Is semen analysis necessary for varicocele patients in their early 20s?

To determine whether it is necessary to analyze the semen of varicocele patients in their early 20s who are not complaining of infertility.

Data was collected retrospectively from 128 men with varicocele with no complaint of infertility, but with complaints of pain/discomfort or a mass/swelling during a 4-year period beginning in January 2009. The varicocele cases were matched 4 : 1 by age to 32 hemospermia controls.

The median patient age was 22.0 years in the case group and 24.0 years in the control group. The median values of the percentage of normal motility, normal morphology, and density in the case group were 42.5%, 40.0%, and 51.0×10(6)/mL, respectively. The median serum testosterone level was 4.2 ng/mL and 7.0% of the total patients had low serum testosterone levels in the case group. The number of patients with asthenospermia (17.2%), oligospermia (10.9%), and teratospermia (5.5%), and those with at least one abnormal semen parameter (19.5%) was significantly higher in the case group than the control group. The median values of the motility, morphology, and density of the case group were significantly lower than those of the control group. The multivariate analysis showed that patient characteristics (age, presence of pain, duration of symptoms, and grade of varicocele) cannot help to predict abnormal semen parameters (asthenospermia, oligospermia, teratospermia, or cases of at least 1 abnormal semen parameter) or serum testosterone levels <3.0 ng/mL.

Semen analysis is required as a screening test for semen abnormalities regardless of the chief complaint in varicocele patients in their early 20s.