what should be the course of action if 50% of 36 million/ml sperm count are dead ?

There are many things that can affect sperm count. Smoking, stress, chemicals, heat, infection and others. I have low sperm count/motility also. My wife is pregnant for the second time and i have not had anything done to me. Coincidentally, both times i have gotten her pregnant i was taking medication for infection and swelling. I went to mexico and saw a urologist there and he prescribed low dose anabolic steroids. I did some investigating and found out that steroids are sometimes used to reduce swelling. i then saw a urologist in houston and found that i had a few small varicocele veins. I set a surgery date and was looking forward to it when i got my wife pregnant. It seems that the treatment i got in mexico worked after all. If i could suggest anything else i would say take vitamins containing lots of vitamin c and see a doctor. You never know if there is a small infection present.