Male fertility testing in London: from semen analysis to DNA fragmentation and hormones

Male factors contribute to around half of all fertility difficulties, yet testing for men is often an afterthought. The good news is that male fertility testing follows a clear, logical sequence — it starts simple, and only becomes more detailed when the results or your history call for it.

This guide walks through that sequence: the first-line semen analysis, then the advanced tests — sperm DNA fragmentation and hormone testing — and when each one is actually indicated.

Almost every male fertility investigation begins with a semen analysis. It is the foundation test, and for many men it is the only test they will need. It assesses sperm count, motility, and morphology, along with volume and pH.

If you want the full details of what is measured, the normal ranges, and how to book, see our dedicated sperm testing service. The rest of this guide focuses on what happens when a basic analysis is not the whole story.

Hormones control sperm production. When a semen analysis returns abnormal results — or when there are symptoms such as low libido — a hormone panel can reveal whether an imbalance is contributing. The main markers are:

• Testosterone — the primary male sex hormone
• FSH (Follicle-Stimulating Hormone) — stimulates sperm production
• LH (Luteinising Hormone) — signals testosterone production
• Prolactin — elevated levels can interfere with reproductive hormones

Imbalances in these can affect both sperm production and performance, which is why hormone testing is a logical next step when the picture is unclear.

A standard semen analysis assesses the external quality of sperm — how many there are, how well they move, and their shape. What it cannot see is the genetic integrity of the sperm. That is what a sperm DNA fragmentation test measures.

This distinction matters because a man can have a completely normal semen analysis and still have high levels of DNA damage. Where that is the case, it can affect:

• Embryo development and IVF success
• The overall risk of miscarriage

Many factors affect sperm quality. Some are within your control, and some are not. Identifying the cause is the first step toward improvement.

Lifestyle factors

• Smoking and alcohol
• High stress levels and poor sleep
• Diet and nutrition
• Heat exposure

Medical factors

• Hormonal imbalances
• Varicocele
• Infections
• Genetic conditions

Testing only one partner can miss key information. A combined approach speeds up diagnosis, provides a fuller fertility picture, and reduces guesswork. This is why testing together is strongly recommended when a couple is investigating difficulty conceiving.

If you're ready to begin, the most useful first step is usually a semen analysis. From there, your results will guide whether hormone testing or DNA fragmentation is worth adding. For a breakdown of what testing costs, see our guide to sperm test prices in London.