Semen examination is a routine examination for the male partner of infertile couples, generally in the absence of contraceptive measures for more than one year after marriage without pregnancy, it is necessary to carry out this examination in order to understand the amount of semen, the number of sperm, sperm viability, activity rate and sperm morphology is normal, and so on. In our years of infertility treatment, we found that many patients now have the following misunderstandings about semen examination. The first misunderstanding: the man is very healthy, semen examination need not be done. Influenced by the traditional feudal thinking, think that can not have children is the woman’s business, the husband always blame his wife, “a piece of salty alkaline land, planting what do not grow!” Therefore, there are many infertile couples treatment for many years, but has always been the woman in the hospital running around, the man is not willing to do the most basic checks. There is a couple married for 8 years infertility, from their hometown to see Guangzhou, then to Beijing, bounced around to Shanghai. The woman underwent repeated examinations and treatments, but still did not get pregnant. I wanted the man to do a simple routine semen examination, he said he was normal and did not need to do it. When I asked him for the report of the outside examination, I realized that the man had not done any examination, and I asked him the reason was that he thought he was very healthy and did not have any disease so he did not need to be examined. It was only after my repeated persuasion that he agreed to undergo a semen test, and it was found that no sperms were seen in his semen. He could not face the result and thought that there was something wrong with our test. It was only after the review result a week later that he accepted this reality. Therefore, couples who are asking for fertility must get out of this misunderstanding, and they can go through many fewer detours. The second misconception: If the semen test result is normal, it is the woman’s problem. In outpatient treatment, there are many husbands are with apprehension waiting for the results of the semen test, once told that the test results indicators in the normal range, the president will be long and relieved to tell their wives: “I’m good, that’s your problem!” This either/or judgment is actually another misconception, because normal semen test results ≠ fertile. The results of routine semen examination can only be from the amount of semen, smell, color, liquefaction time and the number of sperm in the semen, motility, activity rate, morphology have a general understanding of the internal structure of the sperm normal, fertilization ability and genetic material is not known to be complete. That is to say, we can only know its “external image” but not its “internal quality”. In addition, about 10% of all infertile couples have unexplained infertility, in which all the tests that the couple can do are normal, but they just can’t get pregnant. Some couples get divorced due to infertility, and when he/she gets married again, they can easily get pregnant again. So, if the semen test results are normal, after the woman undergoes further tests, if they are basically normal, then the man has to undergo further tests. The third misconception: one routine semen test is enough. We often find in the male clinic, some patients in the first semen routine examination report, they are eager to know their own situation is good, can not make the woman pregnant. In fact, it is too early to draw conclusions. We know that the condition of male semen is greatly influenced by other factors, such as the interval between semen collection and the last ejaculation, whether there is a sauna 2 weeks before the semen collection, whether to take drugs affecting sperm vitality, and the examination of the personnel and machines are closely related to each other. Therefore, a semen examination sometimes cannot fully and correctly reflect the real condition of semen. For this reason, the World Health Organization specifically requires that routine semen examination should be done more than 2 times in 2 weeks before a diagnosis can be made based on the results. Therefore, we should not jump to conclusions after getting the report, especially if the result is abnormal, sometimes it takes 3 consecutive times before it can be clear. The fourth misunderstanding: you can’t get pregnant if the result of routine semen test is not normal. There is such a couple, after 5 years of marriage infertility, the male examination found that the sperm density is less than 10 × 106 per milliliter, sperm viability is also less than 10%, is a serious oligozoospermia. After a number of hospitals of drug treatment, the effect is not obvious. And just when he was feeling desperate for his inability to have children, his wife got pregnant, not only was he not happy, but he suffered more because he thought that the child she was carrying was not his. From then on, the family was never at peace, and in the midst of suspicions, quarrels and bitterness, the child was finally born. He looked at the child who did not look like him and found it unbearable and filed for divorce. The wife, feeling subjected to his unwarranted suspicions and accusations, agrees to the divorce, but on one condition, asking for a paternity test to clear her name. Paternity test results he is the father of the child, the man first can not believe that it is a mistake, after confirming, and then on his knees begging for his wife’s forgiveness, and finally the family is still so split up. Afterwards, he took a stack of sperm test reports to consult me, why his sperm so poor, several hospital doctors told him even the conventional IVF are not enough conditions to do only a single sperm cytoplasmic injection (commonly known as second-generation IVF), how could his wife get pregnant? Indeed, for the general public, see such test results will think that it is impossible to make the woman pregnant, which is another common misunderstanding. In fact, pregnancy is a matter of probability, a normal couple of childbearing age, have a normal sex life, the chance of getting pregnant each month is only about 20%. If the semen test result is lower than the reference value, such as the woman’s normal, then the woman’s chance of getting pregnant each month will be less than 20%. Theoretically, the worse the result of the semen test, the lower the chance for the woman to get pregnant, but as long as there is one sperm with good motility present, the woman has the possibility to get pregnant. So, after we understand these situations, tragedies like the above family’s tragedy will not happen.