Hi pfb, your dr. will prob suggest iui first followed by ivf if 'nessecery'. I would agree with jbean and exhaust all natural medicine avenues first. If I was treating a person in your fiance's position i would generally begin with diet, slightly higher in protien than carbs, a good quality (practitioner brand) multi vitamin, caffiene, alcohol, smoking and laptops are a no no. Based on the specifics of his previous tests (some abnormaility is very common, however the parameters of what is considered normal, are much too low) and health history, he would also recieve Chinese Medicine and acupuncture regularly for 3 months and be retested again in 4-5months.