Hello, I'm Marred For A Year And Since Then Me

Hello,

I'm marred for a year and since then me and my wife are trying to conceive. My wife was found with normal ovulation. I have made a Semen Analysis below are the results:

Volume: 3.1 ml
Liquefacation time: 18 minutes
Viscosit: Normal
Colour: white
PH: 7.8

Spermatozoa count/ml : 20,100,000
Crystals: Nil
Pus cells: 2-3 /HPF
Red cells: 1-3 /HPF
Spermatozoa germ cells: present
Normal forms: 60%
Abnormal forms: 40 %
Type of abnormality: Head: Amorphous

Motility Viability by EOSIN
1st Hour 30% 35%
2nd Hour 25% 25%
3rd Hour 20% 20%
4th Hour 10% 10%

Motility rating: 25% show forward movements

I have also mad a scrotal ultrasound and it showed the following

Simple large left epididymal cyst
Mild bilateral varicocele with Grade I venous reflux


So my questions are:

1- Do I need to get operated reference to the ultasound?
2- What do I do about the low motlity? any medications needed?

Regards.