Mr. and Mrs. Wang have been married for more than 1 year, and the wife has not been pregnant. The woman underwent a series of examinations in the gynecology department, and the results did not reveal any problems. The gynecologist suggested Xiao Wang to go to the male department to check the semen, and the routine semen result showed that it was also normal. So Xiao Wang and his wife were confused? Both sides are normal, why can’t they get pregnant? “This is a question that has troubled many couples: “Both husband and wife have been examined and the results are normal. Is the examination that the patient understands here a specialist examination at a regular hospital’s male, gynecological, or reproductive center? The specialist will select the appropriate items for the examination according to the patient’s condition. However, in the actual outpatient work, many patients say that the comprehensive examination is only some of the most basic examination items. If the female partner does not find any abnormality, it is not enough to check the semen routine in the male consultation, and it does not mean that Wang has no problem. Secondly, we need to clarify the concept of “normal test results”. In the case of infertility, for example, the whole process of pregnancy is very complicated, involving both men and women, and despite the rapid changes in science and technology, there are still many unknowns, which cannot be solved at our current medical level. Therefore, when we judge the condition, we need to make a comprehensive judgment in the face of normal test results. On the one hand, the results are really normal; on the other hand, there are abnormalities that cannot be detected with the current level of testing, and there are still more than half of the male infertility patients who cannot find the cause. Finally, let’s get to know the semen routine. It includes the volume (normal 1.5ml~8ml), color (normal milky white or yellowish), liquefaction (normal 30~60 minutes liquefaction), viscosity (normal <50px), ph value (normal 7.2~8.0), number of sperm (normal >15×106/L), activity rate (normal >40%), and vitality (normal >32%) of semen. The semen routine in some hospitals also includes white blood cell staining, sperm malformation rate, etc. As we know from the name of semen routine, it is only a routine examination of semen, the most basic understanding of semen, so it can only initially assess male fertility. Semen is composed of spermatozoa and seminal plasma. One can understand sperm as tadpoles and seminal plasma is the water in which the tadpoles live. In male infertility, there is a significant proportion of patients with semen routine that is basically normal, but there are problems with both sperm and seminal plasma. For the problem of tadpoles, we can check through sperm functionology (sperm penetration test in vitro, etc.) to clarify; for the problem of water, we can check through seminal plasma biochemistry (seminal plasma fructose, alkaline phosphatase, etc.). Of course, for different patients, we need to further select scrotal ultrasound, microbial culture, sperm DNA fragmentation, immunology and other tests to find the cause of the disease to help treatment based on the patient’s medical history, physical examination, and the results of semen routine. The various tests mentioned above reflect the quality of male semen from different angles, and the results of these tests have a crucial impact on whether the male partner’s semen can conceive and on the quality of the embryo. Therefore, routine semen is only the most basic test content, and even if the results are normal, it does not mean that there is no problem with the male partner’s fertility. After further examination, Xiao Wang found the problem – there was an abnormality in the seminal plasma. After treatment, the female partner has successfully conceived. Through the problems encountered by Mr. and Mrs. Xiao Wang, we need to have a new understanding of the significance of semen routine, not to stick to the stereotypes, but to follow the advice of the male doctor, actively search for the cause and cooperate with the treatment. Do not think that just because the semen routine is normal, there is really no problem!