🧬 Male Fertility
♂ Built for men · 8 markers · $176.40
with code CAMERON $196.00
Trying to conceive, planning to, or wanting to know where you stand before starting anything that could affect it. Male factor contributes to roughly half of infertility cases.
🩸 Order this exact panel — 10% off
All 8 markers load into your cart in one click. No doctor's visit, drawn at any Quest location in the US, results by email in about two weeks. Code CAMERON applies automatically.
Add all 8 markers — $176.40 → Open the full Bloodwork Vault →Why this panel
Male fertility is assessed on two axes: the hormonal signals that drive sperm production, and the sperm themselves. This panel covers the hormonal half thoroughly and tells you whether a semen analysis is likely to be the next step.
What this panel can settle, and by what logic
Male fertility has two axes: the signals that drive sperm production, and the sperm. This panel covers the first one properly, and its job is to tell you what a semen analysis is likely to show and why.
LH & FSH is the marker that carries this panel, and it is the one usually left off. LH drives Leydig cells and testosterone; FSH drives Sertoli cells and spermatogenesis specifically. That separation is why a man can hold a Total Testosterone of 600 ng/dL and still have badly impaired sperm production, and why a testosterone-only panel reads as complete reassurance Livingston 2023.
The FSH-plus-testosterone pattern localizes the problem. High FSH with low testosterone is primary testicular failure: the testis is not responding and the pituitary is compensating. Low or normal FSH with low testosterone is secondary, arising above the testis, and it is the more treatable of the two — hCG and selective estrogen receptor modulators can restore the axis where exogenous testosterone would shut it down Livingston 2023. FSH is also one of the three hormonal predictors formally evaluated for sperm retrieval in non-obstructive azoospermia, alongside inhibin B and Anti-Müllerian Hormone (AMH) Pozzi 2024.
Prolactin is a cheap catch with a big consequence. Hyperprolactinemia suppresses the whole axis and is treatable, but roughly a fifth of raised prolactin results are macroprolactin — a biologically inactive complex that the assay counts and the body does not use Sharma 2021.
What it cannot settle, and what would
No blood panel measures sperm, and nothing on this list is a substitute for a semen analysis. The WHO's sixth-edition manual is the reference standard for concentration, motility and morphology, and its own critical review is explicit about how much the method matters Boitrelle 2021. If you are trying to conceive, the semen analysis is the test. This panel tells you what is likely to be behind the result, which is a different and cheaper question.
Normal hormones do not exclude a fertility problem. Obstructive azoospermia, varicocele, antisperm antibodies, DNA fragmentation and a great deal of idiopathic subfertility all sit behind a completely unremarkable LH & FSH and Total Testosterone Boitrelle 2021.
And abnormal hormones do not predict an individual outcome. In the meta-analysis of FSH, inhibin B and AMH as predictors of microdissection sperm retrieval, the mean retrieval rate across studies was 45% and AMH reached statistical significance at an odds ratio of 0.82 (95% CI 0.73–0.92) Pozzi 2024. That is a real association and a poor individual prediction; a high FSH is not a verdict.
It carries no genetic testing. Karyotype, Y-chromosome microdeletion and CFTR testing belong to a urologist or a reproductive endocrinologist, and androgen receptor CAG repeat length varies between populations and associates with semen quality without being a test you act on alone Osadchuk 2022.
Draw conditions that decide whether the money is wasted
Two of these markers have a rhythm and one has a well-known false positive.
- 7 to 10am, fasted. Total Testosterone peaks in the early morning and an afternoon value can read a man into a diagnosis he does not have Livingston 2023.
- Prolactin rests before the draw. Prolactin rises with stress, a difficult venepuncture, nipple stimulation and sleep, so sit quietly for 20 to 30 minutes first. If it comes back high, the correct next step is macroprolactin screening rather than an MRI — around 20% of hyperprolactinemia is macroprolactin Sharma 2021.
- No biotin for 72 hours Li 2020. LH, FSH, prolactin and TSH are all streptavidin-based immunoassays on the common platforms, so one hair supplement can shift four of the eight markers at once.
- Book the semen analysis at the same time, with 2 to 7 days of abstinence as the manual specifies Boitrelle 2021. Doing both in one fortnight is what makes either interpretable.
How you would know it answered your question, and what each pattern means next
Four patterns, and where each one goes.
- High LH & FSH with low Total Testosterone: primary testicular failure. This goes to a urologist, and the semen analysis becomes urgent rather than optional Pozzi 2024.
- Low or normal FSH with low testosterone: secondary. Add Prolactin and Ferritin and see a specialist. Critically, do NOT start testosterone: it suppresses the gonadotropins further and is the one treatment that makes the fertility problem worse Livingston 2023.
- Raised Prolactin: repeat it rested, then screen for macroprolactin before anyone books imaging Sharma 2021.
- Everything normal with an abnormal semen analysis: that is the commonest result of this pairing, and it is informative. It points at obstruction, varicocele or an idiopathic cause rather than at the endocrine axis Boitrelle 2021. Retest the semen analysis at 12 weeks — spermatogenesis takes roughly 74 days plus transit, so a repeat inside 8 weeks is measuring the same cohort of cells you already measured.
Sources read for these sections
- Boitrelle F, et al. The Sixth Edition of the WHO Manual for Human Semen Analysis: A Critical Review and SWOT Analysis. Life (Basel) 2021 · PMID 34947899
- Pozzi E, et al. Role of Follicle-stimulating Hormone, Inhibin B, and Anti-Mullerian Hormone in Predicting Sperm Retrieval from Men with Nonobstructive Azoospermia Undergoing Microdissection Testicular Sperm Extraction: A Systematic Review and Meta-analysis. European Urology Open Science 2024 · PMID 38854995
- Livingston M, et al. Adult Male Hypogonadism: A Laboratory Medicine Perspective on Its Diagnosis and Management. Diagnostics (Basel) 2023 · PMID 38132234
- Osadchuk L, Vasiliev G, Kleshchev M, Osadchuk A. Androgen Receptor Gene CAG Repeat Length Varies and Affects Semen Quality in an Ethnic-Specific Fashion in Young Men from Russia. International Journal of Molecular Sciences 2022;23(18):10594 · PMID 36142533
- Sharma LK, et al. Prevalence of Macroprolactinemia in People Detected to Have Hyperprolactinemia. Journal of Laboratory Physicians 2021 · PMID 34975255
- Li D, Ferguson A, Cervinski MA, Lynch KL, Kyle PB. AACC Guidance Document on Biotin Interference in Laboratory Tests. J Appl Lab Med 2020 · PMID 32445355
What's inside
This panel covers 8 markers chosen for this specific situation. The full list, the clinical reasoning behind each marker, draw timing and how to interpret your results are available to Skool members.
Every marker and why it's here — plus the full evidence-graded Male Fertility protocol: why the blood test isn't the test, the marker that tells you whether this is fixable or not, what the 90-trial Cochrane review really concluded about fertility supplements, and the timeline that stops people quitting an intervention too early. $10/mo, cancel anytime.
Unlock the full panel →A few of the markers — free to read
These explainers are free: what each one measures, the optimal range rather than just the lab range, and what actually moves it.
What this panel is ordered to decide
A panel is a set of numbers until it settles something. These are the decisions this one feeds — each links the pathway it belongs to, what that pathway claims, and what its test list is read for.
Recovery is tracked on LH and FSH, not on how you feel. They move first, and testosterone follows weeks later — which is why people abandon a working restart too early.
Related panels
Frequently asked questions
8 markers: LH & FSH, Total T [LC/MS] & Free T [Eq. Dialysis], Estradiol, Sensitive [LC/MS-MS], Prolactin, SHBG (Sex Hormone-Binding Globulin), TSH (Thyroid-Stimulating Hormone), HbA1c (Hemoglobin A1c), Complete Blood Count (CBC) w/ Differential.
$196.00 before discount, $176.40 with code CAMERON applied automatically. Individual markers add a one-time $10 draw fee. Ordered through Marek Diagnostics and drawn at any Quest Diagnostics location in the US.
No. These are ordered direct-to-consumer through Marek Diagnostics — you order online, walk into a Quest location, and results are emailed to you in about two weeks. No physician visit or insurance required. Not available in NY, NJ or RI.
Morning, 7–10am, fasted. A semen analysis is a separate test and is essential — no blood panel can substitute for it.
Where this goes next
This page is how to read the panel. What to DO about each result — the dosing, the order to correct things in, the week-by-week schedule and what to retest — is a lesson inside Skool.