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Acupuncture Research on Male Factor Infertility

A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia.

Fertil Steril. 2009 Oct;92(4):1340-3. Epub 2009 Apr 25.

Dieterle S, Li C, Greb R, Bartzsch F, Hatzmann W, Huang D.

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Witten/Herdecke, Dortmund, Germany. dieterle@ivf-dortmund.de

Abstract

In this first prospective, randomized, single-blind, placebo-controlled study, 28 infertile patients with severe oligoasthenozoospermia received acupuncture according to the principles of traditional Chinese medicine (TCM) and 29 infertile patients received placebo acupuncture. A significantly higher percentage of motile sperm (World Health Organization categories A-C), but no effect on sperm concentration, was found after acupuncture compared with placebo acupuncture.

Point-and frequency-specific response of the testicular artery to abdominal electro acupuncturein humans

Cakmak Y et al, Fertil Steril 2008;90:1732–8

Fertility and Sterility

Just as electrocaupuncture can increase blood flow to the ovaries and uterus see reports above) so it can to the testicles. These authors demonstrate that particular frequencies applied for just 5 minutes are effective in increasing blood flow in the testes, and suggest that such a stimulus may address the damaged microcirculation associated with varicoceles, and with aging. They note that decreased testicular arterial blood flow may result in impaired spermatogenesis from defective metabolism in the microcirculatory bed and suggest that further research is needed to discover if electro acupuncture can improve sperm manufacture in this instance.

Abstract

Objective: To clarify the role of the abdominal acupuncture points and the frequency of short-term electro acupuncture (EA) stimulation on testicular blood flow (TBF) in humans.

Design: A prospective, randomized study.

Setting: University hospital, Department of Radiology, ultrasound unit.

Patient(s): Eighty healthy male volunteers were randomly allocated to three groups in stage one and to a single group in stage two. In the first stage of the study, the abdominal acupuncture points ST-29 (guilai) were stimulated using simple needle insertion, 2 Hz burst EA or 10 Hz EA, in three different groups. In the second stage of the study, abdominal acupuncture points ST-25 (tianshu) were stimulated with the frequency found to be more effective in stage one. Stimulation was for 5 minutes in each group.

Intervention(s): Electroacupuncture and Doppler flowmeter.

Main Outcome Measure(s): Four groups were compared for volume flow and other related parameters of TBF.

Result(s): The 10-Hz EA stimulation of ST-29 (guilai) increased TBF, but simple needle insertion and 2-

Hz burst stimulation did not. The 10-Hz EA stimulation of ST-25 (tianshu) did not result in significant changes in TBF.

Conclusion(s): For the first time point-and frequency-specific effects of abdominal EA on TBF are shown in humans.

Further investigation is required to ascertain whether these findings may be helpful in the clinic treatment of infertile men.

Effect of Acupuncture on Sperm Parameters of Males Suffering from Subfertility Related to Low Sperm Quality

1997, Vol. 39, No. 2 , Pages 155-161

S. Sherman1, F. Eltes2, V. Wolfson1, N. Zabludovsky2 and B. Bartoov2†

1Institute of Chinese Medicine, Tel Aviv, Israel

2Male Fertility Laboratory, Department of Life Sciences, Bar-lan University, Ramat Gan, Israel

†Correspondence: B. Bartoov, Male Fertility Laboratory, Department of Life Sciences, Bar-Ilan University, Ramat Gan, 52900, Israel

The aim of this prospective controlled study was to assess the effect of acupuncture on the sperm quality of males suffering from subfertility related to sperm impairment. Semen samples of 16 acupuncture-treated subfertile

patients were analyzed before and 1 month after treatment (twice a week for 5 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 ultra morphological observations. The fertility index increased significantly (p≤. 05) following improvement in total functional sperm fraction, percentage of viability, total motile spermatozoa per ejaculate, and integrity of the axonema (p≤. 05), which occurred upon treatment. The intactness of axonema and sperm motility were highly correlated (corr. =. 50,p≤. 05). Thus, patients exhibiting a low fertility

potential due to reduced sperm activity may benefit from acupuncture treatment.

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

Pei J et al Fertil Steril. 2005 Jul;84(1):141-7

Fertility and Sterility

A group of infertile men who had pathological semen analyses according to WHO criteria, were treated with acupuncture twice a week for 5 weeks. A statistically significant increase after acupuncture in the percentage and number of sperm with no structural defects was demonstrated compared to the control group of patients who received no treatment. They concluded that male infertility patients could benefit from having acupuncture. A general improvement of sperm quality, specifically in the ultrastructural integrity of spermatozoa, was seen after acupuncture.

Abstract

OBJECTIVE: To evaluate the ultramorphologic sperm features of idiopathic infertile men after acupuncture therapy.

DESIGN: Prospective controlled study.

SETTING: Christian-Lauritzen-Institut, Ulm, IVF center Munich, Germany, and Department of General Biology, University of Siena, Siena, Italy.

PATIENT(S): Forty men with idiopathic oligospermia, asthenospermia, or teratozoospermia. INTERVENTION(S): Twenty eight of the patients received acupuncture twice a week over a period of 5 weeks. The samples from the treatment group were randomized with semen samples from the 12 men in the untreated control group. MAIN OUTCOME MEASURE(S): Quantitative analys

is by transmission electron microscopy (TEM) was used to evaluate the samples, using the mathematical formula based on submicroscopic characteristics.

RESULT(S): Statistical evaluation of the TEM data showed a statistically significant increase after acupuncture in the percentage and number of sperm without ultrastructural defects in the total ejaculates. A statistically significant improvement was detected in acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibers of sperm organelles.

However, specific sperm pathologies in the form of apoptosis, immaturity, and necrosis showed no statistically significant changes between the control and treatment groups before and after treatment.

CONCLUSION(S): The treatment of idiopathic male infertility could benefit from employing acupuncture. A general improvement of sperm quality, specifically in the ultrastructural integrity of spermatozoa, was seen after acupuncture, although we did not identify specific sperm pathologies that could be particularly sensitive to this therapy.

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

Gurfinkel E et al Asian J Androl. 2003 Dec;5(4):345-8.

Asian Journal of Andrology

In a prospective, controlled and blind study, a group of infertile men (married for 3 – 11 years without children) were randomized into two groups, the treatment group receiving 10 acupuncture treatments and the control group receiving sham acupuncturetreatments. The patients in the acupuncture group demonstrated a significant increase in the percentage of normal forms compared to the control group.

Abstract

Aim: To evaluate the effect of Chinese Traditional Medicine, acupuncture and moxa treatment, on the semen quality in patients with semen abnormalities.

Methods: In a prospective, controlled and blind study, nineteen patients, aged 24 years ~ 42 years and married for 3 years ~ 11 years without children with semen abnormalities in concentration, morphology and/or progressive motility without apparent cause, were randomized into two groups and submitted to acupuncture and moxa treatment at the therapeutic (Study Group) and the indifferent points (Control Group), respectively, for 10 weeks. Semen analyses were performed before and after the treatment course.

Results: The patients of the Study Group presented a significant increase in the percentage of normal-form sperm compared to the Control Group (calculated U=16.0, critical U=17.0).

Conclusion: The Chinese Traditional Medicine acupuncture and moxa tech

niques significantly increase the percentage of normal-form sperm in infertile patients with oligoastenoteratozoo spermia without apparent cause.

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

Zhang M et al J Huazhong Univ Sci Tech Med Sci.2002;22(3):228-30

Journal of Huazhong University (Abstract in Chinese)

This trial looks at sperm behaviour in an IVF setting. It was a ―before and after‖ study involving 82 infertile men with pathological semen abnormalities and who’s sperm achieved a poor fertilization rate in at least 2 IVF/ICSI cycles. They were given acupuncture twice a week over 8 weeks and the IVF/ICSI cycles were repeated. The fertilization rates after acupuncture (66.2%) were significantly higher than that before treatment (40.2%) (P < 0.01).

Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study.

Siterman S et al Andrologia. 2000 Jan;32(1):31-9.

Andrologia

This pilot study once again showed a positive effect of acupuncture on sperm count -but this time on men with such low sperm counts (or no sperm) that they would usually require a testicular biopsy to extract sperm for use in an IVF cycle. Seven of the 15 men with no sperm at all produced sperm detectable by the light microscope after a course of 10 acupuncture treatments (p < 0.01)

i.e. enough sperm could be produced for ICSI to be performed without

recourse to testicular biopsy. The control group with similar semen analysis had no treatment and showed no change after 3 months.

Abstract

Classic therapies are usually ineffective in the treatment of patients with very poor sperm density. The aim of this study was to determine the effect of acupuncture on these males. Semen samples of 20 patients with a history of azoospermia were examined by light microscope (LM) and scanning electron microscope (SEM), with which a microsearch for spermatozoa was carried out.

These examinations were performed before and 1 month after acupuncture treatment and revealed that the study group originally contained three severely oligoteratoasthenozoospermic (OTA), two pseudoazoospermic and 15 azoospermic patients.

The control group was comprised of 20 untreated males who underwent two semen examinations within a period of 2–4 months and had initial andrological profiles similar to those of the experimental group.

No changes in any of the parameters examined were observed in the control group. There was a marked but not significant improvement in the sperm counts of severely OTA males following acupuncture treatment (average=0.7±1.1×106 spermatozoa per ejaculate before treatment vs. 4.3±3.2×106 spermatozoa per ejaculate after treatment). A definite increase in sperm count was detected in the ejaculates of 10 (67%) of the 15 azoospermic patients. Seven of these males exhibited post-treatment spermatozoa that were detected even by LM. The sperm production of these seven males increased significantly, from 0 to an average of 1.5±2.4×106 spermatozoa per ejaculate (Z=−2.8, P≤0.01). Males with genital tract inflammation exhibited the most remarkable improvement in sperm density (on average from 0.3±0.6×106 spermatozoa per ejaculate to 3.3±3.2×106 spermatozoa per ejaculate; Z=−2.4, P≤0.02).

Two pregnancies were achieved by the IVF-ICSI procedure. It is concluded that acupuncture may be a useful, nontraumatic treatment for males with very poor sperm density, especially those with a history of genital tract inflammation.