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Five-marker hormonal fertility panel for men — FSH, LH, testosterone, SHBG, and prolactin to assess the hormonal drivers of sperm production.
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A five-marker hormonal fertility panel for men — measuring FSH, LH, total testosterone, SHBG, and prolactin.
Male fertility contributes to approximately half of all fertility challenges in couples, yet male hormonal assessment is often undertaken after extensive investigation of the female partner. The Male Fertility Check provides the five core hormonal markers needed to assess the male contribution to conception difficulties.
FSH is the pituitary signal that directly drives spermatogenesis in the testes. Elevated FSH indicates that the pituitary is working hard to stimulate testes that are not producing sperm adequately — a pattern consistent with primary testicular impairment. LH drives testosterone production in the testes. Together, LH and FSH reveal whether the problem is at the testicular level (primary hypogonadism) or the pituitary level (secondary hypogonadism). Total testosterone supports libido, sexual function, and provides the hormonal environment necessary for sperm production. SHBG determines bioavailable testosterone. Prolactin, when elevated, suppresses gonadotrophin-releasing hormone (GnRH) and the entire reproductive axis — a treatable and commonly missed cause of male infertility.
This panel assesses the hormonal side of male fertility. Semen analysis (sperm count, motility, morphology) is a complementary assessment not included in this panel. Morning venous draw required. GMC-physician reviewed results within 5 to 7 working days.
Understand what each marker measures, why it matters, and what the science says — not just a list of numbers.
Primary driver of sperm production in the testes; elevated FSH suggests testicular impairment.
Drives testosterone production from Leydig cells; low LH with low testosterone indicates secondary hypogonadism.
Essential hormonal environment for spermatogenesis and male sexual function; supports libido and sperm quality.
Binding protein controlling free testosterone availability; high SHBG can reduce bioavailable testosterone despite normal total levels.
When elevated, suppresses LH, FSH, and testosterone through the hypothalamus — a treatable hormonal cause of male infertility.
This panel is designed for adults who want a comprehensive, evidence-based picture of their metabolic health — not a GP referral panel.
Men who have been trying to conceive with a partner for 6 or more months
Those with known low sperm count who want to investigate the hormonal cause
Men on testosterone therapy who are concerned about fertility
Those with low libido or sexual dysfunction alongside fertility concerns
This panel assesses the hormonal side of male fertility but does not include semen analysis (sperm count, motility, morphology), which is an essential component of a complete male fertility workup. Normal hormones do not guarantee normal semen parameters; and abnormal hormones do not confirm infertility. Testosterone must be collected before 10 am for accurate measurement. Prolactin is stress-sensitive and a single elevated result should be confirmed with a repeat test before further investigation. This panel does not include testicular ultrasound or genetic testing for Y-chromosome microdeletions or Klinefelter syndrome (47 XXY), which are relevant investigations for azoospermia. Please share results with a GP or urologist or reproductive specialist.
From order to physician-reviewed report in as little as three working days.
Three options designed to fit your schedule, location, and preference — all producing a laboratory-standard sample.
Adults 18+ in mainland UK. Not suitable if you have had a transfusion in the last 3 months.
Order anytime; kit dispatched within 24 hours Mon–Fri.
Allow 24–48 hours for sample transit on top of lab processing time.
Adults 18+ within 20 miles of a serviced city centre.
Mon–Sun, 06:00–20:00. Next-day booking typical.
Sample reaches the lab within 24 hours of collection.
Adults 16+ with photo ID. Paediatric draws by appointment at selected sites.
Mon–Fri, with Saturday hours at most metropolitan locations.
Samples processed same-day at the receiving clinic.
Every test is processed in a UKAS ISO 15189-accredited laboratory, overseen by GMC-registered physicians, and governed by UK GDPR. No overseas processing, no offshore data.
Follow these guidelines to ensure accurate, reproducible results. Most markers are sensitive to recent food, exercise, and sleep.
Can't find your answer? Our clinical support team is available Monday to Friday, 9am–5pm.
Contact supportFSH (follicle-stimulating hormone) is the pituitary hormone that directly stimulates sperm production (spermatogenesis) in the Sertoli cells of the testes. When the testes are damaged or functioning inadequately, the pituitary releases more FSH in a compensatory attempt — a pattern called hypergonadotrophic hypogonadism. Causes of elevated FSH in men include: Klinefelter syndrome (47 XXY), testicular injury or surgery, radiotherapy or chemotherapy damage, mumps orchitis, cryptorchidism, and idiopathic spermatogenic failure. In general, markedly elevated FSH (above 20 IU/L) with impaired semen parameters suggests significant testicular impairment, and conventional fertility treatments may have limited success.
No — testosterone replacement therapy (TRT) actively suppresses male fertility. Exogenous testosterone shuts down the pituitary’s release of LH and FSH, which are essential signals for sperm production. Most men on TRT become azoospermic (producing no sperm) within months of starting treatment. If you are considering TRT but also want to preserve fertility, discuss HCG (human chorionic gonadotrophin) therapy with a fertility specialist — human chorionic gonadotrophin (hCG) mimics LH and maintains testicular function while supplementing the hormonal effects of testosterone. Fertility typically returns after stopping TRT, though recovery can take 6 to 18 months and is not guaranteed.
Prolactin suppresses gonadotrophin-releasing hormone (GnRH) in the hypothalamus, reducing LH and FSH output from the pituitary. Lower LH means reduced testosterone production; lower FSH means impaired spermatogenesis. The result is a pattern of secondary hypogonadism with low testosterone and potentially impaired sperm production, even though the testes themselves are healthy. Treating the cause of elevated prolactin — whether it is a medication, hypothyroidism, or a pituitary adenoma — typically normalises the hormonal axis and restores fertility without the need for assisted reproduction in many cases.
Yes, ideally. The hormonal panel and semen analysis are complementary assessments that together give the most complete picture of male fertility. Normal hormones with poor semen parameters suggest a structural problem (e.g. varicocele, obstruction, or idiopathic spermatogenic dysfunction) rather than a hormonal one. Abnormal hormones with poor semen parameters confirm a hormonal driver. Normal hormones with normal semen parameters in a couple struggling to conceive redirects attention to the female partner. Semen analysis is available through NHS GP referral or private fertility clinics and should be performed within 3 to 5 days of abstinence for standardised results.
Testosterone is required within the testes at very high local concentrations to support spermatogenesis. The intratesticular testosterone concentration is far higher than circulating serum testosterone. When LH is low (secondary hypogonadism), the Leydig cells produce less testosterone, which impairs sperm production even if serum testosterone is only mildly reduced. This is one reason why testosterone replacement — which provides systemic testosterone but suppresses LH — is counterproductive for fertility. Stimulating LH with human chorionic gonadotrophin (hCG) or FSH with recombinant FSH injections can restore intratesticular testosterone and sperm production in men with secondary hypogonadism who wish to conceive.
