Objective  To examine the willingness to receive a semen examination (SE) and its influencing factors among couples taking free premarital medical examination (PME) in Shenzhen city and to provide evidences for incorporating SE into the items of free PME.

  Methods  We conducted a questionnaire survey among examinees of PME randomly recruited at Premarital Medical Service Centers in Futian, Luohu, and Baoan district of Shenzhen municipality from September to November 2017.

  Results  A total of 1 601 PME examinees participated in the survey, including 860 males and 741 females. Of the male participants, 86.9% (747) reported the willingness to have a SE free of charge and 76.5% (658) expressed the willingness to have a self-paid SE, with a significant higher ratio for the free SE than that for the self-paid SE (P < 0.05); while, of the female participants, 97.6% (723) and 88.7% (657) expressed the support to their spouses to have a free or a self-paid SE during PME, also with a significant higher ratio for the free SE than that for the self-paid SE (P < 0.05). Compared to those of Futian and Luohu district, the participants of Baoan district reported significantly higher willingness to receive and support to their spouses to have free or self-paid SE (both P < 0.05). In comparison to migrant participants, the participants with local residence register or permit reported a significantly higher willingness to receive a self-paid SE; the participants with moderate and low income reported a significantly higher willingness to receive a SE free of charge than the participants with high income. There were 45.2% of the participants considering that the acceptable price for a self-paid SE could be between 0 and 100 Yuan RMB. Main reasons for the participants to receive a SE or to support their spouses to have a SE were to get some health benefits (reported by 24.8% of those participants) and to have a normal childbirth or a healthy infant (21.7%). Of the participants being unwilling to receive a SE or not to support their spouses to have a SE, 46.5% considered that they or their spouses were healthy.

  Conclusion  The majority of examinees of premarital medical examination are willing to receive or to support their spouses to have a free or self-paid semen examination; the results indicate that semen examination could be incorporated into the items of premarital medical examination.