Inclusion criteria:
Age of 18 to 40 years,
Man with primary infertility,
Abnormality in at least one of the sperm parameters (volume, concentration, number, motility, or morphology),
Body mass index less than 30,
Exclusion criteria:
Chromosomal abnormalities,
Varicocele,
Cryptorchidism,
Chronic diseases such as diabetes, kidney disease, infectious diseases, genital tract infection, thyroid disorder,
Drug or alcohol use,
Taking spermatogenic drugs (methotrexate, nitrofurantoin, colchicine or chemotherapy),
Taking pituitary suppressive drugs (testosterone, GnRh analogs),
Taking anti-androgens (cimetidine or spironolactone),
Taking alpha-blockers, antidepressants, or phenothiazide,
History of testis surgery