The Smartphone Semen Analysis: Cool or Crazy?

At Home Semen Analysis
van Leeuwenhoek of Holland. The father of at-home semen testing (Courtesy: Wikipedia)

It’s amazing what you can do at home nowadays. Get a college degree, work a job, sell anything you own to someone half way around the world, garner YouTube fame, exercise along with hundreds of others, or self-publish a book. And now you can also analyze your sperm.
Patient lab testing, otherwise known as “at-home” testing, has been a boon for medicine. Just look at how home glucose monitoring has improved control of diabetes among millions of patients. In our field, who could argue about the value of at-home ovulation predictors or over-the-counter pregnancy test kits?

No Place Like Home

Indeed, the benefits of at-home testing in medicine are very real: It reduces medical costs, social stigma and patient inconvenience. It also improves patient engagement and enables more frequent testing if needed. It’s the way of the future and it can’t happen fast enough.
Believe it or not, at-home semen testing has been around for hundreds of years. It probably all started with van Leeuwenhoek who in 1677 took a gander at semen under the microscope for the first time. Since then, the lab-based study of semen has become its own scientific discipline, termed “andrology”. The field even has its own bible, and it over 270 pages long! The modern semen analysis now involves measuring several “liquid” issues in semen including volume, liquefaction, viscosity and agglutination as well as sperm numbers, motility, progression and shape. Other cells in the semen are also assessed. And it takes some serious training and certification to do this well.

Rudimentary Results

But now you can avoid all this and just go to Amazon and order up your own at-home semen test. If you do, here’s what you’ll find:
SpermCheck Fertility. A pregnancy dipstick type test that is quick, cheap and easy, and indicates if sperm counts are above or below 20 million/mL, but it offers no information on your exact sperm count, motility or sperm shape.
Micra Sperm Test. Essentially this is a home science experiment, using a microscope and all. Measures sperm count, motility and volume of semen but there’s plenty of room for user error!
Trak. Another home science experiment that involves a sperm-spinning centrifuge instead of a microscope. Evaluates only sperm count.
Fertell Male Fertility Home Test. Another “dipstick” type test that tells you whether you have more than or less than 10 million sperm/mL in your semen. Not available in the US.
SwimCount Sperm Quality Test. This relatively inexpensive test reads the number of motile sperm in the semen. By a color-coded readout, it gives a range of motile sperm that the semen contains, from <5 million motile sperm to >20 million.
YO Sperm Test. A smartphone and microfluidic based home semen test that measures motile sperm counts in semen. Literally uses the phone’s camera and flash to record a video of your sperm which you then send to the cloud for analysis. And you have a video of your sperm!
Reprosource @Home Collection Kit. This is a full-on, doctor-ordered, lab-based semen analysis. It has all the bells and whistles, but is collected at home. It is not the same as the others.

Two-Edged Sword

I have to admit that some of these tests are very cool and wickedly convenient, but none of the at-home tests provide a complete picture of a man’s semen quality. They really only test for one or two of about a half dozen important semen variables. This opens up the possibility of “false-positive” results in which the test suggests that you’re infertile when you’re really not. Or, it could give you a false sense of security that you’re normal when you’re really not, potentially delaying care. Neither situation is ideal but that’s the way it stands today with at-home semen testing. The most valuable semen analysis remains the classic, laboratory-based one in which all relevant semen variables are measured.
Are we headed in the right direction? You bet! I am all about patients owning and directing their care. If a couple has a hunch, and wants to act on it, there should be something to act on, as they know themselves better than anyone else. But the information obtained should be reliable and actionable, otherwise there will be added confusion. At-home semen testing is a great start and will only get better with time. But for now, if you go this route, be prepared to contact a medical provider to order an official semen analysis to know for sure.