Male Infertility | Chiyu Acupuncture

What are the common causes of fertility problems in men? When I was a medical student (1984-1990), I learned that male infertility accounts for 10%. Then it went up to 20%, and then 30% when I was practicing as an MD in Japan. Now? It accounts for 40-50%!

What are the most common causes of fertility problems in men?

Low sperm count or no sperm

Low sperm motility (movement)

Abnormal morphology (shape and size of sperm)

High DNA Fragmentation Index (DFI) (separation or breaking of DNA strands into pieces)

Problems with semen - volume, liquefaction time, pH, white blood cell count, fructose level

Problems with sperm delivery - obstruction, previous vasectomy, or retrograde ejaculation

Problems with erections or other sexual problems

Immunological problems - anti-sperm antibodies

Can Traditional Chinese Medicine help male infertility?

Yes! Male infertility can be treated with Traditional Chinese Medicine (TCM), including acupuncture and Chinese herbs. Both quality and quantity can be improved with acupuncture and Chinese herbs. If you have low sexual desire, it can also be improved.

In TCM, the kidneys are the organs that are responsible for the growth, development, reproduction and aging of our body. The kidneys have two aspects; yin and yang. The kidney-yin is the water of the body (and nutrition), while the kidney-yang is the fire of the body (and energy). They need to be in balance, however, if you are deficient of the kidney-yin (not enough water), the fire aspect of the body becomes dominant and the body gets heat (called deficiency heat). This heat may affect the production of sperm since sperm-producing cells in the testicles do not function well in a warm environment. In other words, there is not enough nutrition (kidney-yin) for sperm production. Deficiency heat may cause premature ejaculation since heat accelerates the flow of energy. A hectic life consumes the yin and could be a cause of this.

On the other hand, if you are deficient of the kidney-yang, the water aspect of the body becomes dominant and the body gets cold (called deficiency cold). The yang represents energy, and therefore kidney-yang deficiency accounts for low sperm count and mobility (low energy of sperm) as well as fatigue, decreased libido, impotence, etc. This could be a aging factor in men.

There are two other important TCM patterns: one is damp-heat, the other stagnation of qi/energy and blood.

Accumulation of damp-heat in the genital area is much like inflammation - white blood cells may be seen in your semen. Smoking, alcohol and poor diet lead to this condition. High abnormal morphology may be seen along with low sperm count. You may have a history of urinary tract infections (sexually-transmitted disease: STD) or prostate problems.

If you have a history of injury or surgery of the testicles, you may fall into this pattern called qi/energy and blood stagnation. Varicocele, which causes the stagnation, needs to be surgically corrected for fertility; however, some reports say that varicocele correction may not improve fertility (Surgery or embolisation for varicoceles in subfertile men. Evers JH et al. Cochrane Database Syst Rev. 2009 Jan 21;(1)). In Chinese medicine, surgery itself causes qi and blood stagnation. Patients with this pattern often have low sperm count as well as low motility and high abnormal morphology.

Since the cause of infertility is different for each patient, the treatment will be different as well.

Also please keep in mind that lifestyle changes including diet are crucial.

How long do I need treatment?

Since sperm takes 2-3 months to form, acupuncture treatment for at least 3 months is generally recommended- once-a-week treatment for 12 weeks, or twice-a-week for 5 weeks especially when there is not enough time before IVF/ICSI, IUI etc.

Acupuncture has a very good calming effect, reduces stress and helps a couple get through a frustrating time. For certain cases, Chinese herbs may be recommended in addition to or instead of acupuncture.

Studies on Male Fertility

Low Sperm Count & Acupuncture

Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study. Siterman S et al. Andrologia. 2000 Jan;32(1):31-9.

Sperm Morphology & Acupuncture

Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Pei J et al. Fertil Steril. 2005 Jul;84(1):141-7. "Controlled study with 28 infertile men - 10 acupuncture treatments (2/wk) significant improvement in sperm quality especially morphology."

Effects of acupuncture and moxa treatment in patients with semen abnormalities. Gurfinkel E et al. Asian J Androl. 2003 Dec;5(4):345-8. "Controlled study with19 infertile men randomised into 2 groups, 1st given 10 acupuncture and moxa treatments (1/wk), 2nd given sham acupuncture - significant increase in % of normal forms in acupuncture group."

ICSI (Intracytoplasmic Sperm Injection) & Acupuncture

Influence of acupuncture on idiopathic male infertility in assisted reproductive technology. Zhang M et al. J Huazhong Univ Sci Technolog Med Sci. 2002;22(3):228-30. "Acupuncture can improve sperm quality and fertilization rates in assisted reproductive technology."

Antisperm Antibodies & Chinese Herbs

Clinical observation on effect of zhenqi zhuanyin decoction combined with intrauterine insemination in treating spleen-kidney deficiency type patients of sterility with positive anti-sperm antibody. Lian F et al. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2002 Feb;22(2):95-7. "Combined therapy of zhenqi zhuanyin decoction and IUI shows a better effect in treating infertility with positive AsAb than that by zhenqi zhuanyin decoction or IUI alone."

Clinical study on the treatment of male immune infertility by Huzhangdanshenyin. Lu TK et al. Zhonghua Nan Ke Xue. 2006 Aug;12(8):750-5. "The Chinese medicine Huzhangdanshenyin works more effectively than prednisone in the treatment of male immune infertility. It could improve the antisperm antibody reversing ratio, clinical symptoms and signs and ameliorate sperm indexes with no obvious advierse effects."