Male Factor and Fertility

One of the best-kept secrets in the world of infertility is that, believe it or not, “Male Factor” plays a major role in up to 50% of the cases of infertility.

Despite the above figure, only a small percentage (about 5%) of patients have been formally diagnosed with any sort of “male factor” involvement. However, when sperm parameters are considered (ie: sperm count, motility, morphology, etc.) many men are being brushed-off as having only “borderline” male factor involvement and being told the borderline values will not be of impact. A “borderline” value is still technically a value that is “sub-normal” and one that is definitely not “optimal”. The fact of the matter is that most reproductive medical clinics only need one sperm to fertilize an egg with IVF in a process called ICSI (Intra-Cytoplasmic Sperm Injection). In this way, as far as assisted reproductive technology is concerned, the male portion of the infertility equation has been circumvented with little or no attention.

 Unfortunately, this ignores some very important facts. To begin with, many clinics only look at three major factors: sperm count, sperm motility and sperm morphology. There are, however, many other aspects to sperm health beyond these three. Looks aren’t everything in the world of sperm. For example, newer technology is now demonstrating that there can be significant DNA fragmentation (damaged DNA) in sperm that “look good” & appeared “normal” according to basic parameters…and DNA fragmentation is only one test. There are many other potential factors that contribute to suboptimal sperm that science has yet to identify. 

Consider this:

  1. Male fertility significantly declines with age. With all other factors being equal, at 35 years of age, a man has only HALF the fertility potential he had before age 30.
  2. Any male over 35 is twice as likely to be infertile as a male under 25.

Infertility is only one aspect of “older” sperm, with IVF and ICSI bypassing only some of the limitations of suboptimal sperm. Bypassing a problem, however, is not correcting the problem.  Pregnancy studies have shown that the miscarriage rates increase proportionally with the age of the father independent of the mother’s age. Studies have also found that children of men of advancing age were much more likely to have developmental problems. For example, offspring of men aged 40 years or over were almost 600% more likely to have autism than offspring of men under 30. The same is true for Down Syndrome where paternal age was a factor in half of the cases where the maternal age exceeded 35 years. Men over 40 years old are also more than twice as likely to have a child with schizophrenia. And the list goes on….

 What all of this data tells us, is that we should address the health of both partners to optimize our chances of having healthy pregnancies AND healthy children. Even if we are planning on doing IVF/ICSI, we should not simply rely on “adequate” sperm quality, as ignoring the realities of male factor could be ignoring HALF of the problem.

Chinese Medical Treatment can be utilized and provide support for a range of Men’s health disorders that cause Male Infertility such as:

  • Oligozoospermia (low sperm count, <20 millions/ml or < 40 million per ejaculate): the most common male factor of infertility, and azoospermia (lack of viable sperm).
  • Sperm abnormalities:
    • Morphology: <30% normal (WHO Standards); < 14-15% Normal (Kruger Criteria – More strict)
    • Motility: <50% forward moving sperm or < 20% total Motile Sperm
  • Semen factors:
    • Semen volume: < 2 ml/ejaculation (Normal: 2.0-5ml/ejaculation)
    • Abnormal pH: (Normal 7.2-8.0)
    • Prolonged liquefaction time: > 30 min (Normal: < 30 min)
    • Sperm Vitality (% of alive Sperm): (Normal: >75% of sperm alive
    • Seminal White Blood Cell count: (Normal: < 1 million/ml)
  • Some sexual functional disorders, such as retro ejaculation.
  • Other Urologic or Reproductive Health Issues.

In many occasions, the exact underline causes and mechanisms of the resultant abnormalities in semen and sperm listed above often can be unknown, as well as, difficult to address from the Western Perspective, other than circumnavigating the issue with ICSI (Intracytoplasmic Sperm Injection).  However, current research demonstrates the promising effects Chinese Medicine – both acupuncture and Chinese Herbal Medicine, play with improving the semen parameters in male factor.  We suggest at least 12  weeks of treatment (3 months minimum) as the development and maturation of new sperm (spermatogenesis) takes between 90-100 days.  Depending on the severity of Male factor, treatment could last up to a year+.  Acupuncture treatment frequency is usually biweekly to once per month combined with ongoing internal Chinese Herbal Therapy, dietary and nutritional therapy, as well as, applying lifestyle modifications if necessary.

Reversing the risk factors involved with advancing paternal age and sperm damage is very important to both your health, and your future baby’s health. Studies have found that the combination of acupuncture, herbs and nutrition (diet and supplementation) can substantially improve the overall health and efficacy of one’s sperm. This, however, should not be a process of randomly taking self-prescribed supplements and herbs, as you could be doing yourself a great disservice. Studies have shown that taking too much of a nutrient can damage sperm as much as having too little of that nutrient. Nutrition, diet and supplementation (herbal medicine, vitamins, minerals, amino acids, etc..) make up a delicate balance for each person and your particular, individual requirements should be investigated, determined and discussed with you by a licensed practitioner so as to help you achieve optimal results.

By identifying and correcting your unique health imbalances, you can optimize your fertility potential and the health of your future child.

Acupuncture Studies

  • ABORM final Comprehensive Review of Published Literature on the Role of TCM with or without Acupuncture on Reproductive Medicine – by Diane K. Cridennda, L.Ac., (FABORM)
  • Acupuncture associated with Increased number of motile sperm,  Increased number of sperm with intact tails, and Increased % of viable sperm in 32 subfertile males with sperm impairment – Sherman S et al, Arch Androl. 1997 Sep-Oct;39(2):155-61
  • Acupuncture and Chinese Herbal Therapy Associated with a significant decrase in Anti-Sperm Anti-Bodies (ASABs) as compared to treatment by oral Prednisone – Fu B et al, J Tradit Chin Med. 2005; 25(3):186-9
  • Acupuncture improving very low Sperm count – Sherrman S Andrologia. 2000 Jan;32(1):31-9.
  • Acupuncture and ICSI – Improvement in rapid sperm movement, normal morphology and fertilisation rates – Zhang M et al J Huazhong Univ Sci Tech Med Sci.2002;22(3):228-30
  • Acupuncture Improving Morphology:
    • Trial 1: Controlled study with 28 infertile men – 10 acupuncture treatments (2/wk) significant improvement in sperm quality especially morphology – Pei J et al, Fertil Steril. 2005 Jul;84(1):141-7
    • Trial 2: Effects of Acupuncture and Moxa in Patients with semen abnormalities – 
      • Controlled study with19 infertile men randomised into 2 groups, 1st given 10 acupuncture and moxa treatments (1/wk), 2nd given sham acupuncture – significant increase in % of normal forms in acupuncture group – Gurfinkel E et al, Asian J Androl. 2003 Dec;5(4):345-8.

Chinese Herbal Medicine Studies

  • A Comprehensive Review of Studies Related to Chinese Herbal Medicine and Traditional Chinese Medicine (TCM) in Conjunction with Assisted Reproductive Technology (ART), IVF, and IUI for Male and Female Infertility by Ray Rubio, DAOM, L.Ac., (FABORM)
  • EFfect of Chinese Herbal Therapy on Chromosomal issues in Sperm – decreasing high aneuploidy after 6 months of Chinese Herbal Therapy – Tempest J et al, Asian Jnl Andrology 2005, 7 (4) 419 – 425
  • Chinese Herbal Therapy improving pregnancy rates in patients with Anti-Sperm Antibodies, both undergoing IUI and Not undergoing IUI compared to patients just recieving IUI without any Chinese Herbal therapy intervention  – Lian F et al Zhongguo Zhong Xi Yi Jie He Za Zhi. 2002, 22(2):95-7
  • Adding the Chinese Herbal Formula, “Bu Zhong Yi Qi Tang”, protects from in vitro effects of Anti-Sperm Anti-bodies – Yamanaka M et al, Nippon Hinyokika Gakkai Zasshi, 89(7):641-6 1998
  • The Chinese Medicinal, Shan Zhu Yu,Improves Sperm’s swimming ability, aka forward progression – Jeng H et al, Am J Chin Med 1997, 25 (3-4) p301-6

Resources & References:

  • Damone, B, Principles of Chinese Medical Andrology: An Integrated Approach to Male Reproductive & Urological Health, 2008
  • Fritz, M., Speroff, L., Clinical Gynecologic Endocrinology and Infertility, Eighth Edition, 2011
  • Liang, L, Acupuncture & IVF, Third Edition, 2005
  • Magarelli, P – Western Reproductive Endocrinology Course – Prod Seminars
  • Rizk, B, et. al, Infertility and Assisted Reproduction, 2008
  • Treatment of Infertility with Chinese Medicine – The complete course – by: Jane Lyttleton
  • Notes from the following Courses:
    • The Treatment of Male Infertility – An Integrative TCM Approach – Presented by: Chris Axelrad, L.AC, Dipl. NCCAOM, ABORM, Pro D Seminars
    • Introduction to Men’s Health & Fertility – presented by Peter Deadman, L.Ac., Pro D Seminars
    • Acupuncture and Herbal Treatments with IVF – Presented by Richard Blitstein, M.S.O.M., L.Ac., Pro D Seminars

Healing Traditions Integrated Wellness specializes in Acupuncuture and Chinese Herbal Medicine for the treatment of infertility for Residents in Denver and Lakewood, Colorado.