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Study Entry Criteria Based on WHO criteria, an abnormal spermogram was defined as follows in at least two samples taken four weeks apart: Sperm count less than 20 million per milliliter Total sperm motility less than 50% Forward sperm motility less than 25% Normal sperm morphology less than 30% Normal levels of gonadotropins, testosterone, and prolactin Study Exclusion Criteria Underlying conditions like varicocele grades 3 and 4, testicular atrophy, ejaculation disorders Any medication use in the past two months Patients with azoospermia, endocrine or anatomical disorders, or infections Patients eligible for ICSI due to severe spermogram disorders and other infertility factors Sample Size The sample size was set at 30 participants based on previous studies

Saravanan, R

Shteinfer-Kuzmine A, Arif T, Krelin Y, Tripathi SS, Paul A, Shoshan-Barmatz V

Shah-Desai, S