When a couple has trouble conceiving, attention often falls on the woman first — but male factors contribute to around half of all fertility difficulties. Sperm production is controlled by a chain of hormones, and when that chain is disrupted, sperm quality and quantity can suffer. Understanding these hormones, and testing them where appropriate, is an important part of investigating fertility as a team.
How the hormones fit together
Sperm production is directed by signals from the brain. The pituitary gland releases hormones that instruct the testes to make sperm and testosterone. When one link in the chain is off, the knock-on effects can reduce fertility. The key hormones are:
- FSH (follicle-stimulating hormone) — drives sperm production; a high level can indicate the testes are struggling.
- LH (luteinising hormone) — stimulates testosterone production in the testes.
- Testosterone — the main male hormone, essential for sperm development and libido.
- SHBG (sex hormone binding globulin) — carries testosterone in the blood and affects how much is available.
- Oestradiol — a form of oestrogen present in men; an imbalance can affect fertility.
- Prolactin — when raised, it can suppress the hormones needed for sperm production.
Why a semen analysis is still essential
Hormone blood tests reveal the signals controlling sperm production, but only a semen analysis directly measures sperm count, movement and shape. The two work together: a semen analysis shows whether there is a problem, and the hormone panel helps explain the cause. If you are investigating fertility, expect both to feature in the workup, usually arranged through a fertility service.
A male hormone panel assesses the hormones behind fertility.
This panel measures FSH, LH, testosterone, SHBG, oestradiol and prolactin — the hormones that control sperm production — to help explain a fertility concern alongside a semen analysis.
Check fertility hormonesLifestyle and sperm health
Hormones are not the whole story. Sperm quality is influenced by weight, smoking, alcohol, heat, certain medications and general health. Many of these factors are modifiable, and small changes can make a meaningful difference over the two to three months it takes to produce new sperm. A doctor can help you focus on the changes most likely to help in your situation.
When to get checked
It is generally sensible to seek advice if you have been trying to conceive for a year without success, or after six months if your partner is over 35. Testing may be worth considering sooner if you have a history of undescended testes, previous surgery or injury, low libido, or symptoms suggesting low testosterone. Fertility is a shared journey, and getting checked early gives you the most options.
Check fertility hormones
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Specialist interest: Cardiovascular Medicine · OneMedicine, CQC-registered clinic