in March. It really helped set me on a quick path. My wife and i had been trying to 9 months, and i figured i’d get this done and “out of the way” (ahh, hubris, thinking i wouldn’t be the problem).
Well, sure enough, it came back “negative”, meaning someone “wrong” (count, motility, morph). Yes, it doesn’t get specific, but that’s ok. It gets you in to a urologist – which i did. Sure enough, a full sperm analysis showed overall count in normal, but low motility, and really low morphology.
and wouldn’t you know it, while i’m there, he diagnoses a varicocele, essentially varicose veins in the scrotum that can seemingly overheat heat sperm, thereby making you infertile. Fast forward only about 3 weeks, and i’ve already had microsurgery, where he tied off the veins. Hoping this is the fix to my issues. Surgery was not fun and no joke, but i am a week removed from it, and i seem to be healing rapidly.
Long story short – guys, if you’ve like to just “check this box” even if you have not been trying for a kid for a long time, i say do this. it’s private, and convenient.
to add: there is a theory that the varicocele also may disrupt hormone (T) production. So i’m hopeful this surgery will boot T levels as well. It’s not proven, but my urologist says he normally sees at least a 100 point drop.
Guys, feel your scrotum – left side mainly…if you feel a “bag of worms,” get to a urologist. However, it might not make sense for surgery unless you plan to have a family, or are really struggling with low T.
sorry – amendment: my urologist said he sees a 100 point *jump* after varicocele repair, NOT drop. sorry.
Hi dr., a question about sperm counts. My husband has been diagnosed with a low sperm count, but after many tests, he has had total swimming sperm numbers of 6 million, 8 million, 27 million and once it was 45 million. the 27 million was after quitting smoking and 45 million was after anastrozole. My question is how much does sperm count normally vary from person to person. Could a man diagnosed with low sperm count sometimes have a good count and sometimes a bad count, even without treatment? Or do they usually stay within a range? Can sperm count just get better (or worse) for no reason at all? Thanks!
Hi Christie, I’m sorry, but I can’t answer personal questions about your husband’s health. Please read the FAQ.
Ok, I understand. I didn’t mean for it to be a personal health question. My question is the following: How much is a normal variance in sperm count over time? Say, if you tested a man every month for a year, should you expect a large variance in the count or could you expect it to be within a small range?
Variation in sperm parameters over short periods of time is large, which is why we typically perform at least two semen analyses when initially evaluating a man. Variation over longer periods of time is very large.
Thank you!
@Christie – I don’t know you but I implore you to have your husband do a cryopreservation. I was diagnosed with low sperm count and setup IVF with ICSI and when it came time to give a sample, it was blank and has been for two years now. Completely zero and my wife and I have a moral objection to using donor’s. Thus, no kids.
@maledoc – I have read your blog for over a year now hoping you have come across someone in my situation. With the above noted, if I may suggest, a topic regarding cryopreservation to help prevent this from happening to anyone else would benefit many in my position two years ago. The local fertility clinic performs this for $400 and is worth the investment.
It’s been many years, and I’ve finally turned off comments for this WordPress blog. Why? Although it’s the first question in the FAQ, I still get comments (a bunch a day!) asking personal medical questions that I can’t answer. That’s sad and frustrating for me, because as a doctor, I really like to help patients. But this WordPress site was never meant to deliver personal medical care, and the University lawyers tell me that doing so would run afoul of State and Federal laws.
If you have specific questions about your own personal care, I urge you as outlined in the FAQ to use the American Urological Association’s Society for the Study of Male Reproduction’s search engine
I also urge you to read through all of Maledoc.com and especially the comments. For the five or so years that it was active, A lot of excellent questions were asked, including by other healthcare providers. Chances are, if you have a general question, it’s been answered here and more than once.