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| Symptom | Recommended Action | |---------|--------------------| | Persistent low count (< 15 M mL⁻¹) after 3 months of lifestyle change | Full endocrine work‑up (FSH, LH, testosterone). | | Testicular pain, swelling, or lumps | Immediate urology evaluation – rule out varicocele or infection. | | Unexplained infertility after 12 months of trying | Referral to a fertility specialist for advanced testing (DNA fragmentation, hormone panel). |