Acupuncture and male subfertility: review of clinical studies

Review of clinical studies

1. Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility

Twenty eight German men with idiopathic oligospermia (too few sperm), asthenospermia (poor motility) or teratozoospermia (poor morphology) received acupuncture twice a week for five weeks and were then compared to 12 men in the untreated control group. The following points were used: Guanyuan REN-4, Shenshu BL-23, Ciliao BL-32, Taichong LIV-3, Taixi KID-3 as main points and Zusanli ST-36, Xuehai SP-10, Sanyinjiao SP-6, Guilai ST-29 and Baihui DU-20 as secondary points. Deqi was obtained, and specifically directed to the sacral, perineal or anterior hypogastric areas from Shenshu BL-23 and Ciliao BL-32. The needles were manipulated again after ten minutes and retained for 25 minutes. After treatment there was a significant improvement in the percentage and number of normal morphology sperm (particularly acrosome position and shape , nuclear shape , axonemal pattern  and shape, and accessory fibres of sperm organelles ) as well as improvement in total motility (from 44.5% to 50%).

Pei. J., Strehler, E., Noss, U., Abt. M , Piomboni, P., Baccetti, B., Sterzik, K. (2004). Fertility and Sterility, 84:1, 141-147.

2. Effects of acupuncture and moxa treatment in patients with semen abnormalities.

In this prospective, controlled, blind study, 19 men with idiopathic oligospermia, asthenospermia or teratozoospermia were randomised into two groups. Both groups were given acupuncture and moxibustion, the treatment group at ‘therapeutic’ points and the control group at ‘indifferent’ points. Treatment lasted ten weeks (25 minutes of acupuncture and 20 minutes of moxibustion, twice a week). Deqi was obtained. The acupuncture points in the treatment group were Qichong ST-30, Taixi KID-3, Zusanli ST-36, Hegu L.I.-4, Sanyinjiao SP-6, Gongsun SP-4, Taichong LIV-3, Neiguan P-6, and the moxibustion points Shenshu BL-23, Qihai REN-6, Shimen REN-5, Qimen LIV-14, Zhishi BL-52, Guanyuan REN-4, Taiyuan LU-9, Zigong (M-CA-18), Sanjiaoshu BL-22, Zhongji REN-3, Feishu  BL-13, Mingmen DU-4, Pishu BL-20, Jueyinshu BL-14, Ciliao BL-32, Weishu BL-21, Xinshu BL-15.

After treatment there was a significant increase in the percentage of normal-form sperm in the treatment group compared to the control and the authors conclude that "Chinese Traditional Medicine acupuncture and moxa techniques significantly increase the percentage of normal-form sperm in patients with  oligoastenoteratozoospermia without apparent cause."

Gurfinkel E, Cedenho P, Yamamura Y, Srougi M. (2003). Asian J Androl. 5:4, 345-8.

3. Does acupuncture treatment affect sperm density in males with very low sperm count?

A pilot study Azoospermia is one of the most intractable forms of male infertility, and very few therapeutic regimens have provided effective treatment for azoospermic or severely oligozoospermic patients. In this study, 20 patients with a history of azoospermia were examined by light microscope and scanning electron miscroscope, revealing three severely oligoteratoasthenozoospermic (OTA), two pseudoazoospermic and 15 azoospermic patients. A control group of 20 patients had similar profiles. Acupuncture treatment was given twice a week for five weeks, deqi was obtained, and the needles were retained for 25 minutes. Main points, used in all patients, were Sanyinjiao SP-6, Guanyuan REN-4, Lieque LU-7, Zhaohai KID-6 and Qichong ST-30. For Kidney yang deficiency, Taixi KID-3, Shenshu BL-23, Henggu KID-11 and  Zhishi BL-52 were reinforced. For damp-heat, Yinlingquan SP-9, Ligou LIV-5, Quchi L.I.-11, Shuidao ST-28 and Zulinqi GB-41 were reduced. Fifteen other secondary points were also used (Hegu L.I.-4, Zusanli ST-36, Xuehai SP-10, Shenmen HE-7, Pishu BL-20, Neiguan P-6, Huiyin REN-1, Qugu REN-2, Qihai REN-6, Mingmen DU-4, Baihui DU-20, Fengchi GB-20, Taichong LIV-3, Fuliu KID-7, Wushu GB-27). No more than 12 points were used in any single treatment.

Following treatment, 13 out of 20 patents in the treatment group exhibited a considerable improvement in sperm density, and the three severely OTA males exhibited a marked but nonsignificant improvement in their sperm count. Men with genital tract inflammation exhibited the most remarkable improvement in sperm density, and two men in the inflammation subgroup underwent additional acupuncture and exhibited a continuous improvement in their sperm density. Of the two treated patients who underwent ICSI treatment after acupuncture, both achieved pregnancy, although one ended in a spontaneous abortion. The authors conclude that, "Acupuncture treatment is simple, noninvasive and inexpensive, and does not require any previous preparation, so seems to be clinically preferable to sperm aspiration and extraction from the testis or epididymis."

Siterman S, Eltes F, Wolfson V, Lederman H, Bartoov B. (2000). Andrologia. 32:1, 31-9.

4. Influence of acupuncture on idiopathic male infertility in assisted reproductive technology.

Twenty patients with idiopathic male infertility (less than 20 million perm per ml., less than 20% rapidly motile sperm, less than 30% normal form sperm) who had all failed at least twice with ART, were treated with acupuncture twice weekly for eight weeks at Baihui DU-20, Neiguan P-6, Xuehai SP-10, Neiting ST-44, Shenshu BL-23, Sanyinjiao SP-6, Xuanzhong GB-39, Gongsun SP-4, Fenglong ST-40, Qihai REN-6 and Guanyuan REN-4. Thee months later they underwent ICSI. Rapid sperm motility after acupuncture was significantly improved and the normal form sperm ratio was increased after acupuncture. Fertilisation rates after acupuncture (66.2%) were obviously higher than that before treatment (40.2%, P < 0.01), with four pregnancies (18.2%). There was no significant difference in sperm concentration and general sperm motility after acupuncture. The embryo quality after acupuncture was improved, but the difference was not significant (P > 0.05).  Zhang M, Huang G, Lu F, Paulus WE, Sterzik K. (2002). J Huanzhong Univ Sci Technolog Med Sci. 22:3, 228-30.

Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality Semen samples of 16 acupuncture-treated subfertile patients were analysed before and one month after treatment (twice a week for five weeks). In parallel, semen samples of 16 control untreated subfertile males were examined. Two specimens were taken from the control group at an interval of 2-8 months. The expanded semen analysis included routine and ultramorphological observation.

The fertility index increased significantly (p < or = .05) following improvement in total functional sperm fraction, percentage of viability, total motile spermatozoa per ejaculate, and integrity of the axonema (p < or = .05), which occurred upon treatment. The intactness of axonema and sperm motility were highly correlated (corr. = .50, p < or = .05). Thus, patients exhibiting a low fertility potential due to reduced sperm activity may benefit from acupuncture treatment.

Siterman S, Eltes F, Wolfson V, Zabludovsky N, Bartoov B. (1997).
Arch Androl. 39:2, 155-61.

Chinese herbal medicine

The use of Chinese herbal medicine is beyond the scope of this article. However, herbal medicine can form a significant part of the treatment of male subfertility and is extensively used in China and in fertility clinics elsewhere. Herbs are particularly convenient as the patient does not need to attend the clinic so frequently. Principles of Chinese Medical Andrology by Bob Damone (Blue Popppy Press, 2008) offers a substantial introduction to the use of Chinese herbal medicine in the treatment of male subfertility.