Infertility is the result of many etiological factors, it has its own unique characteristics in terms of etiology, diagnosis and treatment. The occurrence of infertility is related to many factors such as life, work, environment, society, psychology, etc., and it will affect the patient’s psychology, marriage, and family, etc., so it is especially important to give the patients the correct knowledge of reproductive health knowledge. I. Couple factors affecting fertility More than 50% of infertile couples have male reproductive function defects. Almost 1/4 of infertile couples are found to have factors in both partners, therefore, in 50% of male infertility, there may be female factors as well. Infertile couples should be consulted at the same time. Female fertility decreases with age. A woman’s fertility at age 35 is only about 50% of what it was at age 25, drops to 25% at age 38, and may drop further to less than 5% over age 40. In assisted reproduction, a woman’s age is the most significant factor affecting success rates. Nearly 85% of couples can conceive naturally within 12 months. Consideration for infertility evaluation should be initiated only after 12 menstrual cycles or one year of unprotected sex or after six menstrual cycles or six months of unprotected sex for women 35 years of age and older who have not conceived. Infertility testing need not be delayed beyond 12 months when there is a family cause or when either spouse is suspected of being infertile. Between couples, the more fertile partner can also compensate for the less fertile partner. The duration of natural infertility is important in predicting future fertility. Those infertile couples with a history of infertility close to 3 years or less have a better chance of natural conception. If the duration of natural infertility is longer, the more serious the problem exists. In some cases, the natural conception rate can be misinterpreted as a treatment effect. The natural conception rate should be considered in the assessment of the success of all treatments. Timing, frequency, and the presence of sexual dysfunction will all affect conception, and intercourse should be timed around ovulation. Living environment and drug factors affecting fertility 1. Living environment factors affecting fertility There are some factors affecting fertility in the living and working environment, such as: prolonged exposure to heavy metals (e.g. lead, cadmium, mercury, aluminum, copper, manganese, etc.), chemical substances (e.g. pesticides, herbicides, carbon disulphide, dibromochloropropane, methylethyl ketone, formaldehyde, automobile exhaust fumes, benzene-containing paints, cigarette smoke, toxic decorative materials and coatings, household gas, etc.). materials and paints, household gas, etc.), and others (e.g., graphite, radiation, working in hot environments) can reduce fertility. Some scholars believe that exposure to substances that affect hormone secretion, such as estrogens, polychlorinated biphenyls (PCBs), bisphenol A, alkylphenols, phthalates, or androgen antagonists, can lead to reproductive tract malformations, reduce sperm counts, and affect spermatogenesis [3][4]. For details, please refer to the chapter “Environmental factors and male infertility” Lifestyle habits can also have an impact on fertility, such as: smoking, alcohol, sauna, etc.; long-term consumption of crude cottonseed oil can lead to infertility; for sedentary men, spermatogenesis can also be affected; . Microwaves in life have not yet been recognized for their effect on male fertility. 2, the drug factors affecting fertility Commonly used drugs: if ever used these drugs, should consider whether to stop, or to find alternative drugs that do not affect sexual function and semen quality (such as mesalazine instead of salazosulfapyridine for the treatment of Crohn’s disease and ulcerative colitis and other intestinal disorders), the need for long-term use of medication and there is no alternative, as well as radiation therapy patients can consider in the pre-treatment of Cryopreservation of semen. Oncologic chemotherapeutic agents, amphotericin, sulfasalazine, colchicine, allopurinol, tetracycline, erythromycin, cimetidine, calcium antagonists, minoxidil, hormonal therapies, furotropin, nilidazole. C. Educational Points on Semen Examination The real value of semen analysis is only to facilitate the classification of patients presenting to the clinic into three categories: low fertility, uncertain fertility, and good fertility; it can only indicate the degree of fertility potential. The length of abstinence can have an impact on the parameters of semen analysis. Therefore, semen should be taken during 48 hours to 7 days of abstinence, no condoms, lubricants or saliva should be used during semen collection, and the semen specimen should not be contaminated by urine, water or soap. If part of the ejaculated semen is lost, the specimen does not reflect the true condition of the patient’s semen. The semen sample should preferably be obtained in a separate room near the laboratory, otherwise it should be transported to the laboratory as soon as possible (within 1 hour of the semen collection). The semen sample is well insulated (20-40°C) during transportation. If a microbiological examination of semen is to be performed, urinate and wash the penis and hands beforehand, especially turning the foreskin over for cleaning in circumcision. Those with adherent foreskin or prepuce must deal with these problems before masturbating for semen collection. Fourth, the infertility treatment situation education points Generally speaking, the course of treatment to improve semen quality needs three months. Assisted reproductive technology may have an effect on the health of newborns, and prevention of multiple pregnancies is the most effective preventive measure to reduce the incidence of neonatal diseases. Among assisted reproductive technology treatments, ICSI treatment is the ultimate treatment for infertility and is the most laborious, invasive and expensive modality. ICSI treatment may transmit the risk of chromosomal, genetic, and other genetic defects to the offspring; therefore, couples undergoing ICSI treatment should undergo chromosomal analysis. When choosing a treatment strategy, the “principle of de-escalation” should be followed, i.e., less invasive techniques (medication, IUI, or conventional IVF) should be chosen first, followed by more complex, expensive, and invasive methods (ICSI).