Marriage is a journey we embark on towards a new world full of love, and as they say: "Marriage is not just a change in social status, but rather a union of two souls and two bodies to become one soul in one body." However, love and integration are not the only elements that deserve attention; the health status of the spouses is considered an essential element in the success of marriage. Premarital medical examination is a wise and necessary step to build a stable relationship, as it ensures the readiness of the spouses to share a life free of health problems, and helps avoid any unwanted surprises that may appear in the future. In this article,            Dalili Medical, we will review the importance of the tests required before marriage, and explain how these tests can be the key to building a successful and stable marital relationship.

## When do the results appear?

 

The results appear within a period ranging from 24 hours to a week from the date of collecting the sample.

### When is the marriage test not compatible?

 

The test is considered not compatible if it turns out that one of the spouses has a genetic disease that can be transmitted to children, or immunodeficiency diseases such as AIDS, gonorrhea, or syphilis.

### Who receives the marriage test results?

 

After conducting the necessary tests and the results appear to be correct for both spouses, the competent authority issues a compatibility certificate by sending a text message containing the certificate number.

If the result of one of the tests is positive, the message will include a text specifying the clinic appointment to take the necessary measures regarding the disease before issuing the certificate, also via a text message. If the test results are compatible, the certificate is issued, while if they are not compatible, one of the partners is referred to the clinic to take the necessary steps to avoid the transmission of diseases.

*What does the marriage test include?**

 

**HIV:** It is necessary to conduct an HIV test to ensure that it is not infected, as this virus is transmitted through sexual contact. It is also recommended to conduct tests to detect the possibility of infection with the B or C virus, in addition to other tests to detect infections and inflammations.

**Blood type:** Those who are about to get married may think that the blood type test is secondary, but in fact it is important for several reasons. If the Rhesus factor (RH) is positive, it will not affect the first child. However, the negative factor may cause antibodies to form if the fetus's blood enters the mother's bloodstream, which may lead to the death of the child during birth or miscarriage. Therefore, it is necessary to know the RH factor, and if it is negative, the mother must take a special injection during pregnancy to avoid the risk of losing the fetus.

**Fertility Test:** Childbirth is one of the main reasons for marriage, so it is recommended to conduct a fertility test for both parties to avoid any shock if one of them is infertile. These tests include hormonal tests and ensuring the safety of the reproductive organs.

**Mental Health Examination:** A mental health test is an important examination before marriage, as you are about to establish a healthy family. Some mental illnesses, such as schizophrenia, can affect the mental health of your children, so it is important to conduct this examination.

**Chronic Diseases:** If you are preparing for marriage, and you and your partner have a family history of chronic diseases such as diabetes or high blood pressure, it is necessary to conduct a comprehensive examination. This will enable you to find appropriate solutions, as these diseases may affect pregnancy. So, you should be aware of your health condition and seek appropriate treatment.

**Ethnicity:** If you or your partner have African origins, this test is important to prevent your future children from developing anemia. This disease occurs if both parents carry the sickle cell trait. This disease is very serious, as it continues with the affected person throughout his life. Therefore, it is necessary to ensure that one of you is free of this gene to protect the children from infection.

What is a semen analysis in men?

 

Semen is a thick white fluid that contains sperm in addition to other substances such as sugar and proteins, and is secreted by the man during ejaculation.

Semen analysis is a test performed to evaluate a set of aspects related to the health and safety of sperm in men, where a sample of semen is collected and examined under a microscope.

This analysis includes evaluating the following basic aspects:

- Sperm count.

- Sperm shape.

- Sperm motility.

When should this test be performed?

 

Doctors may order this test in the following cases:

● Male infertility** Couples may have difficulty conceiving due to problems with the man’s sperm, with half of all infertility cases being due to problems with the man. A semen analysis helps assess how much of a man’s influence is on the fertility problem.

So if you’ve been trying to get pregnant for 12 months or more without success, your doctor may recommend this test.

● Confirming a successful vasectomy (vasectomy follow-up) Your doctor may order a semen analysis if you’ve recently had a vasectomy, a procedure that prevents pregnancy by cutting the tubes that carry sperm from the testicles to the penis.

Doctors usually order a semen analysis 8 to 16 weeks after surgery to assess whether the procedure was successful. If there are no sperm in the semen, it indicates that the procedure was successful.

### How to do the test

 

Your doctor will ask you to collect a sample of semen in a sterile container for examination under a microscope. Here are some important tips for collecting the sample:

- Make sure to urinate and wash your hands and penis before starting to collect the sample.

- You can collect the sample by masturbating in the test container inside a special room. The man can also collect the sample at home, but it must be kept at the appropriate temperature and delivered to the laboratory within 30 to 60 minutes, before starting theFor sperm to deteriorate.

- It is important to avoid using lubricants or saliva during sample collection, as they can negatively affect sperm motility.

How is this test performed?

 

Here is everything you need to know about how to perform this test:

● Preparing for the test To ensure accurate results, please follow these instructions before the test:

1. Abstain from sexual activity (intercourse and masturbation) for 2 to 7 days.

2. Avoid alcohol, drugs, and caffeine for 2 to 5 days before the test.

3. Stop taking any herbal or hormonal medications (such as testosterone) as directed by your healthcare provider.

**What are premarital tests?**

 

Premarital tests include a set of laboratory tests that both partners perform before marriage, with the aim of detecting any genetic diseases that may be passed on to children, or any infectious diseases that may affect one of them. These tests also aim to educate both partners about the available options, whether in terms of taking the necessary precautions or seeking appropriate treatment methods to maintain the health of the new family.

**Reasons for conducting a semen analysis for men**

 

A semen analysis for men is used for multiple purposes, including:

1. **Reproductive health assessment**: This analysis is used to determine a man's ability to reproduce or to detect possible causes of infertility. Semen analysis is considered a basic test in the field of reproductive medicine, as it provides valuable information about a man's health and ability to reproduce.

2. **Treatment and diagnosis assessment**: This analysis helps diagnose conditions that affect reproductive health, and can be used to evaluate the effectiveness of available treatments.

3. **Research studies**: Semen analysis is used in scientific research to understand reproductive processes and the impact of various factors on them.

4. **Ensuring the success of the vasectomy**: Semen analysis is also performed to ensure the success of the vasectomy (vasectomy) for men.

**Home fertility test for men**

 

Some men may have difficulty collecting the sample in the laboratory, so home fertility testing can be done by collecting the sample at home. However, some important guidelines must be followed:

1. **Storing the sample at room temperature**: Hot or cold weather conditions should be avoided, as this may affect the accuracy of the results.

2. **Do not use lubricants**: Avoid using any lubricants while collecting the sample, as they may negatively affect sperm motility.

3. **Send the sample to the laboratory quickly**: The sample must be transferred to the laboratory within 30 minutes of collection, as the sample testing process begins after this period.

4. **Ensure the cleanliness of the collection tube**: The sample collection tube must be clean, sterile, and not wet. Some laboratories also provide a special condom to collect semen during intercourse.

5. **Proximity of the house to the laboratory**: It is important that the house is close to the laboratory, as the semen sample is very sensitive to weather and time factors.

**How ​​to analyze semen in men**

 

Semen examination is divided into several types:

1. **Visually examined**

2. *Microscopic examination**

3. **Chemical examinations**

4. **Immunological examinations**

**Sample collection methods:**

- Masturbation, which is the best option.

- Having sex with a condom.

- Having sexual intercourse with withdrawal before ejaculation.

- Ejaculation through sexual stimulation.

Can azoospermia be treated?

 

The absence of sperm in the semen means that pregnancy cannot occur, unless there is a sufficient amount of sperm to fertilize the egg. However, modern therapeutic techniques have proven very effective in treating azoospermia in many patients, such as the microscopic examination technique of the testicle. The microscopic examination technique depends on extracting sperm directly from the testicle, in the event that all initial treatments aimed at activating the testicle and increasing the number of sperm fail. After sperm extraction, ICSI can be used to overcome the problem of infertility in this case

What are the risks associated with not undergoing premarital examinations?

 

- Transmission of genetic diseases to children.

- Transmission of sexually transmitted diseases between spouses.

- Detection of infertility or poor fertility and treatment before planning pregnancy.

- Increased risk of fetal growth restriction or miscarriage.

- The mother is exposed to complications during pregnancy or childbirth, such as gestational diabetes or preeclampsia.

- The emergence of disputes between spouses and social problems as a result of the circumstances associated with the emergence of these diseases in the family.

**What is the importance of premarital examinations?**

 

It is recommended that couples who are about to get married undergo these examinations three months before the wedding date.

The importance of these examinations is evident in several aspects, including:

- Assessing the health status of both parties before marriage.

- Detecting the presence of any infectious diseases such as hepatitis B or C, HIV (AIDS), or sexually transmitted diseases.

- Determine whether one of the parties suffers from genetic disorders that may be transmitted to children, such as some blood diseases such as thalassemia, hemophilia, and sickle cell anemia.

These tests are also of great importance to society as a whole, as they contribute to reducing the pressure on government health institutions such as blood banks.

What tests do premarital tests include?

 

1. Some routine tests, such as:

- Complete blood count analysis.

- Blood type test.

- Rh factor test.

- Urine sample analysis.

- Blood smears to assess the shape of the cells.

- Detection of diabetes or thyroid disorders.

2. Tests to detect some infectious diseases, such as:

- Syphilis test.

- TestInfection with hepatitis.

- HIV test (AIDS).

- Gonorrhea and chlamydia test.

3. Genetic tests:

The doctor may request this type of test if the incidence of genetic diseases is high, especially if there is a kinship between the spouses. These tests depend on the medical history of both parties and their family history, as some genetic diseases such as Mediterranean anemia and sickle cell anemia are common in some families.

4. Fertility tests: These tests help identify any problems that may hinder the ability to conceive. This helps in treating infertility issues early, which reduces the psychological and social stress that may result from delayed childbearing.

Fertility tests for men:

Semen analysis is the most common test to evaluate fertility in men, and may be accompanied by measuring the following hormone levels in the blood:

- Testosterone

- Follicle stimulating hormone (FSH)

- Luteinizing hormone (LH)

. General health assessment:

This procedure includes a general health examination of both parties, such as:

- Measuring weight and height

- Monitoring blood pressure

- Evaluating respiratory functions

- Examining the efficiency of heart function

- Performing a breast examination

- Examining the abdominal area

**. Mental health:**

Those about to get married must have a degree of psychological balance and the ability to bear responsibility. Some psychological disorders may negatively affect the ability to bear this new responsibility, and some of these disorders may pose a danger to the life of the individual or those around him.

**First: Semen analysis**Semen analysis reveals the level of fertility in a man by evaluating the characteristics of semen and sperm. It also helps in diagnosing and treating some pathological conditions associated with sperm disorders, which can contribute to avoiding delayed childbearing after marriage. Among the things that are known through this analysis:

1. **Sperm count:** The normal concentration of sperm in semen is at least 15 million sperm per milliliter. If the sperm count is less than this level, it may affect the man's ability to reproduce.

2. **Sperm motility:** Sperm have the ability to move, which enables them to reach the egg inside the fallopian tube and fertilize it. If the percentage of sperm that have movement is less than 40%, this may indicate low fertility in the man.

**3- Sperm shape and composition** The shape and composition of sperm can affect the ability to fertilize the egg, as the percentage of abnormalities in sperm may reach 96%. However, the man maintains his reproductive ability, but some types of abnormalities may hinder the process of fertilizing the egg.

**4- Semen sample size** The volume of semen usually ranges between 1.5 and 5 milliliters per ejaculation. If the volume of semen is less than normal, this may indicate a blockage in the seminal vesicles or retrograde ejaculation, where some of the semen is pushed into the bladder during ejaculation.

**5- Semen liquefaction**Semen is usually viscous when ejaculated, and its fluidity should gradually increase over time. It should become completely fluid within 15-20 minutes after ejaculation, allowing the sperm to break free and move towards the egg. If its viscosity remains for longer than that, it may negatively affect the fertilization process.

**6- Semen pHThe pH of semen is between 7.2 and 7.8, according to the World Health Organization. Any slight change in this number or in the acidity of the semen may negatively affect the effectiveness of the sperm.

7**- Fructose level in semen** Sperm need fructose, which is naturally present in semen, to maintain their vitality and movement after ejaculation. If fructose is absent from the semen, the doctor may suspect a blockage in the seminal vessels.

**8- White blood cells in the semen **There is a certain percentage of white blood cells (WBCs) in the semen sample. However, if this percentage exceeds the normal rate, it may often indicate an infection or inflammation in the male reproductive system.

*: Hormonal tests**

The activity of the male reproductive system depends largely on certain hormones that play a fundamental role in activating the testicles and producing sperm. Therefore, it is necessary to ensure the levels of these hormones in the blood as part of premarital examinations for men. Here are the most prominent of these hormones:

1. **Follicle-stimulating hormone (FSH)** Follicle-stimulating hormone (FSH) is secreted from the pituitary gland located in the brain, and it has a significant effect on the growth of the testicles and activating the production of sperm within them. A low level of this hormone, as a result of a problem in the pituitary gland, may lead to a decrease or inhibition of testicular activity.

Also, a higher than normal FSH level may indicate a problem in the testicle that hinders sperm production, as in Klinefelter syndrome.

**2- Luteinizing hormone (LH) Luteinizing hormone (LH) is also secreted by the pituitary gland, where it stimulates the testicles to produce testosterone, known as the male hormone. A high level of this hormone may indicate a decrease in testosterone secretion from the testicles.

**3- Testosterone** Testosterone is known as the "male hormone" because of its effects on various organs of the body that show signs of masculinity. It also plays an important role in regulating sperm production in the testicles, and affects the level of sexual desire in men. A decrease in its secretion may have negative effects on male fertility.

** Infectious disease tests ** The tests required before marriage for both men and women include tests to detect infectious diseases, such as:

- FHepatitis B virus.

- Hepatitis C virus.

- Human immunodeficiency virus (HIV).

- Sexually transmitted diseases, such as:

- Gonorrhea.

- Syphilis.

- Chlamydia.

** Detection of hereditary blood diseases**

Detection of hereditary blood diseases during premarital examinations helps estimate the likelihood of offspring being exposed to any of these diseases, such as:

- Thalassemia.

- Sickle cell anemia.

- Other hemoglobin disorders.

- Periodic examinations**
In addition to the previous examinations, premarital examinations for men include the following:

- Performing a complete blood count.

- Measuring blood pressure.

- Calculating body mass index.

- Measuring blood sugar levels.

**Premarital Test Results for Men**

Premarital tests are usually conducted for both men and women at the same time, and both wait for the test results that reflect their health status and reveal any diseases or health problems that may affect reproductive ability.

The test results are presented to the specialist doctor, and if negative or undesirable results appear, andrologists evaluate these results and determine their impact on fertility. They also provide the man with a set of medical advice that may help improve his condition, such as quitting smoking and losing excess weight, as these procedures are often sufficient in cases of slight weakness in fertility.

Medical conditions that significantly affect fertility, such as hormonal disorders, worsening varicocele, and sperm abnormalities, are among the things that the andrologist must develop an appropriate treatment plan for each case, with the aim of preserving the chances of conception after marriage

1- Weak sperm **The term weak sperm refers to a group of disorders that may affect sperm during the various stages of their production. Weak sperm can manifest itself in several ways, including:

- Weak motility.

- Increased rate of genetic material breakdown.

- Inability of sperm to fertilize the egg.

- Forming low-quality embryos, which increases the risk of miscarriage.

There are many causes of weak sperm in men, the most prominent of which are:

- Obesity.

- Infection.

- Smoking.

- Malnutrition.

- Varicocele.

- Orchitis.

- Undescended testicle.

- Testicular cancer.

- High testicular temperature.

- Taking anabolic steroids (steroids).

**- Sperm abnormalities**Premarital tests show abnormalities in sperm, as sperm abnormalities indicate any change in their normal composition in any part of their parts. These abnormalities may or may not affect a man's fertility, depending on the percentage of abnormal sperm and the location of the abnormality. Sperm abnormalities can be caused by several factors, including:

- Infection.

- Smoking.

- Diabetes.

- Overweight.

- Varicocele.

- Genetic disorders.

- Lack of antioxidants.

- High testicular temperature.

- Side effects of some medications, including chemotherapy or radiation.

- **Azoospermia*Azoospermia refers to the complete absence of sperm in the semen during ejaculation, and is considered one of the main causes of delayed childbearing in men. Azoospermia may be caused by several factors, including:

- Testicular failure.

- Hormonal disorders.

- Obstruction of the sperm duct.

What are the risks of neglecting premarital examinations?

 

Many complications of varying severity can occur if both parties do not undergo premarital examinations, especially in the following cases:

1. When marrying a woman who has a negative RH factor**The RH factor is a protein found on the surface of red blood cells in most individuals. If a person has this protein, he is considered RH positive, but if he lacks it, he is RH negative.

When one of the spouses is positive and the other is negative, this is medically known as RH incompatibility.

The problem is that the mother can carry a child who has a different RH factor than hers. This condition does not pose a risk in the first pregnancy, but it can threaten the life of the second child if the mother is not aware of it and does not take the necessary precautions.

This is because the blood of the mother and the fetus may mix during the birth of the first child, which prompts the mother's body to recognize the different RH factor as a foreign body, and begins to produce antibodies against it.

When the mother carries the second child, these antibodies may begin to attack the fetus's blood, which puts his life at risk, and this may lead to damage to his red blood cells.

The second dose is given 72 hours after birth.

.** Women with thyroid disorders** A woman should be aware of her condition if she suffers from a thyroid disorder, whether hyperthyroidism or hypothyroidism, before deciding to become pregnant. Thyroid hormones directly affect the fetus, especially in the first months of pregnancy, and any imbalance in this context may lead to:

- Premature birth.

- Preeclampsia.

- Miscarriage.

- Low birth weight.

These problems can be overcome by monitoring thyroid activity before and during pregnancy, and ensuring adherence to the appropriate dose of medications if the doctor deems it necessary.

### . Pregnancy and Diabetes** Diabetes does not pose a risk if it is well controlled, and the mother is keen to adhere to the appropriate therapeutic dose and continuous follow-up with the doctor.

However, if the mother neglects her treatment during pregnancy or is not aware of her diabetes, this may cause serious harm to the fetus. The most prominent of these damages are:

- High blood sugar levels affect the fetus during the first weeks of pregnancy, which is the period of formation of vital organs such as the brain and heart, which increases the possibility of birth defects.

- High blood glucose levels duringTo carry to:

- Premature birth.

- Birth of an overweight baby.

- Breathing problems in the fetus.

- Increased risk of miscarriage.

- Stillbirth.

### . If one of the parents suffers from thalassemia** It is a genetic disease that is transmitted from parents to children through genes, and affects red blood cells, leading to a decrease in their number and thus reducing the amount of hemoglobin in the body.

The degrees of thalassemia vary from simple cases to serious cases that may lead to health complications.

**Tips before performing a semen analysis for men**

 

When going to the laboratory to perform a fertility test, it is recommended to follow the following instructions to ensure obtaining an accurate and error-free sample:

1. **Have sex normally**: It is preferable to have sex normally two to five days before the test date, as this helps to obtain a sample containing more active sperm.

2. **Abstain from sexual activity**: It is recommended to abstain from sexual intercourse or masturbation for a period ranging from two to five days, to ensure an increase in sperm count.

3. **Avoid influencing substances**: You should stay away from alcohol, caffeine, and drugs of all kinds, such as marijuana and cocaine, as the THC compound in marijuana can negatively affect sexual desire and reduce the production of testosterone and sperm.

4. **Avoid opiates**: Taking opiates can reduce sperm production, which affects the number.

5. **Stop taking herbal medications**: It is preferable to stop taking any herbal medications before the examination.

6. **Consult a doctor about hormonal medications**: You should stop taking hormonal medications based on the recommendations of a specialist doctor.

Following these tips will help obtain accurate and reliable results for the fertility examination.

**What are the factors that affect the semen analysis in men?**

 

There are a number of factors that may affect the results of semen analysis in men, some of which are related to the person himself and his lifestyle, while others are related to the surrounding conditions during sample collection. It is important to consider these factors during the examination, including:

1. **Age**: The quality of semen is affected by age, as the number and quality of sperm decrease with age.

2. **Healthy habits**: A healthy lifestyle and healthy eating habits, such as eating a balanced diet and exercising, play an important role in improving semen quality.

3. **Environment**: Some environmental factors, such as air pollution and exposure to harmful chemicals, can negatively affect semen quality.

4. **Genetic factors**: Some men may be prone to semen problems as a result of genetic factors that affect the maturation and growth of sperm.