Male Subfertility

In Chinese medicine, male subfertility, like female subfertility, has everything to do with the Kidney energy. The Chinese medical term ‘Kidney’ embraces more functions and areas in the body than does our concept of the kidney organ in Western medicine.

In Chinese medicine, the basic requirement for full reproductive potential is strong Kidney Jing. Also, there needs to be a normal balance of Kidney Yin and Yang. Most cases of male subfertility will be diagnosed as
Kidney Yin or Yang deficiency.

Other patterns which will be considered in diagnosis of male subfertility can be due to excess/stagnant Qi/Blood or deficient Qi/Blood. There can also be a pattern called Damp-Heat. Diagnosis is made by assessing all the symptoms and signs which indicate these patterns, some of which are listed below.

With Kidney Yang deficiency there may be:

  • thin and watery seminal fluid,
  • a low libido,
  • impotence or inability to sustain erection
  • a cold scrotum
  • sensitivity to the cold
  • lethargy

With Kidney Yin deficiency there may be:

  • excessive libido possibly with premature ejaculation, or spermatorrhoea
  • the man may be hot at night, excess thirst and restlessness

With Blood and Qi stagnation:

  • this is usually associated with varicocele,
  • patients often have low sperm count plus poor motility and high abnormal morphology,
  • there may be visible dissention in the scrotal veins,
  • there may be inguinal/testicular pain and hard, tender scrotal lumps.

Where there is a condition know as Damp-Heat or Phlegm, you may find:

  • low sperm count,
  • low motility
  • there may be white blood cells in the semen (which may indicate an infection)
  •  history of urinary tract infections or prostate problems
  •  thick cloudy and /or discoloured ejaculate
  •  the patient will have a tendency to be fat and flabby
  •  there may be testicular lumps

Sperm are delivered to the female genital tract in a fluid called semen. This fluid contains constituents important for sperm function and survival and for conditioning the lining of the uterus to accept an embryo containing the father’s protein. Sperm constitutes only about 1% of the semen volume. The dynamic and fast-moving sperm represent the Yang within the moistening and nourishing Yin of the seminal fluid.

In Chinese medicine, when we are treating a sperm disorder, it is important that both the Yin and the Yang aspects are considered, i.e. both the sperm and the fluid containing them.

We will consider the male patient holistically and diagnose him individually according to the patterns of Chinese medicine. The treatment will proceed according to the patient’s patterns and constitution, and despite the common label ‘subfertility’, each patient will receive different individualised treatments. We will also consider aspects of diet and lifestyle to help enhance male fertility.

As sperm take a long time to form (2-3 months), we recommend that acupuncture treatment should continue for at least 3 months. We tend to see the patient initially weekly for 6 weeks then space treatments out to once a month to coincide with the partner’s cycle, approximately 3-4 days before her ovulation.

Acupuncture can be effective in strengthening any Kidney Deficiency. It can also address some of the disorders which could be contributing to subfertility, especially those where there is some obstruction of Qi or Blood. It can also help clear blockages from the scrotal/lower abdominal areas.

Some clinical trials suggest that acupuncture improves sperm motility (Dieterle 2009), increases sperm count (Siterman 2009, Siterman 2001), improves sperm quality (Pei 2005; Gurfinkel 2003) and has a beneficial effect on psychogenic erectile dysfunction (Engelhardt 2003). The research results are promising but still at a preliminary stage in terms of numbers and quality of studies.
Acupuncture may help in the treatment of male infertility (Stener-Victorin 2010), by:

  • lowering scrotal temperature (Siterman 2009);
  • enhancing local microcirculation, by increasing the diameter and blood flow velocity of peripheral arterioles (Komori 2009);
  • reducing inflammation, by promoting release of vascular and immunomodulatory factors  (Zijlstra 2003)
  • by improving sperm maturation in the epididymis, increasing testosterone levels, and reducing liquid peroxidation of sperm  (Crimmel 2001)

For further details about male subfertility, how acupuncture can help and the research cited above please see the factsheet published by the British Acupuncture Council at http://www.acupuncture.org.uk/members-research-fact-sheets/1561-acupuncture-and-male-infertility.html

Sources

http://www.acupuncture.org.uk/members-research-fact-sheets/1561-acupuncture-and-male-infertility.html

Pei J, Strehler E, Noss U, et al. Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male subfertility. Fertility and Sterility July 2005;84(1):141-7.

Lyttleton J (2004) Treatment of Infertility with Chinese Medicine Churchill Livingstone

Deadman P, notes on Male Infertility lecture