The clinical management of couple infertility suffers from a way of thinking still widely diffused today among those working in the field, who often consider the understanding of the male factor of infertility too vague and its remedies not yet supported by solid scientific evidence. Consequently it often happens that couples are initiated directly to assisted reproduction techniques (ART), even in the presence of a male factor, undiagnosed or untreated Unilateral handling of reproductive care, according to this common way of thinking, should provide the couple with the best chances of procreation. In fact, there are four strong reasons to favor bilateral management of the infertile couple, including an assessment of the male. Firstly, infertility should be considered a disease. It can be an expression of some-times serious disorders not yet diagnosed at the time of the search for pregnancy A comprehensive male infertility evaluation may allow to detect significant disease(s) that otherwise would have remained undiagnosed if the evaluation of the male factor were limited to seminal examination only. Recent studies have suggested that male infertility may be associated with reduced longevity and that male factor infertility is an increased risk factor for certain malignancies Furthermore, the condition of an infertile male can cause psychological and marital stress Quantifying this risk, it has been estimated that for every 15 couples evaluated, in 1 couple (6 %) the male partner has a significant medical condition. Epidemiology While most studies agree that infertility affects approximately 15–20 % of all couples data relating to male infertility are more uncertain. An epidemiologic study of male infertility in fact presents a clinical problem because fertility is a couple-related concept and male fecundity (i.e., his biological capacity to repro-duce) is a component of the fertility rate. Both male and female partners make an independent contribution to a couple’s fertility, but the outcomes of fertility are only fixed in terms of pregnancy rate or births.