The primary causes of male infertility are various including genetic factors, hormone disorders, lifestyle problems (such as smoking, alcohol or drug abuse), urogenital infections and physical problems (such as varicocele[1] and semen irregularities relating to sperm count, concentration, motility, vitality, morphology, antibody and DNA fragmentation disorders).[2] Poor semen quality is a major factor for male infertility.[3] The quality of male sperm has deteriorated significantly due to marriages in later life, lifestyle changes, stress and environmental pollution.[4] There has been mixed results as to the effectiveness of drugs and supplements to enhance poor-quality sperm.[5] It has been suggested that antioxidant vitamins have positively affected semen quality,[6] whilst drugs such as androgens and human chorionic gonadotropin have not been equally effective.[7] In this light, the importance of seeking effective, alternative therapies is heightened. About 30-40% of men with infertility seek alternative therapies such as acupuncture or herbal medicines.[8] The use of traditional Chinese medicine treatment for male infertility was first documented in Chao Yuan-fang’s Zhu Bing Yuan Hou Lun in 610CE.[9] Despite the long-standing empirical knowledge, there has been very little or poor research concerning the efficacy of acupuncture and Chinese herbal medicine treatments on male fertility.[10] This has been due to the small size of the studies and the reliance on research designs that are flawed.[11] Male infertility treatment is therefore still a growing area of traditional Chinese medicine research,[12] with trials regarding acupuncture treatment for sperm disorders being steadily conducted since 1997.[13] Despite this, a number of studies have shown the positive effects of herbal medicines on men with poor sperm quality[14] and on enhancing sperm parameters including sperm count, motility, viability and morphology.[15] These studies cannot be relied to drawn firm conclusions. In animal studies, herbal medicine therapies have shown to enhance male infertility.[16]
In traditional Chinese medicine, it is believed that male infertility is connected to kidney, liver and spleen.[17] It considers that these organs must be healthy and properly functioning to improve male fertility. Kidney deficiency is the basis of male infertility which may involve kidney Yang deficiency, liver Qi stagnation or spleen Yang deficiency.[18] The kidney known as the ‘root of life’ has the following functions: stores Jing (innate essence), governs reproduction, controls the lower orifices and harmonises sexual functions.[19] The rise and decline of kidney essence and kidney Qi are closely connected to the maturation and maintenance of sexual function and the reproductive ability.[20] A decline in sperm parameters (commonly manifested in men over the age of 35), is equated to kidney deficiency.[21] The Yang (positive, active, masculine force) of the kidney gives sperm their motility, warms the semen to prevent it from becoming thin and watery and provides libido and orgasm.[22] The liver regulates the smooth flow of Qi, stores blood[23] and controls the sinews.[24] When there is normal, smooth flow of Qi, the excretion of semen is smooth.[25] The stored blood can produce essence that is stored in the kidney and assists in the production of semen.[26] Liver dysfunction may be caused by a fatty and spicy diet, excessive alcohol consumption, sedentary lifestyle and repressed emotions of anger and frustration.[27] Liver Qi stagnation produces chest oppression, mental depression and sighing.[28] In TCM, the spleen is the source of blood which is necessary for the reproductive process to occur.[29] Further, its function is to transport and transform food and when it fails to perform, there is spleen Qi deficiency which manifests as poor appetite and abdominal bloating and distension after consumption.[30] When there is spleen Yang deficiency, the Yang Qi fails to reach the four limbs and results in an aversion to cold.[31]
Researches suggest that acupuncture treatments given twice per week for 5-10 weeks may significantly enhance sperm count,[32] morphology[33] and motility.[34]
Research findings
In 2016, a case study was conducted to examine the efficacy of acupuncture and Chinese herbal medicine treatments for improving sperm parameters. The subject was a man of 35 years of age, average height, slim build with a healthy complexion.[35] The man’s sperm analysis showed low-normal results for count, motility and morphology and did not suffer from any other symptoms of reproductive disorders.[36] He was diagnosed with liver qi stagnation, damp heat in the liver and gallbladder and a mild kidney yang deficiency.[37]
From the research, the following conclusion was drawn: “This case study demonstrates a male who presented with a semen analysis in the low-normal range and improved his sperm parameters by between 34% and 50% following three months of weekly acupuncture and Chinese herbal medicine. The patient and his wife reported their first pregnancy three months after the treatment period.”[38] However, it is important to understand that this research finding was drawn from one single case study involving one subject. The same effects may not be realised by patients who are dissimilar in terms of their age, characteristics and health conditions.
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[2] Cooper T, Noonan E, von Eckardstein S, Auger J, Baker H, Behre H, et al. World Health Organisation reference values for human semen characteristics. Human Reproductive Update. 2010;16(3):231-45.
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[4] Yao, D.F.; Mills, J.N. Male infertility: Lifestyle factors and holistic, complementary, and alternative therapies.
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[6] Yao, D.F.; Mills, J.N. Male infertility: Lifestyle factors and holistic, complementary, and alternative therapies.
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[7] Professional Committee of Andrology. Clinical guidelines of integrative medicine for male infertility (trial
edition). Chin. Assoc. Integr. Med. 2015, 35, 1034–1038.
[8] Bardaweel, S.K. Alternative and antioxidant therapies used by a sample of infertile males in Jordan: A crosssectional survey. BMC Complement. Altern. Med. 2014, 14, 244
[9] Sharlip I, Jarow J, Belker A, Lipshultz L, Sigman M, Thomas A, et al. Best practice policies for male infertility. Fertility and Sterility. 2002;77(5):873-82.
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[13] Siterman S, Eltes F, Wolfson V, Zabludovsky N, Bartoov B. Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality. Archives of Andrology. 1997;39(2):155-61.
[14] Yao, D.F.; Mills, J.N. Male infertility: Lifestyle factors and holistic, complementary, and alternative therapies.
Asian. J. Androl. 2016, 18, 410–418
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[16] Yun, S.J.; Bae, G.S.; Park, J.H.; Song, T.H.; Choi, A.; Ryu, B.Y.; Pang, M.G.; Kim, E.J.; Yoon, M.; Chang, M.B.
Antioxidant effects of cultured wild ginseng root extracts on the male reproductive function of boars and
guinea pigs. Anim. Reprod. Sci. 2016, 170, 51–60.
[17] Deadman P. The treatment of Male Subfertility with Acupuncture. Journal of Chinese Medicine. 2008;88:5-17.
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[29] Maciocia G. The foundations of Chinese medicine. Edinburgh: Churchill Livingstone; 1989.
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[32] Pei J, Strehler E, Noss U, Abt M, Piomboni P, Baccetti B, et al. Quantitative evaluation of spermatazoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertility and
Sterility. 2005;84(1):141-7
[33] Pei J, Strehler E, Noss U, Abt M, Piomboni P, Baccetti B, et al. Quantitative evaluation of spermatazoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertility and Sterility. 2005;84(1):141-7
[34] Dieterle S, Li C, 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. Fertility and Sterility. 2009;92(4):1340-3
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[38] MacDonald, Nicola. Case study: Improving sperm parameters with acupuncture and Chinese herbal medicine [online]. Australian Journal of Acupuncture and Chinese Medicine, Vol. 10, No2.2016.32-37. https://search.informit.com.au/documentSummary;dn=481567586393776;res=IELHEA ISSN: 1833-9735. [Accessed , 15 May. 2018].
