31 yrs old male pt with c/o infertility for 2-3 yrsof merriage . Semen analysis = count 9 million , motility 5 %, non motile 80% sluggish 15% morphology = 40% abnormal . p/h/o management states count was 15 million as pt claims before 6 months and was given clomifine, Gonadotrophic hormones and ,Zn , vit E, etc.
Physical examination -= nothing abnormal foundrespect to systemic and private. Now how to manage this patient?