Enhancing Male Fertility with Traditional Chinese Medicine
Note: All words in Italics refer to TCM terminology and not the definitions referenced in western medicine and mainstream understanding.
What is male infertility and how does it affect me?
Have you and your partner been trying to conceive but haven't found success? Fear not, because there is a way to overcome infertility. According to the World Health Organization (WHO)[1], infertility is a disease of the male or female reproductive system defined by the failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse. If the male factor is found to be the reason, it is defined as male infertility. For a man, infertility can lead to anxiety, distress, lowered self-esteem, reduced libido, as well as a sense of guilt[2].
Reasons for male infertility
Male infertility can result from various factors, including:
Low Sperm Count (Oligozoospermia): This occurs when a man has a lower-than-normal number of sperm in his semen.
Poor Sperm Motility (Astheno- or Teratozoospermia): Sperm may not move correctly or have abnormal shapes, making it difficult for them to reach and fertilize an egg.
Blockages or Obstructions: Blockages or obstructions in the epididymis or vas deferens can prevent sperm from being ejaculated.
Hormonal Imbalances: Low testosterone can affect sperm production.
Varicocele: This is an enlargement of the veins in the scrotum that can increase testicular temperature and impair sperm production.
Infections: Sexually transmitted infections (STIs) or other infections can damage the reproductive system.
Genetic Factors: Certain genetic conditions can affect sperm production or function.
Ejaculatory Problems: Premature ejaculation or retrograde ejaculation (where semen enters the bladder instead of being ejaculated) can reduce fertility.
Environmental Factors: Exposure to toxins, radiation, or excessive heat can harm sperm.
Lifestyle Factors: Factors like smoking, excessive alcohol consumption, drug use, and obesity can negatively impact sperm quality.
How are the reasons for male infertility uncovered?
To find out the reasons for infertility, a healthcare professional will typically perform the following tests:
Semen Analysis: This involves examining the sperm's quantity, motility, and morphology.
Hormone Testing: Blood tests can assess hormone levels, especially testosterone.
Physical Examination: The doctor will check for physical issues, such as varicoceles or blockages.
Genetic Testing: In some cases, genetic testing may be recommended, especially when disorders of sexual development (DSDs) are suspected.
Imaging: Ultrasound or other imaging techniques can help identify anatomical issues.
Sperm DNA fragmentation test: Tests like the sperm chromatin dispersion test (SCD) or Acridine orange test (AOT) help determine the fertility potential of the male independent of parameters seen in a routine semen analysis.
Self Help tips
General health and male fertility are closely intertwined. Lifestyle habits and choices known to have a negative impact on men's health have been associated with decreased fertility. As such, certain lifestyle changes have to be put in place before improvements to male fertility can be expected.
Alcohol cessation: Alcohol is a well-known mitochondrial toxin. Mitochondria are small organelles in our cells that produce energy. Without proper functioning mitochondria, our cells would not be able to function as they should. In sperm cells, well-functioning mitochondria are especially important because they are needed for the beating of the flagella, which propels sperm forward. Alcohol must be completely removed from the diet to avoid compromising the quality of sperm mitochondria.
Reduced smoking: Smoking causes impairment to the function of the inner lining of blood vessels, thereby limiting blood flow into the organs. Over time, this can result in the loss of flexibility and elasticity of the vessels, thus impairing erectile function and leading to infertility. In addition, smoking exposes one to high amounts of lead and cadmium, heavy metals that have been linked to decreased fertility in men.
Heat exposure: Heat exposure should be limited to a minimum, as spermatogenesis (production of sperm) is a temperature-sensitive process. Tight-fitting clothes and undergarments that trap heat should be avoided. Men who enjoy steam baths and saunas should steer clear from these places, as the high temperature is detrimental to sperm.
Lifestyle modification: A diet high in antioxidants is also greatly beneficial. Antioxidants help combat oxidative stress and may be beneficial in the maintenance of proper sperm development.
Medications: Certain medications can affect spermatogenesis, so be sure to clarify with your doctor to ensure that the medication you are on does not decrease your fertility.
Regulation of emotional state: Trying for a child can be a stressful endeavor. Lowering stress through meditation, exercise, or journaling can help both you and your partner feel more relaxed and increase the chances of a natural pregnancy.
Evidence-Based TCM Approaches for Managing Male infertility
Traditional Chinese Medicine (TCM) typically classifies male infertility broadly into three categories: Excess, deficiency, and a combination of the two. In the excess category, there are sub-categories like "Phlegm-Dampness, Phlegm-Heat, Damp-Heat, Liver and Heart Fire uprising, etc." In the deficiency category, there are sub-categories like "Kidney Yin deficiency, Kidney Yang deficiency, Kidney Qi deficiency, Spleen-Kidney Yang deficiency, etc." Lastly, an individual can have both excess and deficiency combined together in a unique way. Consequently, formulas or herbs that address this imbalance can be useful in the management of infertility.
Herbal Medicine
Modern research has demonstrated that certain herbs can improve sperm quality through modulating levels of cytokines[3]. One such herb is 枸杞子 (Lycium barbarum). This herb is one of four other herbs in a formula known for its fertility-boosting effects: 五子衍宗丸 (Wu Zi Yan Zong Pill). According to medical studies, Wu Zi Yan Zong Pill can exhibit anti-oxidation, anti-apoptosis properties as well as regulate amino acid metabolism[4]. Taking into account the specific constitution of your body, a qualified TCM practitioner can create a personalized formula tailored to you.
Acupuncture
Acupuncture has been shown to aid in improving the percentage of mature and functional sperm. In a pilot study conducted by the Singapore General Hospital and Singapore Thong Chai Medical Institution, it was found that hyaluronan binding assay (HBA) scores increased significantly during the first five weeks of acupuncture treatment and five weeks after the completion of treatment. The study concluded by theorizing that acupuncture treatment may have potential in improving sperm maturity, quality, and fertilizing ability[5]. A prospective, randomized, single-blind, placebo-controlled study was done to investigate the effects of acupuncture on patients with very low sperm concentration and motility. It found that acupuncture was able to significantly increase the percentage of motile sperm, though it had no effect on sperm concentration[6]. Some commonly used acu points for male fertility include 三阴交 San Yin Jiao (SP6), 公孙 Gong Sun (SP4), 气海 Qi Hai (CV6) and 关元 Guan Yuan (CV4).
How Many Sessions Do I Need?
At Common TCM, your physician will review your fertility history and determine the optimal frequency of visits based on your current health, lifestyle, and any presenting symptoms. A single batch of sperm takes around 74 days to develop and, including transport through the ductal system, it takes three months[7][8]. Hence, one course of treatment lasts at least three months. Should the treatment be effective, not only will you experience improved semen parameters, but your overall health and sexual function will also improve.
Who is this suitable for?
There are no exclusions to this treatment, as improved health is a by-product of increased fertility. Furthermore, many aspects of health and well-being remain undetected until pointed out during our well-being consultation. This consultation can be an opportunity to review your well-being status, stress levels, and personalize your healthcare journey.
Most importantly, do your research and seek advice from reputable professionals for an elevated healing experience. For more information, visit our website to learn more about our treatments and physicians or to book an appointment. Your well-being is our priority, and we are here to support you on your journey towards better health.
References:
[1]https://www.who.int/health-topics/infertility#tab=tab_1
[2]https://www.seleni.org/advice-support/how-infertility-affects-men-emotionally
[3]https://www.sciencedirect.com/science/article/pii/S0141813018368119
[4]https://www.sciencedirect.com/science/article/pii/S0378874120330749
[5]https://www.sciencedirect.com/science/article/pii/S2305050015000226
[6]https://www.sciencedirect.com/science/article/pii/S0015028209004312
[7]https://onlinelibrary.wiley.com/doi/10.2164/jandrol.107.004655