Acupuncture & Sperm Research [Archives]
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ACUPUNCTURE AND SPERM; The effectiveness and safety of acupuncture for poor semen quality in infertile males: a systematic review and meta-analysis
Ui Min Jernget al, Asian J Androl. 2014 Nov-Dec; 16(6): 884–891
Asian Journal of Andrology
This review looks at a selected number of RCTs that examined the effect of acupuncture on sperm motility and count, but not morphology. From the 4 trials they examined, they report that motility and sperm concentration were significantly increased in the acupuncture groups (The authors felt the different trial designs were heterogeneous, and the number of trials analysed too small to draw firm conclusions at this stage).
Abstract
The aim of this review is to evaluate the effectiveness and safety of acupuncture for poor semen quality in infertile men. We searched for relevant trials registered up to May 2013 in 14 databases. We selected randomized controlled trials (RCTs) that compared acupuncture, with or without additional treatment, against placebo, sham, no treatment, or the same additional treatment. Two reviewers independently performed the study selection, data extraction, risk of bias and reporting quality appraisal. Risk of bias and reporting quality were appraised by the Cochrane risk of bias tool, the consolidated standards of reporting trials and Standards for Reporting Interventions in Clinical Trials of Acupuncture. The outcomes were sperm motility, sperm concentration, pregnancy rate, and adverse events. Pregnancy was defined as a positive pregnancy test. Four RCTs met the eligibility criteria. Acupuncture increased the percentage of sperm with rapid progression (mean difference – 6.35, 95% confidence interval (CI): 4.38–8.32, P< 0.00001) and sperm concentration (mean difference – 6.42, 95% CI: 4.91–7.92, P< 0.00001), but these two outcomes were substantially heterogeneous among the studies (I2 = 72% and 58%, respectively). No differences in pregnancy rate were found between acupuncture and control groups (odds ratio 1.60, 95% CI: 0.70–3.69, P= 0.27, I2 = 0%). No participants experienced adverse events. The current evidence showing that acupuncture might improve poor semen quality is insufficient because of the small number of studies, inadequacy of procedures and/or insufficient information for semen analysis, high levels of heterogeneity, high risk of bias, and poor quality of reporting. Further large, well-designed RCTs are required.
Randomised clinical trial of comparing effects of acupuncture and varicocelectomy on sperm parameters in infertile varicocele patients
Kucuk EV et al, Andrologia. 2016 Jan 21. doi: 10.1111/and.12541. [Epub ahead of print]
Andrologia
A study comparing surgical versus acupuncture treatment of men who were infertile due to varicoceles in the testes, found both methods were successful in improving sperm parameters although acupuncture was superior to surgery. The acupuncture was performed twice a week for 2 months.
Abstract
The aim of the study was to evaluate the effect of the acupuncture treatment on sperm parameters and pregnancy rates in patients with primary infertility. Between January 2008 and May 2010, 30 men with the primary infertility (one year of unprotected intercourse, healthy wife) and varicocele with normal hormone levels and abnormal semen analysis were randomised into two groups. Group 1 underwent subinguinal microscopic varicocelectomy, and Group 2 underwent acupuncture treatment twice a week for 2 months. Both groups were evaluated with semen analysis at 6 months after the treatment. Patients in both groups evaluated with telephone calls and e-mail in terms of pregnancy. The mean age of the patients was 27.2, and groups were comparable regarding the age (P = 0.542). The pre-treatment sperm concentration, motility and morphological characteristics were similar in both groups. Sperm concentration and motility improved significantly in both groups after the treatment. Increase in sperm concentration was higher in the acupuncture group compared to the varicocelectomy group (P = 0.039). The average follow-up was 42 months, and pregnancy rates were emphasised 33% in both groups. Acupuncture treatment in primary infertile varicocele patients with semen abnormalities seems to be effective and has comparable results with the varicocelectomy treatment.
Effect of acupuncture-moxibustion therapy on sperm quality in infertility patients with sperm abnormality
Chen A et al, Jnl Acup Tuina Sci 2011 Vol 9, Number 4, 219-222
Journal of Acupuncture and Tuina Science
This study in China sought to elucidate the mechanism whereby acupuncture improves sperm quality. The team found that levels of an important enzyme in the semen increased, as did the sperm motility after acupuncture.
Abstract
Objective: Working on seminal plasma acid phosphatase, to explore the mechanism by which acupuncture improves sperm quality (concentration, viability and motility) in infertility patients.
Methods: A total of 118 patients received acupuncture-moxibustion treatment. Before and 3, and 6 months after the treatment were detected their seminal plasma acid phosphatase, sperm concentration, sperm viability and sperm motility were measured.
Results: The differences between before and after treatments in sperm motility and seminal plasma acid phosphatase levels were statistically significant (P<0.01).
Conclusion: Acupuncture-moxibustion can improve seminal plasma acid phosphatase levels in infertility patients.
Acupuncture Helps Lower Scrotum Temperature, Increase Sperm Count
Siterman S. et al
Asian J Androl. 2009 Mar;11(2):200-8. Epub 2009 Jan 5. Siterman S, Eltes F, Schechter L, Maimon Y, Lederman H, Bartoov B.[1] 1Maccabi Fund Complementary Medicine, Kaufman Street, Tel Aviv 68012, Israel [2] 2Refuot-Integrative Medical Centre, Ramat Aviv Gimel, Tel Aviv 69123, Israel.
Conclusion: Men that manifest higher scrotal temperatures due to genital tract inflammation or poor lifestyle habits can benefit from the scrotal temperature lowering effects of acupuncture.
Poor spermatogenesis in patients with inflammation of the genital tract is associated with scrotal hyperthermia. These patients can benefit from acupuncture treatment. We conducted a study to verify whether the influence of acupuncture treatment on sperm output in patients with low sperm density is associated with a decrease in scrotal temperature. The experimental group included 39 men who were referred for acupuncture owing to low sperm output. The control group, which comprised 18 normal fertile men, was used to define a threshold (30.5 degrees C) above which scrotal skin temperature was considered to be high. Accordingly, 34 of the 39 participants in the experimental group initially had high scrotal skin temperature; the other five had normal values. Scrotal skin temperature and sperm concentration were measured before and after acupuncture treatment. The five patients with initially normal scrotal temperatures were not affected by the acupuncture treatment. Following treatment, 17 of the 34 patients with hyperthermia, all of whom had genital tract inflammation, had normal scrotal skin temperature; in 15 of these 17 patients, sperm count was increased. In the remaining 17 men with scrotal hyperthermia, neither scrotal skin temperature nor sperm concentration was affected by the treatment. About 90% of the latter patients suffered from high gonadotropins or mixed etiological factors. Low sperm count in patients with inflammation of the genital tract seems to be associated with scrotal hyperthermia, and, consequently, acupuncture treatment is recommended for these men.Asian Journal of Andrology (2009) 11: 200-208. doi: 10.1038/aja.2008.4; published online 5 January 2009.
A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia
Dieterle et al Fertil Steril 2009 Oct; 92 (4): 1340–3 Fertility and Sterility
Conclusions: After receiving acupuncture twice weekly for 6 weeks motility of sperm (but not overall count) was found to increase significantly.
This recent small clinical trial randomised 57 patients who had extremely low sperm counts, to acupuncture and placebo acupuncture groups. The authors conclude that the results of the present study support the significance of acupuncture in male patients with severe oligoasthenozoospermia. More evidence with larger trials needs to be accumulated before the efficacy and effectiveness of acupuncture in male infertility can be evaluated.
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.
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
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.
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.
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 analysis 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.
Effects of the combined therapy of acupuncture with herbal medicine on male immune infertility--a clinical report of 50 cases
Fu B, Lun X, Gong Y. – J Tradit Chin Med. 2005 Sep;25(3):186-9. – Department of Acupuncture, Second Guangdong Provincial Worker’s Hospital, Guangzhou 510720, China.
Conclusion: The combined therapy of acupuncture with herbal drugs has definite therapeutic effects on male immune infertility, which can regulate AsAb and raise the immunity of the patients. To study the clinical effects of the combined therapy of acupuncture with herbal medicine on male immune infertility and on antisperm antibody (AsAb), 100 male cases of infertility with positive AsAb were divided randomly into two groups, each consisting of 50 cases. The control group was treated with oral prednisone. The clinical therapeutic effects and the impact on AsAb were observed in the two groups. The results showed that the total effective rate in the acupuncture-herb group was 90%; while that of the control group was 64%, the comparison showing a statistically significant difference (P<0.05).
Point- and frequency-specific response of the testicular artery to abdominal electroacupuncture in humans
Cakmak Y et al, Fertil Steril 2008;90:1732–8 Fertility and Sterility
Conclusion(s): For the first time point- and frequency-specific effects of abdominal EA on TBF are shown in humans.
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 electroacupuncture can improve sperm manufacture in this instance.
Objective: To clarify the role of the abdominal acupuncture points and the frequency of short-term electroacupuncture (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.
Further investigation is required to ascertain whether these findings may be helpful in the clinical treatment of infertile men.
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
Conclusions: 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.
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) ie 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.
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.
Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality
Siterman S et al Arch Androl. 1997 Sep-Oct;39(2):155-61 Archives of Andrology
Conclusion: patients exhibiting a low fertility potential due to reduced sperm activity may benefit from acupuncture treatment.
A group of infertile men with abnormal semen analysis were randomly divided into 2 groups; one group was given 10 acupuncture treatments over 5 weeks, and the other group, no treatment. Significant improvements (p < 0.05) were demonstrated in the acupuncture group compared to the control group, in particular improved motility and morphology.
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 ultramorphological observations.
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).
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
Conclusions: Acupuncture can improve sperm quality and fertilization rates in assisted reproductive technology. The fertilization rates after acupuncture (66.2%) were significantly higher than that before treatment (40.2%) (P < 0.01).
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).
The clinical effects of acupuncture on idiopathic male infertility in sperm parameter and on therapeutic results in assisted reproductive technology were investigated. 22 patients failed in intracytoplasmic sperm injection (ICSI) with idiopathic male infertility were treated with acupuncture twice weekly for 8 weeks, followed by ICSI treatment again. The sperm concentration, motility, morphology, fertilization rates and embryo quality were observed. Quick sperm motility after acupuncture (18.3% +/- 9.6%) was significantly improved as compared with that before treatment (11.0% +/- 7.5%, P < 0.01). The normal sperm ratio was increased after acupuncture (21.1% +/- 10.4% vs 16.2% +/- 8.2%, P < 0.05). The fertilization rates after acupuncture (66.2%) were obviously higher than that before treatment (40.2%, P < 0.01). There was no significant difference in sperm concentration and general sperm motility between before and after acupuncture. The embryo quality after acupuncture was improved, but the difference between them was not significant (P > 0.05).
More patient friendly summary…
Influence of acupuncture on idiopathic male infertility in assisted reproductive technology. – Zhang M et al
Conclusions: Acupuncture can improve sperm quality and fertilization rates in assisted reproductive technology. The fertilization rates after acupuncture (66.2%) were significantly higher than that before treatment (40.2%) (P < 0.01).
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 whose 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.
*Zhang M et al J Huazhong Univ Sci Tech Med Sci.2002;22(3):228-30 Journal of Huazhong University
Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality – Siterman S et al
Conclusion: patients exhibiting a low fertility potential due to reduced sperm activity may benefit from acupuncture treatment.
Prospective controlled study. A group of infertile men with abnormal semen analysis were randomly divided into 2 groups; one group was given 10 acupuncture treatments over 5 weeks, and the other group, no treatment. Significant improvements (p < 0.05) were demonstrated in the acupuncture group compared to the control group, in particular improved motility and morphology.
*Siterman S et al Arch Androl. 1997 Sep-Oct;39(2):155-61 Archives of Andrology
Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study – Siterman S et al
Conclusions: 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, especially those with a history of genital tract inflammation.
A course of 10 acupuncture treatments (p < 0.01) produced enough sperm for ICSI to be performed without recourse to testicular biopsy. 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). The control group with similar semen analysis had no treatment and showed no change after 3 months.
*Siterman S et al Andrologia. 2000 Jan;32(1):31-9. Andrologia
Point- and frequency-specific response of the testicular artery to abdominal electroacupuncture in humans – Cakmak Y et al
Conclusion(s): For the first time point- and frequency-specific effects of abdominal EA on TBF are shown in humans.
Just as electro-acupuncture can increase blood flow to the ovaries and uterus (see reports above) so it can to the testicles. Decreased testicular arterial blood flow associated with varicoceles and aging may result in impaired spermatogenesis from defective metabolism in the microcirculatory bed.
*Cakmak Y et al, Fertil Steril 2008;90:1732–8 Fertility and Sterility
A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia – Dieterle et al
Conclusions: After receiving acupuncture twice weekly for 6 weeks motility of sperm was found to increase significantly.
In this first prospective, randomized, single-blind, placebo-controlled study, patients with severe oligoasthenozoospermia received acupuncture according to the principles of traditional Chinese medicine (TCM) and control infertile patients received placebo acupuncture. A significantly higher percentage of motile sperm (World Health Organization categories A–C) was found after acupuncture compared with placebo acupuncture.
*Dieterle et al Fertil Steril 2009 Oct; 92 (4): 1340–3 Fertility and Sterility
Effects of acupuncture and moxa treatment in patients with semen abnormalities – Gurfinkel E et al
Conclusion: The Chinese Traditional Medicine acupuncture and moxa techniques significantly increase the percentage of normal-form sperm in infertile patients with oligoastenoteratozoospermia without apparent cause.
In this prospective, controlled and blind study, a group of infertile men were randomized into two groups, the treatment group receiving 10 acupuncture treatments and the control group receiving sham acupuncture treatments. The patients of the acupuncture 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).
*Gurfinkel E et al Asian J Androl. 2003 Dec;5(4):345-8. Asian Journal of Andrology
Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility – Pei J et al
CONCLUSION(S): 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.
Prospective controlled study of men with idiopathic oligospermia, asthenospermia, or teratozoospermia. 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 improvement was detected in acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibers of sperm organelles.
*Pei J et al Fertil Steril. 2005 Jul;84(1):141-7 Fertility and Sterility
Acupuncture Helps Lower Scrotum Temperature, Increase Sperm Count – Siterman S. et al
Conclusion: men that manifest higher scrotal temperatures due to genital tract inflammation or poor lifestyle habits can benefit from the scrotal temperature lowering effects of acupuncture.
Poor spermatogenesis in patients with inflammation of the genital tract is associated with scrotal hyperthermia. Scrotal skin temperature and sperm concentration were measured before and after acupuncture treatment. The five patients with initially normal scrotal temperatures were not affected by the acupuncture treatment. Following treatment, all of whom had genital tract inflammation, had normal scrotal skin temperature; in 88% of these patients, sperm count was increased.
*Asian J Androl. 2009 Mar;11(2):200-8. Epub 2009 Jan 5. Siterman S, et al.
Effects of the combined therapy of acupuncture with herbal medicine on male immune infertility – Fu B. et al
CONCLUSION: The combined therapy of acupuncture with herbal drugs has definite therapeutic effects on male immune infertility, which can regulate AsAb and raise the immunity of the patients.
To study the clinical effects of the combined therapy of acupuncture with herbal medicine on male immune infertility and on antisperm antibody (AsAb), Cases of infertility with positive AsAb were divided randomly into two groups. The control group was treated with oral prednisone. The clinical therapeutic effects and the impact on AsAb were observed in the two groups. The results showed that the total effective rate in the acupuncture-herb group showed a statistically significant difference in the reduction of AsAb (P<0.05).
*Fu B, Lun X, Gong Y. – J Tradit Chin Med. 2005 Sep;25(3):186-9.
