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 and psychology, and it can affect the patient’s psychology, marriage and family, etc. Therefore, it is especially important to give the correct knowledge of reproductive health to patients. I. Factors affecting fertility in couples More than 50% of infertile couples have reproductive function defects in men. Almost 1/4 of infertile couples are found to have factors in both partners; therefore, in 50% of male infertility, there may be factors in women as well. Infertile couples should consult for medical consultation at the same time. Fertility in women 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% beyond 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. Infertility evaluation should be initiated only after 12 menstrual cycles or one year of unprotected sex or in women 35 years of age and older who have not conceived after 6 menstrual cycles or 6 months of unprotected sex. It is not necessary to postpone infertility testing beyond 12 months when there is a family reason or when either partner is suspected of infertility. Between couples, the more fertile partner can also compensate for the less fertile partner. The duration of natural infertility is important in predicting its future fertility. Those infertile couples with a history of infertility close to 3 years or less have a better chance of conceiving naturally. If the duration of natural infertility is longer, the more serious the problem exists. In some cases, the natural conception rate can be incorrectly interpreted as a treatment effect. The natural conception rate should be considered in the assessment of the success of all treatments. The timing of sex, frequency, and the presence of sexual dysfunction will affect conception, and the timing of intercourse should be chosen around the time of ovulation. Factors affecting fertility in the living environment and drugs 1. Factors affecting fertility in the living environment There are some factors affecting fertility in the living and working environment, such as: prolonged exposure to heavy metals (such as lead, cadmium, mercury, aluminum, copper, manganese, etc.), chemical substances (such as pesticides, herbicides, carbon disulfide, dibromochloropropane, methyl ethyl ketone, formaldehyde, automobile exhaust, benzene paints, cigarette smoke, toxic decorative materials and paints, household gas, etc.). materials and paints, household gas, etc.), and others (e.g. graphite, radiation, working in hot environments) can reduce fertility. Some authors believe that exposure to substances that affect hormone secretion such as estrogen-like hormones, polychlorinated biphenyls, bisphenol A, alkyl phenols, phthalates, or androgen antagonists can cause malformations of the reproductive tract, reduce sperm counts, and affect spermatogenesis [3][4]. For more details, see the section on “Environmental factors and male infertility”. Smoking, alcohol, sauna bathing, etc.; long-term consumption of crude cottonseed oil can lead to infertility; sperm production can also be affected in sedentary men; . The effect of microwaves in life on male fertility has not been confirmed. 2. Drug factors affecting fertility Common drug effects: If you have used these drugs, you should consider whether you can stop them or look for alternative drugs that do not affect sexual function and semen quality (e.g., using mesalazine instead of salazosulfapyridine to treat intestinal diseases such as Crohn’s disease and ulcerative colitis), those who need long-term medication and do not have alternatives, and radiotherapy patients can be considered before treatment Cryopreservation of semen. Oncologic chemotherapy drugs, ambrisentin, salbutamol, colchicine, allopurinol, tetracycline, erythromycin, cimetidine, calcium antagonists, minoxidine, hormonal therapy, furotoxin, nilidazole. III. Educational points of semen examination The real value of semen analysis is only to facilitate the classification of patients coming to the clinic into three categories: low fertility, uncertain fertility and good fertility; it can only indicate the degree of fertility possibilities. The length of abstinence will affect the parameters of the semen analysis. Therefore, sperm should be taken during 48 hours to 7 days of abstinence, no condoms, lubricants or saliva should be used during sperm extraction, and semen specimens should not be contaminated with urine, water, soap, etc. If part of the ejaculated semen is lost, the specimen does not reflect the true condition of the patient’s semen. The semen specimen should preferably be obtained in a separate room near the laboratory, otherwise it should be sent to the laboratory as soon as possible (within 1 hour of the semen collection). During transport, semen samples are well insulated (20-40°C). If a semen microbiological examination is to be performed, urinate and wash the penis and hands beforehand, and in particular, flip the foreskin for washing if it is circumcised. Those with adherent foreskin or prepuce must deal with these problems first before masturbating for semen collection. Fourth, infertility treatment situation education points Generally speaking, the course of treatment to improve semen quality takes three months. Assisted reproductive technology may have an impact on the health of newborns, and prevention of multiple pregnancies is the most effective preventive measure to reduce the occurrence 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 pass on 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 “step-down principle” should be followed, meaning that less invasive techniques (drug therapy, IUI or conventional IVF) should be chosen first, followed by more complex, expensive and invasive methods (ICSI).