Sperm quality is declining
Subfertility in men accounts for 40 - 50% of cases of infertility in couples. In another 20 - 30% both the male and female are subfertile. It is therefore extremely important to address the male factor for couples having difficulty conceiving.

At the complementary medicine practice we develop individualised treatment plans incorporating acupuncture, nutrition and herbal medicine to support and enhance the chances of natural conception. If natural conception is not achieved then we can support both partners through the process of ART (artificial reproductive technology).

Men are continually making sperm. It takes around 3 months for sperm to be formed; so a treatment plan would consist of at least 3 months of attention.

It is common that male infertility is found to be idiopathic (no known cause). This can be frustrating as there is no obvious reason for the poor sperm count or quality. Nevertheless it is important to rule out the possibility of infection, trauma, varicocele, structural damage or endocrinological problems as a cause of infertility. It may be necessary to have a consultation with your doctor if you suspect there is a problem.

At the complementary medicine practice we have experience in treating male factor infertility and have had success in improving sperm parameters using nutritional therapy and acupuncture in men with idiopathic infertility.

What are the parameters measured in a sperm analysis

It is necessary to have 2 - 3 semen samples approximately 3 weeks apart to confirm results as there is normal variation in these measurements at any given time.

Volume (amount of ejaculate): Normal volume should be between 2 - 6 ml

Sperm count (density): greater than 20 million/ml is considered fertile. A sperm count lower than this is called oligozoospermia. Mild to moderate oligozoospermia 5 - 20 million/ml. Severe oligozoospermia < 5 million/ml. Absence of sperm in the semen is called azoospermia.

Motility (movement): greater than 50% "swimmers", for instance progressively swimming is considered fertile. A motility count less than this is called asthenozoospermia.

Morphology (shape): a minimum of 15% of the sperm need to be of a normal shape to be considered fertile sperm. A proportion of abnormally shaped sperm greater than this is called teratozoospermia.

There are a number of influences to consider when trying to improve the quality of sperm. Environmental and nutritional factors have a direct impact on the healthy production of sperm.

Dietary or lifestyle advice

• Keep your cool: In order for the testes to produce sperm they need to be at slightly lower than body temperature, hence the reason for the testes hanging away from the body in the scrotum. It is advisable to avoid overheating the testes: wear loose fitting underwear; avoid saunas; jacuzzis; very hot baths; and use laptop computers on a table rather than on your lap.
• Go organic: Many commonly used pesticides contain substances which have an estrogenic (oestrogen like) effect on the male body which can impact spermatogenesis (sperm formation). In addition many chemicals can make their way into foods such as dioxin, PCB's and DDT can affect spermatogenesis so eating organic food will help minimize your exposure to these chemicals.
• Heavy metal collection: Environmental heavy metals have toxic effects on sperm quality and production. Diagnostic testing can be done to rule this out as a factor in subfertility.
• Avoid plastics: Plastics also contain xenoestrogens (oestrogen like substances). Avoid microwaving in plastic.
• Weight: Being overweight can affect male and female fertility.
• Cut down on alcohol: Excessive alcohol consumption has been linked with a decrease in sperm count.
• Quit Smoking: Smoking and the use of recreational drugs may reduce sperm count and can cause abnormal morphology.
• Relax: There is little doubt that chronic stress plays a role in subfertility, therefore gaining balance in your life and allowing time for relaxation is very important.
• Exercise: moderate exercise is great for stress and cardiovascular health. Heavy training or excessive sport may impact on spermatogenesis.
• Keep hydrated: ejaculate is fluid and dehydration will impact on the amount of ejaculate formed.
• A varied and balanced diet: incorporating a variety of vegetables and fruit, especially a variety of colours, plenty of whole grains, inclusion of nuts, seeds and fish in the diet and a reduction in saturated fat, sugar and caffeine is advocated.

Nutritional and Herbal Supplements
There are several vitamins, minerals, amino acids, essential fatty acids and herbal supplements which have been shown to have a positive impact on sperm counts, morphology and motility. A consultation is required to give accurate and individualised advice regarding supplementation.

Acupuncture
The aim of acupuncture is to restore the vital energies of the male reproductive system.

In 2005 Fertility and Sterility published a small controlled study involving 40 men with idiopathic oligospermia (sperm count less that 20 million/ml), asthenozoosperma (motility count less than 50%) or teratozoospermia (abnormal morphology over 15%). After 20 acupuncture treatments the treatment group had a statistically significant improvement in the structure and form of the sperm (Jian etal, 2005).

In 2000, The Andrologia journal reported a controlled study involving 40 men with azoospermia (absence of sperm) who had been trying unsuccessfully for children for 3 - 13 years. Following a course of ten acupuncture treatments there was a considerable improvement in sperm density in 13 out of the 20 men in the treatment group and no improvement in the control group. Two of the treated men went on to have ICSI treatment, and pregnancies where achieved in both cases (Siterman et al, 2000).

In 2003, The Asian Journal of Andrology reported a small randomized, controlled, blinded study involving 19 men with semen abnormalities in concentration, morphology and progressive motility with no apparent cause (idiopathic). Half of the group was treated with true acupuncture and half with placebo acupuncture. Both groups had twice weekly treatments for ten weeks. The group receiving true acupuncture had a significant increase in the percentage of normally formed sperm in comparison to the control group (Gurfinkel et al, 2004).

In 1997 the Archives of Andrology journal published a study involving a controlled study involving 32 subfertile men. The treatment group received acupuncture twice weekly for five weeks. The treatment group had a significant improvement in motility, and morphology of sperm (Siterman et al, 1997).

References

Gurfinkel, E. Cedenho, A. Yamamua, Y. Srougi, M. 2004. Effects of acupuncture and moxa treatment in patients with semen abnormalities. Asian Journal of Andrology. Dec (5): 345-348.

Jian, P. Strehler, E. Noss, U. Abt, M. Piomboni, P. Baccetti, B. Sterzik, K. 2005. Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertility and Sterility. 84(1): 141-147.

Siterman, S. Eltes, F. Wolfson, V. Zabludovsky, N. Bartoov, B. 1997. Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality. Archives of Andrology. 39(2): 151-161.

Siterman, F. Eltes, F. Wolfson, V. Lederman, H. Bartoov, B. 2000. Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study. Andrologia. 32(1): 31-39.