Fertility: the male factor

Infertility is as much a man’s issue as a woman’s – up to 30 percent of fertility problems can be traced to men – but medically often the focus is on the woman. Recent studies verify that sperm quality can be greatly improved with acupuncture.

In recent years, women have increasingly used the help of acupuncture to improve their chances of natural conception, increase the effectiveness of medical fertility procedures, decrease the risk of miscarriage, and contend with other pregnancy issues. This popularity blossomed in response to a 2002 study looking at the effect of acupuncture on IVF success rates . Since then, women have discovered how acupuncture can prepare them for these fertility procedures, or even help avoid them. More recently, the subject of male infertility and sub-fertility has been receiving the attention it deserves, and acupuncture is proving to be an especially promising course of treatment .

In the last 50 years, researchers have found that sperm counts, as well as sperm quality are on the decline, so increased awareness of treatment options comes at a crucial time. Furthermore, sperm quality (e.g., morphology and DNA integrity) has been correlated with more than simply fertilization rates, but with factors such as development of the fertilized egg, implantation, and–perhaps most importantly–the development of the embryo itself. These findings indicate that the health of a man’s sperm not only impacts the chances of pregnancy, but directly affects the health of a potential child. So occurrences like miscarriage could have more to do with sperm quality than we imagined, and treatments that focus solely on the woman may indeed miss the mark.

With these factors in mind, men are increasingly seeking to improve the quality of their contribution. However, the male factor is often ignored, especially when the cause of infertility is unknown according to conventional medicine. Men do usually receive at least a basic sperm analysis, but even when results are questionable, the condition is rarely addressed (see Importance of Sperm Testing). Instead, treatment is focused squarely on the woman. This may partly explain why medical fertility procedures have fairly poor success rates.

On the other hand, Chinese medicine has a long history of focusing treatment on male sexual health, in part due to China’s long-standing male-centered society. Sexual virility was considered an expression of strength and power, so ancient emperors demanded their physicians provide effective remedies for sexual disorders including impotence and infertility. Classic texts dedicated to the subject date back thousands of years to the Huang-Di Nei-Jing (The Yellow Emperor’s Medical Classic). Today, this means that Chinese medicine can provide a natural, non-invasive way to enhance men’s virility and vitality.

Male infertility : what are the causes?

There are a number of influences to consider. Environmental and nutritional factors have a direct impact on the healthy production of sperm. Unhealthy habits such as smoking and excessive alcohol consumption are an additional risk, and exposure to radiation can directly damage the DNA of the sperm. In contrast, organic farmers (who avoid dietary pesticides and fertilizers) have been found to have double the sperm counts of men with a standard diet.

Studies such as these indicate that environmental toxins play a large role in the development of healthy sperm. Unfortunately, environmental pollutants and food additives are rampant and often imperceptible. Chemicals are added to nearly everything we put in or on our bodies. This is evident by studies that found the presence of hundreds of substances in our blood that are absent in the blood of our ancestors. The dramatic changes in the last half century is evidenced by the artificially lowered the standards of sperm parameters by the World Health Organization (WHO). Today, a “normal” sperm count is 20 million per ejaculate. Only 25 years ago, normal was 100 million. Obviously, lowering the standards is not going to help the situation, only obscure it. On the bright side, a healthy lifestyle and natural treatments have a positive effect on countering these frequently unavoidable circumstances.

Emotional disturbances and high levels of stress are additional factors that should be reduced if possible, and can be addressed in the framework of acupuncture. Some conditions have little to do with environmental or lifestyle factors. Autoimmune conditions, revealed by the presence of anti-sperm antibodies, cause the body to attack its own cells and results in malformed sperm. The various causes of these conditions are best addressed at their root so as to achieve the desired result of improved fertility.

What can Chinese medicine do?

With over 3,000 years in development, Chinese medicine has broad applications for couples experiencing infertility, including the treatment of male disorders. A new study reported in the latest issue of Fertility & Sterility showed that acupuncture significantly improved both sperm count and quality in men with infertility of unknown cause. Previous studies support these findings, reporting improvements in motility (forward movement), morphology (shape), and overall higher rates of successful pregnancies.

Numerous studies have also shown that herbal medicine can improve sperm count and quality on many parameters. Usually herbs are taken orally, but some unusual studies have demonstrated striking effects on sperm incubated in herbal formulas in the lab. After brief incubation, sperm were protected from the effects of anti-sperm antibodies (which were added to the test tube), and were able to swim faster and for longer periods of time. This shows promise for men with very poor sperm activity who require assisted medical procedures, and indicates potential for combining conventional and Chinese medicine. As the measurable evidence from these studies accumulates, so does acceptance of Chinese Medicine by the science-centered Western medical establishment. Even the WHO lists acupuncture as beneficial for the treatment of male sexual disorders.

Chinese medicine addresses specific complaints as well as related symptoms through the use of acupuncture, herbs, and dietary & lifestyle changes. Depending on the case, treatment can make significant changes in just a few weeks. However, further benefit is gained from longer courses of treatment since sperm development is approximately 3 months. Both partners can optimize fertility by starting treatment as soon as they suspect a problem, or if either partner is experiencing symptoms related to sexual or reproductive function. The sooner these conditions are resolved, the sooner natural fertility may be restored, and more extreme measures avoided.

The benefits of treatment go beyond the specific desired result of pregnancy. This is because Chinese medicine is not only natural but it is holistic, meaning it treats the whole body. The focus is always on the chief complaint, e.g. infertility, but the condition is resolved by addressing the root cause of the problem, in the context of a person’s unique system. In this way general health is improved, and natural fertility can often be achieved without side effects. Since conditions such as poor sperm morphology are risk factors for diseases such as testicular cancer, the early resolution of these conditions has implications for the prevention of more serious ones.

What can I expect?

Practitioners of Chinese medicine start by making a full assessment of the patient’s state of health. This entails enquiring about the patient’s symptoms and habits down to their preference for hot or cold beverages, their propensity to sweat or not, their particular food cravings, their ability to sleep soundly, etc. The practitioner will also assess the patient’s body type, look at the color & coat on the tongue, and read the pulse. All of these details contribute to a comprehensive picture of what is called the patient’s pattern of disharmony. Correct pattern differentiation is the cornerstone of Chinese medicine because it allows experienced practitioners to tailor treatments to a patient’s precise needs.

The pattern of disharmony describes what organ system or systems are involved, if it is one of excess or deficiency, whether the condition is hot or cold, and whether it is yin or yang. Most cases of infertility involve the kidneys, which in Chinese medicine are the primary organ of reproductive and sexual function. Kidney yin deficiency describes a condition where the yin, or moist, cooling substances of the body, is in a depleted state. Semen itself is a yin substance; therefore low ejaculate volume is an example of kidney yin deficiency. In this case, herbs, foods, and supplements that nourish yin are selected. Kidney yang deficiency is a condition where the yang, or fervent energy, is depleted. Yang energy is the catalyst that spurs the substances in the body to take action. Forward motility of the sperm is an example of yang energy. Poor motility calls for herbs that stimulate kidney yang.

Some cases are not reflective of a kidney disharmony. For example, the presence of a varicocele is a physical blockage of blood and energy to the testicles, a problem that ordinarily might require surgery. Chinese medical treatment would be aimed at resolving the blockage, restoring proper blood flow. In some cases surgery can be avoided. Prostatitis and urinary infections are both conditions referred to as damp-heat in the lower body. These conditions can affect healthy production of sperm as well. Treatment is aimed at reducing inflammation and eliminating the presence of harmful bacteria.

Besides assessing outward signs and symptoms, laboratory testing is always recommended, as results are helpful to the practitioner of Chinese medicine. Semen analysis aids in both diagnosis as well as the selection of more effective treatment protocols. Certain herbs are known to improve motility, while others are specifically effective for morphology or count. The same is true of certain beneficial vitamin supplements. Testing is also a great way for men to have an idea of the cause of their condition, as well as a way to see positive changes come from their healthy choices.

When it comes to treatment, acupuncture is used to restore hormone balance, reduce the effects of emotional disturbances and stress, to kick-start the reproductive functions of the kidneys, and to help the body purge itself of toxins. It harnesses the body’s own energy to encourage the body to heal itself.

Herbal medicine is considered to be the internal aspect of the medicine, because it adds substances to the body rather than just working with the body’s inherent energy. It provides powerful but safe substances that stimulate reproductive hormones, detoxify, and nourish that which is deficient. Chinese herbs are almost always used as a formula, which is a balanced set of substances that are chosen specifically for each patient and his specific needs. The use of formulas instead of single herbs (or pharmaceuticals) enables the practitioner to tailor the prescription to the individual patient’s condition and unique set of symptoms; details which are inevitable due to the complexity of the human body. Formulas also have the benefit of modifying any side effects that could be caused by the use of the herbs alone. The creation of well-balanced formulas that resolve symptoms, increase health, are seasonally appropriate, and have no side effects has historically been considered to be an elegant and artistic practice as well as a medical and scientific one. Practitioners often make modifications to their formulas as symptoms change or as environmental conditions such as the season change.

This practice of evaluating specific symptoms within a greater systemic framework demonstrates the holistic approach of Chinese medicine. Ultimately, this approach benefits the patient’s health as well as resolving symptoms. Conversely, Western medicine typically treats infertility and other conditions from the tail end. While medically assisted fertility procedures are an amazing development and a boon to millions of couples, if all those couples sought holistic treatment in conjunction with their standard treatments, success rates could double.

For some couples, medical procedures could be unnecessary, saving them tens of thousands of dollars, the stress of the rather intense treatment schedules, and the side effects of heavy-duty hormone therapies. Natural fertility sprouts from a healthy sperm, healthy egg, and good soil in which to implant and develop. None of these should be neglected. When these factors are optimized, as can be achieved through Chinese medicine, artificial techniques are less frequently required, and when they are, success rates are greatly improved. Working together, modern science and ancient medicine can provide powerful treatments for starting families that loving couples deserve.