We may do hormonal tests, looking for low testosterone, high estrogen, thyroid or prolactin issues or abnormal LH or FSH hormone levels. Some men get better sperm with treatment of hormone problems. Some men need genetic tests, and/or a consultation with an Urologist. Mostly we treat mild to medium sperm problems with Intrauterine Inseminations (IUI) where washed sperm is placed inside the woman’s uterus; severe sperm problems need IVF with ICSI (In Vitro Fertilization with Intracytoplasmic Sperm Injection) or use of donor sperm. No sperm (azoospermia) or very severe sperm problems may need a surgical sperm retrieval procedure.