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Maggie Ju (2014) Current opinion in acupuncture on stroke rehabilitation
The Journal of Chinese Medicine And Acupuncture Volume 21 Issue 2 September 2014 P9
Maggie Ju. (2015) What Part Does Acupuncture Play in IVF?
The Journal of Chinese Medicine And Acupuncture Volume 22 Issue 1 March 2015 P21
Maggie Ju (2020) The Potentiality of COVID-19 Treatment with Chinese Herbal Medicine in the UK
The Journal of Chinese Medicine And Acupuncture Volume 27 Issue 2 November 2020 P9
Wednesday, 2 July 2014
Varicocele and male infertility
Infertility affects about 1 in 6 of the couples of reproductive age1. The male factor is involved in 40% - 50% of infertility cases. The most common type of male infertility is unexplained infertility, which is unknown cause. Another common cause of male infertility is varicocele which is enlarged veins in testicles. 78% - 93% of cases varicocele is located on the left side. The left internal spermatic vein inserts into the left renal vein at a right angle which leads to an increase in the hydrostatic pressure of the left spermatic vein causing its dilation. Also internal spermatic veins lack functional valves, which can lead to regression of blood. Possibly there is a partial obstruction of the left spermatic vein due to the compression of the left renal vein between the aorta and the upper mesenteric artery . Varicocele causes elevated temperature of the scrotum possibly due to reflux of warm blood from the abdominal cavity. High temperature causes thermal damage of the DNA and proteins in the nucleus of spermatic tubules' cells and / or Leydig cells. The increased vein pressure can influence testicular blood flow, cause accumulation of toxic metabolites which leads to chronic vasoconstriction and subsequent dysfunction of the spermatic epithelium. Men with varicocele have high FSH level and low sperm counts. Surgical repair of varicocele has been shown to restore the temperature in both animals and humans. However fertility potential is not always improved after surgical repair of varicocele though semen parameters were improved.
Oxidant stress and male infertility
Half of all cases of infertility have male factor involved. Oxidant stress damage to sperm is a significant contributing pathology in 30–80% of cases. What is oxidant stress? In cellular metabolism, there are free radicals produced and they can damage cells and also there are antixodants against this damage. If balance between free radicals and antioxidants is broken, oxidant stress occurs. If oxidant stress occurs in sperm, it reduces the sperm's motility and ability to fuse with the egg by damaging the sperm membrane and sperm DNA. This may cause male infertility. Oxidant stress is not screened nor treated. The possible causes of oxidant stress come from many sources such as life style including smoking, drinking alcohol, stress, environmental factors including heat, pollutions, infections, autoimmune problems, chronic disorders etc.
Management of oxidant related stress include: change life style, reduce exposure to toxic environment, treat infections and inflammations etc. Taking some supplements such as vitamine C, B complex, and E may help reducing oxidant stress. Acupuncture may help reduce oxidant stress by improving blood circulation and taking toxic free radicals away.
Sperm is impaired by inflammation and acupuncture can help
Semen quality is affected by prostate and genital tract inflammation. There was a study on 382 voluntary male subjects who underwent the screening for prostate health. Sperm motility and prostate-related parameters were significantly impaired in patients with chronic prostatitis syndromes and lower urinary tract symptoms in comparison with controls. Elevated seminal markers of inflammation were in positive association with body mass index, prostate-specific antigen, and estradiol level in serum while in negative association with semen volume, total sperm count, and sperm motility. It was suggested that one of the possible pathways for impaired reproductive quality in male subjects >45 years could be related to infection and inflammation in the genital tract with subsequent (partial) obstruction and damage of prostate and other male accessory glands. Previous study has shown that acupuncture could improve sperm parameter in men with genital tract inflammation.
What is ICSI?
ICSI stands for intracytoplasmic sperm injection. This procedure can be used in male factor infertility with low concentration of sperm, low sperm motility and low sperm morphology. This procedure involves that individual sperm is picked up manually and injected into the inner part of the egg. The egg is obtained through the same egg retrieval procedure as IVF. This usually results in normal fertilization in about 75-85% of eggs injected with sperm of course depending on the clinics.
Do you know acupuncture can help increase sperm counts and improve sperm motility in men with varicocele?
Acupuncture may help male fertility by lowering scrotal temperature, reducing inflammation, improving circulation and improving sperm maturation.
Tremellen K Hum Reprod Update (2008) 14:243-58
Kantartzi PD et al Hippokratia. (2007)11: 99–104.
Ausmees K et al World J Urol (2013) 31:1411-25
Siterman S et al Asian J Androl (2009) 11:200-8
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