Male infertility in Acupuncture and Traditional Chinese Medicine (TCM)
Many people are surprised to learn that one in five couples cause of infertility is due to male factor infertility. Male fertility depends on two factors; firstly good production of sperm and secondly unobstructed sperm transport. The ideal temperature of the testes is 35°C to ensure healthy sperm.
In the last few years we have seen a dramatic decrease in sperm density, motility and normality. This implies that environmental and lifestyle factors play a large role. Other common causes include;
- Infections and Sexually transmitted diseases
- Injuries and surgery
- Varicose veins (varicocele). Research in Germany has indicated that 41% of men between the ages of 12-16 years old have varicose veins that could affect their fertility by decreasing circulation and overheating the testes thus damaging the sperm.
- Hormonal causes
- Diet, smoking, drug use, alcohol
- Genetic causes
So what is normal?
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 2 ml |
| Sperm motility | More than 50% of the sperm are moving forward OR 25% are moving forward very quickly |
| Sperm concentration (number) | More than 20 million sperm per ml |
| Sperm morphology (shape) | More than 15% 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 |
Chinese medicine
There are various different problems that can affect sperm production. So let’s look at them major 3 that could be affecting your fertility.
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 25% 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.
References;
- 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
