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A semen analysis is the most reliable testing method to understand your current fertility status. However, that analysis may not provide clear answers for everything. If you have received an abnormal semen analysis, getting additional male fertility testing with a bloodwork evaluation may be your best next step to help understand the reason for the abnormalities and what you can do to get those numbers and your sperm looking better.

It’s estimated that 50% of males who get a semen analysis receive an abnormal result and need further testing for proper treatment. In order to achieve a successful pregnancy, it’s important to optimize your fertility status. A bloodwork evaluation can help ensure you’re doing everything possible to achieve your family goals.

How Does the Bloodwork Testing Work?

Every male fertility clinic will navigate fertility testing a little differently. At Posterity Health, after you have completed your Baseline Assessment with abnormal results or have received an abnormal semen analysis at another facility, you can proceed with our Male Fertility Workup.

Your Workup will begin with an Initial Evaluation, which is a virtual telehealth appointment with our male reproductive urologist where they will review your entire history and determine if additional diagnostic workup is needed. You will also have either an in-person physical exam or scrotal ultrasound to assess for any anatomical factors.

Based on your initial evaluation, medical history, and your semen analysis results, we may recommend additional bloodwork. To get these tests done, we’ll guide you through three steps:

  • Lab Order – You will receive a lab order through our digital patient portal.
  • Blood Draw – Within seven days, you’ll take your lab order to your preferred lab (e.g., LabCorp, Quest, Kaiser, etc.) and get your blood drawn. Some labs may require appointments.
  • Treatment Plan – Posterity Health will schedule a telehealth visit to review your bloodwork results once they’re received from the lab (within 3-5 business days).

During your telehealth appointment, we’ll discuss recommendations for your personalized treatment plan. We may recommend various methods such as lifestyle adjustments, medication, hormonal therapy, surgical procedures, and more. We’ll make sure your treatment is best suited for you, your fertility needs, and your family building goals as a couple.

The Bloodwork Components of Male Fertility Testing

What exactly is being tested by in a “Big 6” hormone panel? When assessing for male fertility issues, your blood tests will mainly check hormone levels in your system. More specifically, there are 6 main components that we check in your bloodwork assessment. These include the following:


Follicle stimulating hormone (FSH) is produced by your pituitary gland and it plays a key role in the functionality of your reproductive organs. In men, this hormone sends a signal to the testicles to make sperm.

High levels of FSH may indicate malfunction of the testes, and low levels of FSH may lead to infertility issues.


Another hormone secreted by your pituitary gland, luteinizing hormone (LH) is an essential chemical signal. LH tells the testicles to produce testosterone and spurs your reproductive system to action. Without sufficient testosterone levels, your testicles won’t be able to produce lots of high-quality sperm.


As we just noted, testosterone directly affects the production of sperm in your testicles. Low testosterone levels may lead to problems like:

  • Decreased libido
  • Erectile dysfunction
  • Decreased energy and fatigue
  • Infertility issues

It’s important to keep in mind that you can have low testosterone levels affecting sperm production even if the levels aren’t so low that you experience these symptoms.

Before you start your testosterone internet search, it is important to understand that taking testosterone (e.g., supplements, gels, injections, etc.) can actually negatively affect sperm production. We manage low testosterone differently when needing to maintain or improve sperm production.


Estradiol is an estrogenic steroid that is essential for modulating libido in men, erectile function, and spermatogenesis.

Elevated levels of estradiol can cause low testosterone and suppress LH and FSH production. Like any other hormonal chemical, it’s important to keep your estradiol levels in balance.


Another hormone created by the pituitary gland; most people associate prolactin with its role in lactation after childbirth in women. However, prolactin is responsible for regulating immune system functions and reproduction systems in males.

For optimal fertility, it’s best for prolactin levels to be quite low in most men. However, when your prolactin levels rise, they can suppress LH and FSH, thus decreasing sperm production and testosterone.


Your thyroid stimulating hormone (TSH) levels are especially important for sperm production. This hormone sends signals to your thyroid (a small gland located near your Adam’s apple). An overactive or underactive thyroid can lead to decreased sperm production and lower testosterone levels.

Get Started with Male Fertility Testing Today

No matter where you are with your family plans, it’s a good idea to test your fertility status sooner rather than later.

At Posterity Health, we can help you get a well-rounded understanding of your current fertility status. Our Baseline Assessment is the best place to start because our male fertility specialists will provide answers for you and educate you on all aspects of your fertility status. If you have an abnormal semen analysis, we will recommend that you complete the Male Fertility Workup which often includes bloodwork assessment of these “Big 6” hormone levels to help us better understand hormonal factors affecting your sperm and create your personalized fertility treatment plan.

Contact Posterity Health today to get started with your male fertility testing.

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