Male Subfertility

When couples have been struggling to conceive for some time, the female partner will often be referred for hormonal blood tests and structural investigations, whilst the male partner will have a physical assessment and a basic semen analysis.

Male fertility problems account for at least 40% of all infertility cases and a semen analysis will look at various aspects of the sperm and seminal fluid.  This includes the pH, the number of sperm per sample and the physical shape and movement of the sperm.  Results can be affected by factors such as how many days of abstinence, time between ejaculation and analysis, so be sure to follow the guidance you've been given by your clinic.  

Semen Analysis Results

If you receive an abnormal test result,  your doctor will usually ask for this to be repeated after 3 months.  This is around the time it takes for sperm to develop and will help your doctor be more certain about your results.  The most common problems in sperm analysis are:

  • Fewer sperm than normal (oligospermia / oligozoospermia)
  • Abnormal shape, or morphology, of sperm (teratospermia / teratozoospermia)
  • Abnormal movement, or motility, of sperm (asthenospermia / asthenozoospermia)

In some cases, these results can be related to hormonal conditions such as diabetes, immune-system problems, infections or structural issues.  However, in 30-40% of cases of male infertility, no known causes can be found and this is referred to as unexplained - or idiopathic - male infertility.  

What does the research say about male subfertility?

If you've been diagnosed with idiopathic male infertility, ask your doctor about ways in which you can improve your sperm health.  Researchers and doctors have described a number of factors that are thought to be linked with poor sperm health and includes:

  • psychological stress affects testicular function and development of sperm
  • poor dietary habits and thus poor nutritional health
  • lack of physical activity leading to reduced circulation, obesity and poor sperm and male hormone levels
  • caffeine, alcohol and smoking which affect sperm count, quality and movement

(Nargund 2015, Jungwirth 2015, Sharma 2013, Tremellen 2008).  

Although these factors can be modified with lifestyle changes and nutritional therapy, there has also been increasing interest in using Chinese medicine.  Clinical research to date have investigated treatments such as acupuncture, electro-acupuncture, moxibustion and Chinese herbal medicine in male patients with varying degrees of subfertility.  These studies report a range of potential benefits which include:

  • higher percentage of progressively motile sperm (Jerng 2014, Dieterle 2009);
  • significant improvements in sperm concentration (Jerng 2014, Siterman 2000); 
  • increased sperm count (Siterman 2000);
  • improved shape, or morphology, and structural integrity of sperm, (Pei 2005, Gurfinkel 2003);
  • reduced sperm clumping, or agglutination (Sun 2006);
  • reduced inflammation of the genital tract which can lead to an increase in scrotal temperature (Siterman 2000);
  • lowered scrotal temperature (Siterman 2009);
  • increased testicular circulation (Cakmak 2008).

It's important to note that the research studies published do not provide evidence for Chinese medicine where structural or genetic abnormalities have clearly been diagnosed and where our treatments will not improve the primary cause of male infertility.  

what treatments are available?

Whether you and your partner are trying naturally, or whether you are preparing to go through assisted conception such as IVF or ICSI, the good news is that there are ways in which you can personally take control by optimising your health and improving chances of success.  

At our practice, we offer a tailored 12-week treatment programme which includes acupuncture treatment as well as lifestyle and dietary advice.  We recommend carrying out a sperm evaluation before starting treatment and to test again at the end of the programme to evaluate your progress.   

To find out more about acupuncture or Chinese herbal medicine, or if you are interested in using acupuncture in tandem with nutritional therapy, take advantage of our complimentary 10 minute no-obligation consultation by clicking on the 'Book now' button - we'll get back in touch with you to arrange a suitable time to call. 


References

Cakmak Y, Akpinar I, Ekinci G, Bekiroglu N. Point- and frequency-specific response of the testicular artery to abdominal electroacupuncture in humans. Fertil Steril. 2008 Nov;90(5):1732-8.

Cooper T, Noonan E, von Eckardstein S, Auger J, Baker H, Behre H, Haugen T, Kruger T, Wang C, Mbizvo M, Vogelsong K. World Health Organization reference values for human semen characteristics. Hum Reprod Update 2010 May-Jun;16(3):231-45.

Dieterle S, Li A, Greb R, Bartzsch F, Hatzmann W, Huang D. A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia. Fertil Steril. 2009 Oct;92(4):1340-3.

Gurfinkel E, Cedenho AP, Yamamura Y, Srougi M. Effects of acupuncture and moxa treatment in patients with semen abnormalities. Asian J Androl. 2003 Dec;5(4):345-8.

Jerng U, Jo J, Lee S, Lee J, Kwon O. The effectiveness and safety of acupuncture for poor semen quality in infertile males: a systematic review and meta-analysis. Asian J Androl. 2014 Aug;16:884-91.

Jungwirth A, Diemer T, Dohle G, Giwercman A, Kopa Z, Krausz C, Tournaye H. Guidelines on Male Infertility. European Association of Urologists. Mar 2014.

Nargund V. Effects of psychological stress on male fertility. Nature Reviews Urology. 2015;12:373-382

Pei J, Strehler E, Noss U, Abt M, Piomboni P, Baccetti B, Sterzik K. Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertil Steril. 2005 Jul;84(1):141-7.

Sharma R, Biedenharn K, Fedor J, Agarwal A. Lifestyle factors and reproductive health: taking control of your fertility. Reproductive Biology and Endocrinology 2013;11:66.

Siterman S, Eltes F, Schechter L, Maimon Y, Lederman H, Bartoov B. Success of acupuncture treatment in patients with initially low sperm output is associated with a decrease in scrotal skin temperature. Asian J Androl. 2009 Mar;11(2):200-8.

Siterman, S., Eltes, F., Wolfson, V., Lederman, H. and Bartoov, B. (2000), Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study. Andrologia, 32: 31–39. doi: 10.1111/j.1439-0272.2000.tb02862.x

Sun Z, Bao Y. TCM treatment of male immune infertility - a report of 100 cases. J Tradit Chin Med 2006 Mar;26(1):36-8.

Tremellen K. Oxidative stress and male infertility - a clinical perspective. Hum Reprod Update 2008 May-Jun;14(3):243-58.
Posted by Lily Lai.