New Study Reveals Key Diagnostic Marker Missed by Semen Analysis in Nearly 50% of Cases

Does Standard Sperm Testing Provide Complete Information? 

A new study is shaking up the status quo in male fertility diagnostics, revealing a critical marker that standard semen analyses may overlook in nearly half of male infertility cases.

The Sperm Testing Status Quo 

Infertility impacts 1 in 6 couples, with ~50% of those couples impacted by male infertility factors. While physicians perform 5–7 million sperm tests annually, current sperm testing technology has long been believed to be missing something when it comes to determining the root cause of male infertility.

The overlooked culprit? Sperm competency, or the ability of sperm to fertilize an egg. Standard semen analysis accounts for sperm count, movement, and shape, but this data means far less if doctors don’t know if the sperm are really capable of fertilization. 

A Groundbreaking Discovery 

In a 2019 study, researchers found that phosphatidylserine (PS) on sperm is essential for sperm-egg fusion. 

• PS must be exposed on the outside of sperm for fertilization to occur. 
• Masking PS on sperm inhibits fertilization. 
• PS receptors on the egg contribute to fertilization. 

This discovery paved the way for PS Detect—a revolutionary diagnostic test that detects the presence of PS on live sperm and delivers a result known as a PS Score. 

For men and couples navigating infertility, this revelation has far-reaching implications for those who may have previously believed male fertility markers were within conception-capable limits.

“A ‘normal’ semen analysis result is not always the end of the story,” says Dr. Ryan Smith, a reproductive urologist at UVA Health and Chief Medical Officer at PS Fertility. “Many patients who experience unexplained infertility have been told their semen parameters are reassuring—yet something is still impairing conception. That’s where deeper insights are needed most, helping to provide answers where presently only uncertainty lies.”

A Smarter, More Comprehensive Approach to Male Fertility Testing

PS Detect determines PS levels on the surface of sperm, generating a PS Score that illustrates the percentage of live, fertilization-capable sperm. With this data, providers can uncover and assess hidden fertility issues among men who have a varicocele, an enlargement of the veins within the scrotum that can impact blood flow. 

In a 2024 study presented at the American Urological Association, nearly half of patients who had a varicocele also had a PS Score below normal. 

• 44% of all varicocele patients had a PS Score below the reference (normal) range, suggesting they were less fertile. 
• 29% had a normal semen analysis and a low PS Score—meaning they were misdiagnosed as fertile. 
• 54% of patients had a normal semen analysis and a PS Score within the reference range, meaning they were likely truly fertile. 

“These findings highlight where advanced testing can fill in the gaps,” says Dr. Smith. “It can help uncover what traditional testing methods may miss and may help providers ensure that patients receive accurate diagnoses and start down the right treatment pathways sooner.”

With the help of PS Fertility, patients and providers can get early, actionable insights, empowering more personalized, effective, and timely fertility care.