Acupuncture treatment of male infertility: a systematic review

Zhonghua Nan Ke Xue. 2015 Jul;21(7):637-45.
He Y, Chen CT, Qian LH, Xia CL, Li J, Li SQ, Liu BP.

Objective

To systematically evaluate acupuncture as a treatment for male infertility.

Methods

We searched Chi na Biology Medical Database (CBM), Wan Fang Medical Information System, China National Knowledge Infrastructure (CNKI), VIP Information Resource System (VIP), and PubMed for published literature on acupuncture as a treatment for male infertility on May 1 2014. Based on the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA), we evaluated the quality of the reports, conducted meta-analysis on the identified studies via RevMan5.2, and assessed the quality of the evidence in the literature by Grading of Recommendations Assessment, Development, and Evaluation (GRADE).

Results

A total of 12 studies involving 2,177 patients were included, the quality of which was evaluated as mediocre. With regard to the cure rate, acupuncture was comparable to traditional Chinese medicine (TCM) (P > 0.05) but better than Western medicine (RR = 4.00, 95% CI 1.63 to 9.82, P < 0.01) while acupuncture + TCM was better than either TCM (RR = 1.77, 95% CI 1.20 to 2.60, P < 0.01) or Western medicine used alone (RR = 2.73, 95% CI 1.51 to 4.93, P < 0.01), and acupuncture + Western medicine was better than Western medicine alone (RR = 1.88, 95% CI 1.17 to 3.02, P = 0.01). The combined use of acupuncture, ear pressure, TCM, and Western medicine showed a higher cure rate than the combination of TCM and Western medicine (RR = 3.45, 95% CI 2.90 to 4.11, P < 0.01). In therapeutic effectiveness, acupuncture was comparable to TCM (P > 0.05) but superior to Western medicine (RR = 1.41, 95% CI 1.12 to 1.71, P < 0.01), acupuncture + TCM was superior to either TCM (RR = 1.14, 95% CI 1.05 to 1.23, P < 0.01) or Western medicine alone (RR = 1.43, 95% CI 1.22 to 1.67, P < 0.01), and acupuncture + Western medicine was superior to Western medicine alone (RR = 1.25, 95% CI 1.05 to 1.49, P = 0.01). In improving sperm concentration, acupuncture was as effective as TCM (P > 0.05) and sham acupuncture (P > 0.05) but outdid Western medicine (RR = 27.00, 95% CI 24.27 to 29.73, P < 0.01) and acupuncture + TCM outdid either TCM (RR = 14.65, 95% CI 7.58 to 21.72, P < 0.01) or Western medicine alone (RR = 1.04, 95% CI–1.43 to 3.51, P > 0.05). In improving grade a sperm, acupuncture exhibited a similar effect to TCM (P > 0.05) and sham acupuncture (P > 0.05), and acupuncture + TCM was more effective than TCM alone (RR = 7.78, 95% CI 3.51 to 12.23, P < 0.01) but equally effective as Western medicine (P > 0.05). In elevating the level of grade a + b sperm, acupuncture + TCM excelled either TCM (RR = 11.00, 95%, CI 3.17 to 18.82, P < 0.01) or Western medicine alone (RR = 12.22, 95% CI 6.87 to 17.57, P < 0. 01), while acupuncture produced a comparable effect with sham acupuncture (P > 0.05). As for the quality of the included studies, only 3 conclusions of the 23 meta-analyses were assessed to be of average quality, while the others of poor or extremely poor quality. Therefore, the recommendation grade of the conclusions was low.

Conclusion

For the treatment of male infertility, acupuncture is reported to be equally effective as TMC and more effective than Western medicine, and its effectiveness is enhanced when applied in combination with either TCM or Western medicine. Acupuncture is distinctively efficacious in improving sperm quality. Nevertheless, the overall quality of the included studies is low.

Acupuncture male infertility research

Influence of acupuncture on idiopathic male infertility in assisted reproductive technology

J Huazhong Univ Sci Technolog Med Sci. 2002;22(3):228
Zhang M, Huang G, Lu F, Paulus WE, Sterzik K.
Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030.

The clinical effects of acupuncture on idiopathic male infertility in sperm parameter and on therapeutic results in assisted reproductive technology were investigated. 22 patients failed in intracytoplasmic sperm injection (ICSI) with idiopathic male infertility were treated with acupuncture twice weekly for 8 weeks, followed by ICSI treatment again. The sperm concentration, motility, morphology, fertilization rates and embryo quality were observed. Quick sperm motility after acupuncture (18.3% +/- 9.6%) was significantly improved as compared with that before treatment (11.0% +/- 7.5%, P < 0.01). The normal sperm ratio was increased after acupuncture (21.1% +/- 10.4% vs 16.2% +/- 8.2%,P < 0.05). The fertilization rates after acupuncture (66.2%) were obviously higher than that before treatment (40.2%, P < 0.01). There was no significant difference in sperm concentration and general sperm motility between before and afteracupuncture. The embryo quality after acupuncture was improved, but the difference between them was not significant (P > 0.05). Acupuncture can improve sperm quality and fertilization rates in assisted reproductive technology.

PMID: 12658811 [PubMed-indexed for MEDLINE]

Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study

Andrologia Volume 32 Issue 1 Page 31 January 2000
S. Siterman, F. Eltes, V. Wolfson, H. Lederman & B. Bartoov

Classic therapies are usually ineffective in the treatment of patients with very poor sperm density. The aim of this study was to determine the effect of acupuncture on these males. Semen samples of 20 patients with a history of azoospermia were examined by light microscope (LM) and scanning electron microscope (SEM), with which a microsearch for spermatozoa was carried out. These examinations were performed before and 1 month after acupuncture treatment and revealed that the study group originally contained three severely oligoteratoasthenozoospermic (OTA), two pseudoazoospermic and 15 azoospermic patients. The control group was comprised of 20 untreated males who underwent two semen examinations within a period of 24 months and had initial andrological profiles similar to those of the experimental group. No changes in any of the parameters examined were observed in the control group. There was a marked but not significant improvement in the sperm counts of severely OTA males following acupuncture treatment (average=0.7±1.1 10 6 spermatozoa per ejaculate before treatment vs. 4.3±3.2 10 6 spermatozoa per ejaculate after treatment). A definite increase in sperm count was detected in the ejaculates of 10 (67%) of the 15 azoospermic patients. Seven of these males exhibited post-treatment spermatozoa that were detected even by LM. The sperm production of these seven males increased significantly, from 0 to an average of 1.5±2.4 10 6 spermatozoa per ejaculate (Z= 2.8, P <0.01). Males with genital tract inflammationexhibited the most remarkable improvement in sperm density (on average from 0.3±0.6 106 spermatozoa per ejaculate to 3.3±3.2 10 6spermatozoa per ejaculate; Z=2.4, P 0.02). Two pregnancies were achieved by the IVF-ICSI procedure.It is concluded thatacupuncture may be a useful, nontraumatic treatment for males with very poor spermdensity, especially those with a history of genital tract inflammation.

Modification of semen quality by acupuncture in subfertile males

[Article in German]
Geburtshilfe Frauenheilkd. 1984 Aug;44(8):510
Fischl F, Riegler R, Bieglmayer C, Nasr F, Neumark J.

Our first attempt in treating subfertility by acupuncture was carried out on 28 males. The results obtained from the experiences in veterinary medicine encouraged us to attempt this type of therapy. Each patient received a total of 10 treatments for a period of three weeks. Several spermiograms were made afterdiagnosis subfertility. We checked spermiograms and hormone levels before and after acupuncture. Total count, concentration and motility were evaluated. In all cases we observed a statistically significant improvement of sperm quality. Having obtained these good results in our first studies, we now intend to continue acupuncture therapy in subfertile males for insemination or intercourse at the time of the ovulation of their female partners.

PMID: 6566639 [PubMed-indexed for MEDLINE]

Acupuncture and Hormone Balance in Ovarian Deficiency: Research Findings

Ovarian deficiency, including primary ovarian insufficiency (POI) and premature ovarian failure, can significantly impact fertility and overall hormonal health. A recent study published in Evidence-Based Complementary and Alternative Medicine has provided promising evidence that electroacupuncture (EA) may help regulate reproductive hormone levels in women with ovarian deficiency.

Key Findings of the Study

Researchers investigated how electroacupuncture influences hormone levels in women with POI. The study included 11 participants who underwent EA treatment following this regimen:

  • Five sessions per week for the first four weeks
  • Three sessions per week for the next two months
  • A three-month follow-up period

Hormonal Changes Observed:

  • Increased estrogen (E2) levels – Essential for menstrual cycle regulation and fertility
  • Decreased follicle-stimulating hormone (FSH) levels – High FSH often indicates ovarian insufficiency
  • Decreased luteinizing hormone (LH) levels – Important for ovulation and hormonal balance

These hormonal improvements persisted even after the treatment ended, suggesting long-term benefits of acupuncture for ovarian function.

Menstrual Cycle Restoration

One of the most remarkable outcomes was that 10 out of 11 women (90.91%) resumed menstruation after acupuncture treatment. This suggests that acupuncture may help restore natural ovarian activity in women with POI.

Safety and Side Effects

Acupuncture was well-tolerated, with only mild temporary pain reported in some cases. No serious adverse effects were observed, making it a safe option for women seeking natural approaches to ovarian health.

What This Means for Women with Ovarian Deficiency

This study supports the growing body of evidence that Traditional Chinese Medicine (TCM), including acupuncture, may offer a natural and effective approach to managing POI. While more extensive research is needed, acupuncture has already shown promising results in reducing FSH and LH levels while improving estrogen levels.

http://www.ncbi.nlm.nih.gov/pubmed/23533511

Acupuncture and acupressure for pain management in labour and birth: A critical narrative review of current systematic review evidence

Levett KM, et al., Complementary Therapies in Medicine, 06/17/2014

Results

The RCTs included in these systematic reviews differed in terms of study designs, research questions, treatment protocols and outcome measures, and yielded some conflicting results. It may be inappropriate to include these together in a systematic review, or pooled analysis, of acupuncture for labour with an expectation of an overall conclusion for efficacy. Trials of acupuncture and acupressure in labour show promise, but further studies are required.The aim of this study is to examine current evidence from systematic reviews on the topic of acupuncture and acupressure for pain management in labour and birth, and to evaluate the methodological and treatment frameworks applied to this evidence. The use of current systematic reviews of the evidence for acupuncture and acupressure for labour and birth may be misleading. Appropriate methods and outcome measures for investigation of acupuncture and acupressure treatment should more carefully reflect the research question being asked, the use of pragmatic trials designs with woman–centred outcomes may be appropriate for evaluating the effectiveness of these therapies.

Methods

A search limited to systematic reviews of the MEDLINE, CINAHL, PUBMED, EMBASE and Cochrane databases was performed in December 2013 using the keywords ‘CAM’, ‘alternative medicine’, ‘complementary medicine’, ‘complementary therapies’, ‘traditional medicine’, ‘Chinese Medicine’, ‘Traditional Chinese Medicine’, ‘acupuncture’, ‘acupressure’, cross–referenced with ‘childbirth’, ‘birth’, labo*r’, and ‘delivery’.The quality of the evidence is also evaluated in the context of study design.

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