Hi, Thanks for posting in HCM. I have read your description and understand your concern. From your semen analysis report, it appears that the sperm count is less than normal. Also motility of sperms is less than normal. However, it doest not indicate any gross infection in the testis. Doppler studies is indicative of varicocele, which is an abnormal enlargement of the pampiniform venous plexus, which drains the testicles, in the scrotum. Your sperm count and its motility might have been affected due to varicocele, as it affects about 35 percent of men with primary infertility and in 75 to 80 percent of males with secondary infertility. Premature ejaculation is a different entity all together and does not have any physical connection to your problem with varicocele or sperm count. It can be overcome by means of pause and squeeze technique and use of medications selective serotonin reuptake inhibitors (SSRIs), such as sertraline. Paternia tablets contains L-carnitine, Ubidecarenone, Lycopene and Elemental Zinc, which provides various elements for improvement in sperm count and its maturity. You can consume it for a month and repeat the semen analysis to look for the improvement. Along with it, Avoid hot working place and wear loose undergarments. Drink plenty of water/fluids to keep hydrated and active all time. Also, quit habit of smoking and alcohol, if you are habituated to. You can also try treatment options available for correction of varicocele, namely: 1. Varicocele surgery, which is performed on out-patient basis and may improve fertility. 2. Embolization, which is alternative to surgery, which is a minimally invasive treatment, generally performed by an interventional radiologist. Hope the information provided would be helpful. All the best.