Male Infertility

According to traditional Chinese medicine your reproductive health is the result of your body being in proper balance. Stress, poor lifestyle, inadequate diet and other factors can disturb your natural balance. This results in poor health including impaired semen quality and quantity.

It takes approx 74 days for your body to create and mature sperm. An individualized acupuncture program may include herbal formulas or supplements (vitamins), dietary advice and lifestyle counselling. The treatment should be commenced for a minimum of three months prior to IVF on a weekly basis.

Clinical trials have shown that acupuncture

  • Significantly increase sperm production
  • Increase the percentage of healthy sperm
  • Improve sperm movement (motility)
  • Improve the levels of hormones responsible for fertility
  • Increase the rate of pregnancy when used in conjunction with ART

 

What causes male infertility?

For about one in five infertile couples the problem lies solely in the male partner. In most cases, there are no obvious signs of an infertility problem. Intercourse, erections and ejaculation will usually happen without difficulty. The quantity and appearance of the ejaculated semen generally appears normal to the naked eye. Unfortunately, medical scientists do not yet understand all the details of sperm production and the fertilisation process. As a result, for many men with a sperm production problem, the cause cannot be identified. However some known causes include:

Sperm production problems
  • Chromosomal or genetic causes the testes to descend at birth)
  • Torsion (twisting of the testis in scrotum)
  • Varicocele (varicose veins of the testes)
  • Radiation damage
  • Undescended testes
  • Infections
  • Heat
  • Medicines and chemicals
  • Unknown cause
Blockage of sperm transport
  • Infections
  • Absence of vas deferens
  • Prostate related problems
  • Vasectomy
Sperm antibodies
  • Vasectomy
  • Unknown cause
  • Injury or infection in the epididymis
  • Vasectomy
  • Injury or infection in the epididymis
  • Unknown cause
Sexual problems
(erection and ejaculation problems)
  • Retrograde and premature ejaculation
  • Infrequent intercourse
  • Prostate surgery
  • Some medicines
  • Failure of ejaculation
  • Spinal cord injury
  • Damage to nerves
Hormonal problems
  • Pituitary tumours
  • Anabolic (androgenic) steroid abuse
  • Congenital lack of LH/FSH (pituitary problem from birth)

Basically male fertility depends on high-quality production of sperm and unobstructed sperm transport with the ideal temperature of the testes being 35°C to ensure healthy sperm.

Recently there has been a decline in sperm density, motility and normality, implying that environmental and lifestyle factors are major contributors to the problem. Some causes include;

  • Infections and Sexually transmitted diseases
  • Injuries and surgery
  • Over heating caused from tight underwear, laptop use on the legs, bicycle riding
  • Diet, smoking, drug use, alcohol.


So what is normal sperm?

The World Health Organisation (WHO) has published the following measurements to help work out if semen analysis results are normal.

Volume of semen  More than 1.5ml
Sperm motility  More than 40% of the sperm moving forward rapidly and progressively
Sperm concentration (number)  More than 15 million sperm per ml
Sperm morphology (shape)  More than 4% have a ‘normal’ shape(as defined by strict criteria)
White blood cells  Less than 1 million cells per ml
Sperm antibodies  Less than 50% coated sperm

 

From a Chinese medicine viewpoint

There are various different problems that can affect sperm production. Let us consider three common TCM causes of male infertiltiy.

 

1. Damp-heat

The Damp-heat pattern tends to occur as a result of diet, typically an excess of rich food and especially alcohol, or may follow an unresolved or sub-acute direct transmission of Damp Heat from a sexual partner (STD).
Symptoms associated with damp heat; Sexually transmitted diseases, painful urination, feeling of heat in the body, inability to get or maintain a full erection, excessive sweating around the scrotum and groin, and itching or pain in the genitals, heaviness and aching in the lower limbs, lethargy and afternoon fatigue, a greasy yellow posterior tongue coat and a slippery or soft pulse.
Some men may exhibit a poor sperm count or low motility and anti-sperm antibodies. The ejaculate may be thick or congealed with retarded liquefaction.
Treatment includes Acupuncture, dietary changes and the use of modified formula; Long Dan Xie Gan Wan for 3 months

 

2. Qi and blood stagnation / varicocele

The Qi and blood stagnation pattern is often seen in varicocele, a varicose vein in the scrotum. It is suggested that up to 30% of infertile men and 10-15% of the general population suffer from varicocele. Western medical procedures yield 30-50% increased pregnancy rates.
However in Chinese medicine terms Qi and Blood stagnation can also be a result of trauma or surgery to the testicles or just poor circulation. Both Varicocele and Qi/Blood stagnation causes a pooling of blood and higher intrascrotal temperatures.

Symptoms associated with qi and blood stagnation; Varicose veins in testes, legs or groin, cold fingers and toes, a purple huge to the tongue, distended sublingual veins beneath the tongue and the pulse may be inhibited.

A recent study suggested the use of formula; Yi Shen Tong Luo Fang. However in clinic we have more success with using Tian Qi tablets or Gui Zhi Fu Ling Wan

 

3. Kidney yang deficiency

The Kidney Yang deficiency pattern is commonly relative to age, older men typically fall into this pattern. However sometimes we see this pattern in younger men, commonly due to poor lifestyle or genetics. Poor lifestyle can include; drinking cold drinks or eating too much raw or cold foods, working or staying in a cold environment for long periods of time, too much sex

Symptoms associated with Kidney Yang deficiency;

intolerance for cold, frequent pale urine, fatigue, impotence, nocturnal emissions, nocturnal urination, low libido, holding water, pale tongue and slow pulse.

Some men may exhibit a thin watery ejaculate with low sperm count and poor motility.

Treatment includes acupuncture, moxibusion and the herbal medicine. Some herbs that help Kidney Yang deficiency include;

  • Gou Qi Zi – Chinese Goji berries
  • bu gu zhi – Psoralea fruit
  • lu rong – deer velvet
  • Ying yang huo – horny goat weed

Azoospermia, the congenital absence of sperm, has no known cure and TCM is not effective to resolve this condition. But for all other men trying to boost their sperm statistics, acupuncture and herbal therapy may be the answer.

 

Things you can do to improve sperm quality

Whilst being treated, simple lifestyle changes can be implemented. Not all cases of male infertility can be prevented, but you may be able to reduce your risk by changing some of your behaviors.

  • Avoid using tobacco, marijuana, anabolic steroids, and “recreational” drugs.
  • Avoid excessive use of alcohol.
  • Avoid exposure to harmful chemicals and heavy metals.
  • Protect yourself from sexually transmitted diseases.
  • Avoid prolonged use of drugs with adverse effect on fertility.
  • Maintain a healthy weight.
  • Exercise moderately, but not excessively.
  • Avoid testicular injury in sporting events.
  • Wear looser fitting shorts and pants.
  • If you bicycle, try using a softer saddle.

 


Avoid Using Tobacco, Marijuana, Anabolic Steroids, and Recreational Drugs

Cigarette smoking reduces sperm count and motility and increases the number of abnormal sperm. Smoking also adversely affects hormone levels and may affect the cells in the testes that produce testosterone. Like cigarette smoking, use of marijuana also can adversely affect sperm count, sperm motility, and sperm morphology. It can also reduce plasma testosterone levels. Anabolic steroids influence production of reproductive hormones and can reduce fertility. Use of cocaine also negatively affects sperm parameters as well as the ability of sperm to penetrate cervical mucus. Opiates (heroin, morphine) may reduce fertility in men by altering hormone production.

 

Avoid Excessive Use of Alcohol

Although moderate alcohol consumption does not affect male fertility, excessive alcohol intake alters hormone levels and reduces sperm count and sperm quality.

 

Avoid Exposure to Harmful Chemicals and Heavy Metals

Numerous chemicals used in industry or found in the environment as contaminants have been linked to male infertility. These include organochlorine pesticides, dioxins (used to bleach paper products), and vinclozolin (a fungicide used on food). These chemicals are thought to reduce fertility by disrupting hormone function. Avoid exposure to these chemicals whenever possible.

 

Protect Yourself From Sexually Transmitted Diseases

Unprotected sexual intercourse (intercourse without a condom) increases your risk of developing a sexually transmitted disease (STD). Several STDs, including Gonorrhea and Chlamydia , often produce no symptoms, especially in men, so you may not know you are infected. Untreated STDs can cause scarring in the sperm-carrying tubes, which reduces the number of sperm in semen and increases the risk of fertility problems. The more sexual partners you have, the greater your chance of contracting an STD. Using condoms and minimizing the number of sexual partners will reduce your risk of getting an STD.

 

Avoid Prolonged Use of Drugs With Adverse Effect on Fertility

There are many medications which could either cause subfertility or infertility. These include the following categories:

  • Antibiotics: erythromycin, tetracycline, sulfasalazine, nitrofurantoin
  • Antihypertensives: alpha blocker, calcium channel blockers, spirorolactone
  • Chemotherapy
  • Others: cimetidine, colchicines, allopurinol, minoxidil

 

Maintain a Healthful Weight

High body fat can alter hormone metabolism. If you are overweight, consult with your healthcare provider or a registered dietitian to find out what weight is healthy for you and to get help in attaining it.

 

Exercise Moderately, but Not Excessively

Moderate exercise increases sperm production and may have beneficial effects on fertility. However, excessive exercise, such as that performed by long-distance runners, reduces sperm production.

 

Avoid Testicular Injury in Sporting Events

The testicles are easily damaged during vigorous sporting events or fights. These injuries can cause inflammation that reduces the blood supply to the testicles, which can permanently damage sperm-producing cells.

 

Wear Loose-Fitting Shorts and Pants

Underwear and clothing that is tight and constricting may reduce blood flow in the groin and adversely affect sperm production.

 

If You Bicycle, Try Using a Softer Saddle

Certain bicycle seats may cause circulatory and neurologic damage in the groin that can affect erectile function.

“In conjunction with ART or even for reaching natural fertility potential, acupuncture treatment is a simple, non-invasive method that can improve sperm quality.” (Dr. Jian Pei, Fertility and Sterility 2005: 84:141-147)


References

http://www.thirdage.com/hc/c/male-infertility-prevention
http://www.medicalnewstoday.com/articles/221051.php
http://www.andrologyaustralia.org
Male Sexual Dysfunction, By Will Maclean
http://www.juliesenko.com/article5.html
Pictures;
http://www.studyblue.com/notes/note/n/yang-tonifying-herbs-action/deck/2969278

Abstracted & translated by Bob Flaws (2003) Blue poppy press recent research report #382; Varicocele & Male sterility, www.blue poppy.com
Patricia Karnowski (2012) Effects of Gui Zhi Fu Ling Wan on male infertility with varicocele,
http://www.fertilityformulas.com/MaleFactor.html