Travelers often go online to search for travel “tips” before they travel, to get a comprehensive understanding of the environment, scenery and travel of the destination, and to learn what others have said after going there, so that they can prepare for their own trip and make their trip full of expectations and surprises. Patients may have a similar idea to see a doctor, first go online to find out which hospital and which doctor is better at his disease, when to go can be found, and approximately how long it will take. In fact, most people have no certainty about these results, it is the patient himself who decides when to go to see them without adequate preparation, often arriving at the hospital without being able to get a number, or having seen the doctor for the first time but waiting for the examination takes not a short time, without being prepared for the time. In our country, there is basically no one-to-one doctor-patient appointment system, so if a patient wants to see a doctor, he or she has to come early in the morning and wait in line to register if he or she is not introduced by someone who knows the doctor, and the number of patients a doctor can see in a day is limited after all, and there are a lot of follow-up patients. Even if you can get a number and the doctor has seen you, you will have to do some tests to help diagnose and treat the disease in general. This gives you the time to make an appointment and wait for the test results, and you need to register again to see the doctor. Therefore, it will take a lot of time if you do not know the basic condition of the disease and the examination and treatment process. Time is precious for a working person or a person coming from out of town to seek medical treatment. The incidence of infertility is 10-15%, and male factors account for half of it. Male infertility is a complex disease and in most cases cannot be accurately explained by one etiology. Common causes of male infertility today include varicocele, idiopathic infertility, azoospermia, and infection, but sometimes it is difficult to find the exact cause. The first step is the medical history and physical examination. The history can reveal clues such as previous fertility history, sexual life, seminal emission, past medical history and medication history, and female partner’s condition. Physical examination is also important to evaluate the size and texture of the testicles, the epididymis, the vas deferens, and the presence of varicocele. Some tests are needed to find the cause of the disease if possible. The first important test for patients with infertility is a semen test, which in most hospitals does not require an appointment and the results are available in about 1-2 days. The semen examination items vary from hospital to hospital, and the semen examination results are very simple in hospitals without specialized male departments, while the semen examination results are relatively comprehensive in hospitals with specialized male departments. Generally speaking, the basic semen routine examination should at least include volume, acidity, sperm density and vitality, and sperm malformation rate. The standards used to determine semen quality vary from hospital to hospital, and the most commonly used now are the WHO 4th and 5th edition standards. In general, a normal semen examination result should be (WHO 4th edition): volume > 2 ml, pH 7.5, liquefaction time < 60 minutes, sperm density ≥ 20 million/ml, percentage of forward-moving sperm (class a+b) ≥ 50% or class a ≥ 25%, and percentage of normal morphology sperm > 15%. Many people are afraid that a high deformation rate will lead to fetal malformation, this view is not correct, in fact, with the current standard measurement of male sperm in the normal form of sperm are only a minority. If you want a more comprehensive examination of semen, you need to include tests for infectious factors such as white blood cells, mycoplasma, chlamydia and bacterial culture, which of course takes longer to produce results, about 3-5 days. If the semen test is normal, there is no need for further in-depth tests, but if the semen results are not normal, further tests are needed. There are also some special tests in semen examination such as seminal plasma biochemistry, sperm DNA fragmentation, etc. These tests have relative indications and the waiting time for results is also longer. Ultrasound examination of the reproductive system is another routine examination to find out the volume of the testes, the presence of lesions in the testes, the condition of the epididymis, the presence of varicocele, the condition of the prostate and seminal vesicles, etc. Ultrasound is a non-invasive test that can be used to aid in the diagnosis of varicocele, obstructive azoospermia, congenital hypogonadism, etc. In our hospital, because it is a male-specific ultrasound machine, the examination can usually be completed and results obtained within 1-2 days. In contrast, the ultrasound in most hospitals is a comprehensive ultrasound, and the appointment time varies. Sex hormone tests are also commonly used for male infertility to understand the function of the male gonadal axis and to help diagnose male infertility. A high follicle stimulating hormone (FSH) in azoospermic patients often indicates spermatogenic dysfunction of the testes. Low testosterone levels (T) suggest the possibility of hypogonadism. Sex hormone tests are generally recommended to be drawn between 8-11pm and the results are usually available in about 3-4 days. Chromosomal examination is a special test for infertility. The incidence of chromosomal abnormalities in male infertility is 10-20% and is a test that needs to be taken seriously. Chromosomal examination is generally recommended for patients with severe oligospermia (density below 5 million/mL semen) and non-obstructive azoospermia. Chromosomal examination includes karyotype analysis and Y chromosome microdeletion, which can help diagnose and guide treatment. Chromosomal tests take longer to perform, usually about 2 weeks to get results. What tests are needed for different disorders? I’ll give a brief overview of some common male infertility disorders here. Varicocele, as one of the most common causes of male infertility, usually requires semen examination, ultrasound and sex hormone examination routinely, and treatment includes medication and surgery. Moderate and above varicocele combined with abnormal semen quality and small testicles require surgery, and the general hospital stay is 4-6 days. Obstructive azoospermia is also a common cause of male infertility. Most obstructions can be treated by microscopic reconstructive surgery, and some couples achieve natural conception through surgical treatment thus avoiding IVF. An approximate estimate of the site of obstruction is needed before surgery, which can be determined roughly by physical examination, semen routine, and ultrasound. Most obstructions are located in the epididymis and can be operated on. The general hospital stay is 5-7 days. Non-obstructive azoospermia is the most difficult type of male infertility to treat and is caused by testicular spermatogenic dysfunction. Common causes include genetic diseases such as Crohn’s disease and Y chromosome microdeletion, congenital hypogonadism, after radiotherapy, testicular atrophy after mumps, cryptorchidism, etc. There are also many patients who have difficulty in identifying the cause. For non-obstructive azoospermia patients routinely need to check semen routine, reproductive ultrasound, sex hormones, karyotype analysis and Y chromosome microdeletion, which takes 1-2 weeks. Non-obstructive azoospermia can be treated with microscopic orchiectomy for sperm extraction and IVF if sperm can be obtained. The hospital stay is usually 5-7 days. There are also many patients who cannot find out the cause and can only be treated with empirical medication. Generally 3 months of medication is a course of treatment, the duration of medication should not be too long, usually 1-2 courses of treatment is sufficient, if it is not effective, other treatments such as assisted reproduction techniques have to be considered.