Genetic testing in patients with impaired seminal parameters and history of couple infertility must be proposed in selected cases. A wide use of such tests represents an inappropriate clinical practice both from a clinical and an economic point of view. The analysis of karyotype and microdeletions of the Y chromosome are indicated in male patients with non-obstructive azoospermia or severe oligozoospermia (sperm concentration below 5-10 million/mL). The screening for mutations of cystic fibrosis gene (CFTR) should be restricted only to patients with congenital absence of the vas deferens. For patients with hypogonadotropic hypogonadism, the analysis of specific multi-gene panel (10-30 genes) is suggested. The search of mutations of androgen receptor gene, and DPY19L2 and AURKC genes should be considered only for selected patients.Available assays for evaluation of sperm DNA fragmentation are heterogeneous and differ each other for the type of damage they are able to detect, for the methodology, and for cut-offs, making them not comparable and not standardized. Data about the relationship between abnormal DNA integrity and reproductive outcomes are not strong enough to recommend the use of these tests in routine evaluation of infertile male.