A basic semen analysis may be done to learn if a man is infertile (unable to father a child). Sometimes a basic semen analysis does not provide all the information your doctor needs to diagnose and treat infertility. Your doctor may recommend more specialized tests; these tests are frequently referred to as “advanced semen tests.” The most common of these tests examine the semen for reactive oxygen species, total antioxidant capacity, and damage to the genetic material (DNA) contained within the sperm. 
  A basic semen analysis combined with advanced semen testing is known as a semen profile.
  Reactive oxygen species (ROS) are also called free radicals. When present in large amounts, ROS may damage the sperm and the DNA within the sperm. This damage may lower the chances of pregnancy.
  There may be many reasons why your doctor recommends a ROS tests. Common reasons for this test include:

• a high number of white blood cells in the semen 
• varicocele (the veins coming from the testicle are dilated, or widened, because of a problem with the valves that control the flow of blood from the testicles to the body) 
• history of spinal cord injury
• unexplained infertility

If your doctor thinks you might have an infection, he or she may recommend additional tests and/or prescribe a course of antibiotics. If you have a varicocele, your doctor may recommend a procedure to fix it. In many cases, the doctor will recommend you consume more antioxidants in your diet. This can be done by eating a diet rich in fresh fruits and vegetables or by taking a nutritional supplement that includes antioxidants. 
  The total antioxidant capacity (TAC) test measures the amount of antioxidants in the semen. Antioxidants in the semen are believed to protect the sperm by cancelling out the harmful effects of reactive oxygen species. 
  The TAC test is typically ordered with the ROS test. Together, the two tests can show how likely the sperm are to be damaged by ROS.
  In many cases, the doctor will recommend you consume more antioxidants in your diet. This can be done by eating a diet rich in fresh fruits and vegetables or by taking a nutritional supplement that includes antioxidants.
  DNA contains our genetic blueprint. The DNA fragmentary index (DFI) test compares the number of sperm with broken DNA strands to the total number of sperm in a man’s semen. 
Because sperm with broken DNA can look the same as healthier sperm, the percentage of sperm with broken DNA cannot be determined by a basic semen analysis. Every man has sperm with damaged DNA, but men who have a higher percentage of damaged sperm may have a harder time creating a pregnancy. Therefore, if your DFI is high, your doctor may recommend a treatment to try to reduce the DFI or may recommend a change to your reproductive treatment plan. 
  There may be many reasons your doctor may recommend a DFI test. The most common reasons are:

• varicocele
• unexplained infertility
•  lack of pregnancy after multiple attempts

Please note that a DFI test may not be possible in men who have a very low number of sperm in the semen.
  There are several suggestions for lowering the DFI:
Men with a high DFI should stop using all tobacco products and all recreational and/or illicit drugs, as these substances are believed to damage sperm DNA. 

If you have a varicocele, your doctor may recommend it be fixed. 
If your ROS is elevated, your doctor may recommend you consume more antioxidants by eating a diet rich in fresh fruits and vegetables or by taking a nutritional supplement that includes antioxidants. 
If your doctor recommends an intervention, such as those mentioned above, it is usually appropriate to repeat the DFI test several months after treatment.
  Once the semen sample is submitted, it typically takes 2 to 3 days to complete the ROS test and 2 to 3 weeks to complete the TAC and DNA tests. Once the tests are completed, your fertility team will review the results with you.