In clinical practice, there are many reasons in order that a specialist asks for a semen analysis, as follows:
1. Premarital: It evaluates the fertility status of a man, before the marriage. Semen analysis generally is asked with other examinations.
2. Male infertility: It evaluates disorders in the sex organs that make difficult to achieve a pregnancy.
3. Genital infections: Both symptomatic and asymptomatic genital infections are common in men and they may be sexually transmitted. There are many seminal parameters that investigate the presence of infections in semen. Prostatitis and prostato-vesiculitis are usually found in routine semen analysis, whereas epididymitis, orchitis and orchi-epididymitis are less frequent. Asymptomatic urethritis may also be detected by the examination. The increase of bacteria in the semen (bacteriospermia) is also commom and significant clinically, since bacteria may affect the semen quality and likewise they may cause infections in women, when carried out by semen.
4. Investigation of genital pathologies: Semen analysis is also helpful to investigate genital pathologies. For example, a color change in semen, mainly the brown color, is indicative of hemospermia. Semen analysis detects alterations related to the disturbance, often determining its origin.
5. Investigation of pathological entities in adolescents such as varicocele (vascular abnormality of the scrotum defined as dilated veins of the pampiniforms plexus) and undescended testis (cryptorquidism), which may affect its fertility status in adult life. Semen analysis is recommended to investigate abnormal semen quality resulting of these disturbances.
6. Recurrent spontaneous:In couples with history of one or more abortions, semen analysis is advised in the attempt of detecting the causes. Often the examination reveals abnormalities that might be the cause of the disturbance, mainly if the semen would meticulously analysed.
7. Pre and post vasectomy: The examination is advisable, chiefly after the surgery. The exam must be made at least between 45 to 60 days ensuing the surgery, generally after 15 ejaculations.
8. Semen analysis after treatments: If a patient submitted to any treatment after a previous semen analysis, the examination is generally repeated (the doctor defines the time), to check if there was beneficial improvement of the semen quality. It is recommended to repeat the examination in the same laboratory as the patient made the exam previously.
9. Semen analysis in men undergoing to continued therapy: Some types of treatment are extended like sulfasalazine. Such treatments may affect semen quality. Semen analysis is recommended, particularly after the treatment.
10. Semen analysis in neoplasms: Treatment of neoplasms are generally aggressive and they can lead to azoospermia and sterility. Semen analysis is recommended to evaluate the status of fertility of the patient pre and post-treatment. Pre-treatment semen analysis is generally pointed out for men who wish to criopreserve the semen for future inseminations, mainly younger men.
11. Semen analysis in scrotal pathologies: semen analysis is also recommended in patients with scrotal edema ensuing traumatisms, or with hidrocele, to evaluate their status of fertility.
12. Semen analysis in non-genital infections: A very common case is the orchitis post-parotitis (mumps orchitis). The 'descent' of the mumps to the testicle may affect the production of spermatozoa. Semen analysis is requested only when the mumps affects postpubertal males. In children, mumps orchitis does not cause any damage.
13. Semen analysis in vasovasostomized men (vasectomy reversal): Semen analysis is of pivotal role after the surgery in identifying the presence of spermatozoa and their quality.