Study Shows Acupuncture Treatment May Help Male Infertility Problems

Acupuncture may help some men overcome infertility problems by improving the quality of their sperm, according to a new study.

photo via pinterest.com

Researchers found that acupuncture treatment reduced the number of structural abnormalities in sperm and increased the overall number of normal sperm in a group of men with infertility problems.
They say the results suggest that acupuncture may complement traditional infertility treatments and help men reach their full reproductive potential.

photo via pinterest.com

Acupuncture May Ease Male Infertility
The male partner is a factor in up to 50% of infertile couples, write the researchers. In many cases, the cause of male infertility is unknown.
Previous studies of acupuncture and male infertility have suggested that acupuncture can improve sperm production and motility and count.
In this study, researchers looked at the effects of acupuncture on the structural health of sperm in men with infertility of unknown cause. The findings appear in the July issue of Fertility and Sterility.
Twenty-eight infertile men received acupuncture treatments twice a week for five weeks, and 12 received no treatment and served as a comparison group.
Researchers analyzed sperm samples at the beginning and end of the study and found significant improvements in sperm quality in the acupuncture group compared with the other group.
Acupuncture treatment was associated with fewer structural defects in the sperm and an increase in the number of normal sperm in ejaculate.
But other sperm abnormalities, such as immature sperm or sperm death, were unaffected by acupuncture.
The researchers write that acupuncture treatment is a simple, noninvasive method that can improve sperm quality.


SOURCE: Pei, J. Fertility and Sterility, July 2005; vol 84: pp 141-147.

The Sperm Chromatin Structure Assay (SCSA) and DNA Fragmentation: What Is It and What Does It Mean?

This article from a Resolve 2006 newsletter written by Dr. Werthman

Until several years ago the belief among most reproductive specialists was that if a man had live sperm then they were suitable for use with IVF / ICSI and if the female partner didn’t get pregnant or a miscarriage ensued then it was probably an egg quality issue. Several studies had implied that the conventional sperm parameters (count, motility and morphology) as measured on a routine semen analysis had no bearing on success when ICSI was used. Many couples pursued egg donation after failed IVF attempts because the husband’s semen parameters were relatively normal and yet conception hadn’t occurred. Some of these same couples were still unable to conceive even with the “better quality” donor eggs leaving both the doctors and the couples frustrated and perplexed. Some couples then went on to use both egg donors and surrogates thinking it was both an egg quality and implantation issue, again without success. The only commonality was the husband’s sperm.

About a year and a half ago a relatively new concept was introduced to clinical practice; sperm quality was dependent on the amount of damage to the sperm DNA or DNA fragmentation. Simply put, DNA is arranged in a double helix or ladder configuration with side rails and rungs. If the rungs are broken, then the ladder is unsteady and won’t function properly. What has recently been shown in several studies is very interesting and in some ways unexpected. Sperm DNA fragmentation has little or nothing to do with the parameters that we measure on the routine semen analysis. It has little to do with the shape of the sperm or whether the sperm are moving. It is a completely independent variable. Men with otherwise normal semen analyses can have a high degree of DNA damage and men with what was called very poor sperm quality can have very little DNA damage. More importantly what has also been demonstrated is that the degree of DNA fragmentation correlates very highly with the inability of the sperm to initiate a birth regardless of the technology used to fertilize the egg such as insemination, IVF or ICSI. Sperm with high DNA fragmentation may fertilize an egg and embryo development stops before implantation or may even initiate a pregnancy but there is a significantly higher likelihood that it will result in miscarriage. By testing for sperm DNA fragmentation, many cases of formally “unexplained” infertility can now be explained. Many of those couples who have been previously unable to conceive with what would be considered extreme measures have been diagnosed with high sperm DNA fragmentation and treated. It is now very clear to see that having this information about the quality of the sperm can be tremendously helpful to couples and their physicians.

There are several ways to test for sperm DNA fragmentation; the most widely used and statistically robust test is called the Sperm Chromatin Structure Assay or SCSA. The patient semen samples are frozen and shipped in a liquid nitrogen container to the SCSA reference laboratory in South Dakota. The sperm are thawed out and a stress is applied (low pH). The sperm are then labeled with a special orange colored dye that only attaches to the ends of broken DNA within the sperm cell. If the DNA is intact then no dye will attach to the sperm. A machine called a flow cytometer is used to analyze ten thousand sperm from the sample. The sperm are passed single file by a beam of light that hits the dye inside the sperm cell and reflects light at a specific wavelength causing the sperm to appear either orange (damaged) or green (normal). A computer counts the percentage of green versus orange-labeled sperm and software allows for creation of a graphic plot of the percent of damaged sperm giving an index known as the DNA fragmentation Index (DFI).

The data from thousands of patients has been analyzed and correlated with the patient’s clinical outcomes and references ranges were compiled. A normal sample has less then 15% of the sperm with DNA damage. Men with poor fertility potential have greater then 30% of their sperm damaged. A DFI Between 16% and 29% is considered good to fair fertility potential but becomes poorer as it approaches 27%. These numbers are thresholds meaning that above 30% the outcome for most couples was failure to have a birth even though only 30+ percent of the sperm were damaged. Under 15% most couples achieved success. The logical questions that arose were: what about the rest of the undamaged sperm in the sample? Why don’t those sperm work? What causes sperm DNA fragmentation? Can the DNA fragmentation be reduced and the sperm improved? If so, How?

DNA fragmentation can be thought of as a marker for other types of damage to the sperm. It is a kin to seeing the tip of the iceberg. Apparently, in semen samples with greater then 30% DNA fragmentation, other abnormalities are occurring with the non-fragmented sperm that the SCSA doesn’t measure and that is why samples used with DFIs above this level do not usually result in births.

The causes of high DNA fragmentation are those same causes of male factor infertility that we have known about for years such as chemical/toxin exposure, heat exposure, varicocele, infection, age, smoking, testicular cancer, radiation, and anything that increases the free radical levels in the semen among a list of many other things. It is very important to understand that sperm DNA fragmentation can change with time and it can be improved in many cases. The goal of a male factor evaluation is to seek out the causes of poor sperm quality and try to correct them so conception can occur naturally or to improve the sperm quality for IVF and maximize the chances of success. In situations where DFI can’t be improved there is evidence to suggest that removing the sperm directly from the testicle via biopsy and using it with ICSI may lead to better outcomes then using poor quality ejaculated sperm. Other options include counseling patients regarding the use of donor sperm either by insemination or fertilizing a portion of the eggs harvested for ICSI with donor sperm and a portion with the patient’s sperm, once again to maximize odds.

The clinical utility of the SCSA is readily apparent. All men with an abnormal semen analysis are candidates for this test as well as men with normal semen analyses who have failed IVF for unexplained reasons. Those couples using egg donors or surrogates may also benefit from screening prior to going thru the procedures because the effort and costs are so great. Men with poor DFI should have a male factor evaluation including a physical examination by a male reproductive specialist. These new concepts have a significant implication on how we practice and what we recommend to couples but we must bear in mind that this test does not have a predictive values of 100% as healthy babies have been born from men with high DFI but this is fairly uncommon.

There are herbal medicine formulas which are exceedingly high in antioxidant properties. At The Berkley Center for Reproductive Wellness we have had great success in treating this disorder.

Study Shows Acupuncture Treatment May Help Male Infertility Problems

Acupuncture may help some men overcome infertility problems by improving the quality of their sperm, according to a new study.

Researchers found that acupuncture treatment reduced the number of structural abnormalities in sperm and increased the overall number of normal sperm in a group of men with infertility problems.

They say the results suggest that acupuncture may complement traditional infertility treatments and help men reach their full reproductive potential.

Acupuncture May Ease Male Infertility

The male partner is a factor in up to 50% of infertile couples, write the researchers. In many cases, the cause of male infertility is unknown.

Previous studies of acupuncture and male infertility have suggested that acupuncture can improve sperm production and motility and count.

In this study, researchers looked at the effects of acupuncture on the structural health of sperm in men with infertility of unknown cause. The findings appear in the July issue of Fertility and Sterility.

Twenty-eight infertile men received acupuncture treatments twice a week for five weeks, and 12 received no treatment and served as a comparison group.

Researchers analyzed sperm samples at the beginning and end of the study and found significant improvements in sperm quality in the acupuncture group compared with the other group.

Acupuncture treatment was associated with fewer structural defects in the sperm and an increase in the number of normal sperm in ejaculate.

But other sperm abnormalities, such as immature sperm or sperm death, were unaffected by acupuncture.

The researchers write that acupuncture treatment is a simple, noninvasive method that can improve sperm quality.

SOURCE: Pei, J. Fertility and Sterility, July 2005; vol 84: pp 141-147.

Male Contribution to Viable Embryo

Centriole definition: a structure found in the cell cytoplasm (cytoplasm: all of the contents outside of the nucleus and enclosed within the cell membrane of a cell) that plays a role in embryo development.


Sperm centrioles were traced from fertilization to the hatching blastocyst stage. The sperm centriole is introduced into the egg at fertilization. As the male and female aspects of the developing embryo (called pro nuclei) fuse (called syngamy) to become a shared environment of both male and female DNA, centrioles play a pivotal role in cell division (cleavage) of the embryo.

This division, when the embryo goes from a single cell organism to a two cell organism to a four cell organism to an eight cell organism to a sixteen cell organism is called mitosis or cleavage. Sperm centrioles were detected at all stages of embryonic cleavage from the 1-cell through 8-cell stages, right up to the hatching blastocyst stage.

It is evident that the sperm centrosome ( formed from centrioles and having to do with cell division) is the functional active centrosome in humans, while the female is inactive.

Did you know? Embryos having 7-9 cells on day 3 have an increased chance of developing to the blastocyst stage. A blastocyst is a 5 day embryo and is considered to be of significant quality. Embryos with <7 cells or >9 cells are less likely to make it to the blastocyst stage.

My question is this: if a woman consistently produces 4 or 6 cell embryos during a stimulated IVF cycle is it not possible that the male partner’s sperm has some ultra structural defect whereupon centriole quality is subfunctional?

Since we know that the male contribution of healthy centrioles is necessary to facilitate cleavage of embryos to the blastocyst stage, it is my ardent recommendation that male partners of all women who are trying to conceive should also be treated with acupuncture and herbs. Even when the male partner presents within the normal range for volume, count, morphology and motility, centriole health cannot be easily determined.

Case: A female patient has 15 eggs retrieved during an IVF cycle; 10 fertilize, and 7 survive. She has 7, day 3 embryos ranging in size from 6 to 10 cells with zero fragmentation and a healthy10mm endometrial lining. The reproductive endocrinologist transfers three of these beautiful embryos and the cycle fails. Why? We do not know for sure: it could be that the embryos were chromosomally abnormal. This can be due to chromosomally abnormal eggs or sperm. It can also be due to the fact that the male centriole health and function were not optimal. This may be considered a ‘hidden’ cause of infertility.

The use of acupuncture and certain herbal medicines can vigorously stimulate blood flow to the testicles carrying oxygen and nutrients, as well as hormones from the brain, as well as electrolytes, while simultaneously carrying debris or dead cells away from the testicles. This increased delivery of the ‘good’ and increased excretion of the ‘bad’ may improve ultra structural properties of the sperm including centriole quality and function and thereby improve embryo quality and help facilitate cleavage to the blastocyst stage and thereby potentiate take home baby rates.

Summary: It is my opinion, based on clinical experience, that both partners should be treated with acupuncture and herbal medicine when wishing to start or grow a family and is having difficulty doing so.

[1] Alikani M, Caulderon G, Tomkin G, et al. Cleavage anomalies in early human embryos for transfer after in vitro fertilization. Human Reprod 1997; 12(7): 1545-1549

Male Infertility

The integrity of sperm DNA is essential for the transmission of the father’s gene contribution.

Tests which show an increased fraction of sperm DNA fragmentation often correlates to other sperm pathologies such as poor motility, count and morphology. Most reproductive endocrinology clinics do not test for sperm DNA fragmentation even when the patient presents with poor sperm parameters.

As in all areas of medicine, there is internecine battling going on between physicians as to the meaning and the effect of sperm DNA fragmentation on male fertility.

Some doctors completely disagree with its relevancy as a contributor to male infertility; some physicians accept its contribution but don’t know what to do with the findings; others think that the only real detriment to the quality of sperm rendered by DNA fragmentation is the sperms inability to penetrate the egg and they think that injecting the sperm into the egg (ICSI) effectively deals with the problem. It does not.

Sperm DNA fragmentation has a far reaching effect on fertility and surpasses the mere diminished ability of sperm to penetrate egg.

Some studies show that with higher percentages of sperm DNA fragmentation, there are increased correlations in spontaneous abortions. The proportion of patients with abnormal sperm DNA integrity is higher in couples with spontaneous miscarriage. This is not surprising as a good embryo is nothing other than the combination of a good egg with a good sperm and sperm with DNA fragmentation is not good sperm.

In sperm without DNA fragmentation the DNA is protected from damage while being transported through both the male and female reproductive tracts; if there is damage to the DNA then impaired fertility is an obvious consequence.

Causes of DNA fragmentation are many and varied ranging from genetic anomalies to reactive oxygen species due to white blood cell (leukocyte) infiltration), as well as vericoceles.

As DNA repair systems are less active in the later stages of sperm production, sperm with fragmented DNA can readily reach the ejaculate.

Men that have sperm DNA fragmentation greater than 30% are typically infertile.

Treatment options
Antioxidant therapy

Antioxidants ‘scavenge’ reactive oxygen species and can, in some instances, reduce sperm DNA fragmentation percentages. A n anti oxidant compound which has been shown to be effective in some instances is composed of lycopene 6mg, vitamin E 400IU, vitamin C 100mg, zinc 25mg, selenium 26 mg, folate .5 mg and garlic (available in pill form)1000 mg. This should be taken once daily.

Acupuncture and Herbs

Acupuncture with its ability to stimulate blood which transports oxygen and nutrients to the testes, while carrying debris away from the testes may also be an effective treatment.

Many herbal medicines also have high antioxidant properties and should be included in the treatment regimen.

Combining antioxidant therapy as described above with acupuncture and herbal medicine can potentially reduce sperm DNA fragmentation and increase fertility outcomes in men with high percentages of DNA fragmentation.

Smoking cigarettes and marijuana have been shown to contribute to sperm DNA fragmentation. Elimination of these mitigators may also reduce sperm DNA fragmentation percentages.

Mike Berkley, L.Ac.

The Male Contribution to Viable Embryos

Centriole definition: a structure found in the cell cytoplasm (cytoplasm: all of the contents outside of the nucleus and enclosed within the cell membrane of a cell) that plays a role in embryo development.

Sperm centrioles were traced from fertilization to the hatching blastocyst stage. The sperm centriole is introduced into the egg at fertilization.

As the male and female aspects of the developing embryo (called pro nuclei) fuse (called syngamy) to become a shared environment of both male and female DNA, centrioles play a pivotal role in cell division (cleavage) of the embryo.

This division, when the embryo goes from a single cell organism to a two cell organism to a four cell organism to an eight cell organism to a sixteen cell organism is called mitosis or cleavage.

Sperm centrioles were detected at all stages of embryonic cleavage from the 1-cell through 8-cell stages, right up to the hatching blastocyst stage.

It is evident that the sperm centrosome ( formed from centrioles and having to do with cell division) is the functional active centrosome in humans, while the female is inactive.

Did you know? Embryos having 7-9 cells on day 3 have an increased chance of developing to the blastocyst stage. A blastocyst is a 5 day embryo and is considered to be of significant quality.

Embryos with <7 cells or >9 cells are less likely to make it to the blastocyst stage.1

My question is this: if a woman consistently produces 4 or 6 cell embryos during a stimulated IVF cycle is it not possible that the male partner’s sperm has some ultra structural defect whereupon centriole quality is subfunctional?

Since we know that the male contribution of healthy centrioles is necessary to facilitate cleavage of embryos to the blastocyst stage, it is my ardent recommendation that male partners of all women who are trying to conceive should also be treated with acupuncture and herbs.

Even when the male partner presents within the normal range for volume, count, morphology and motility, centriole health cannot be easily determined.

Case: A female patient has 15 eggs retrieved during an IVF cycle; 10 fertilize, and 7 survive. She has 7, day 3 embryos ranging in size from 6 to 10 cells with zero fragmentation and a healthy10mm endometrial lining. The reproductive endocrinologist transfers three of these beautiful embryos and the cycle fails.

Why? We do not know for sure: it could be that the embryos were chromosomally abnormal. This can be due to chromosomally abnormal eggs or sperm. It can also be due to the fact that the male centriole health and function were not optimal. This may be considered a ‘hidden’ cause of infertility.

The use of acupuncture and certain herbal medicines can vigorously stimulate blood flow to the testicles carrying oxygen and nutrients, as well as hormones from the brain, as well as electrolytes, while simultaneously carrying debris or dead cells away from the testicles.

This increased delivery of the ‘good’ and increased excretion of the ‘bad’ may improve ultra structural properties of the sperm including centriole quality and function and thereby improve embryo quality and help facilitate cleavage to the blastocyst stage and thereby potentiate take home baby rates.

Summary: It is my opinion, based on clinical experience, that both partners should be treated with acupuncture and herbal medicine when wishing to start or grow a family and is having difficulty doing so.


1. Alikani M, Caulderon G, Tomkin G, et al. Cleavage anomalies in early human embryos for transfer after in vitro fertilization. Human Reprod 1997; 12(7): 1545-1549

Study Shows Alternative Treatment May Help Male Infertility Problems

Aug. 3, 2005 -- Acupuncture may help some men overcome infertility problems by improving the quality of their sperm, according to a new study.

Researchers found five weeks of acupuncture treatment reduced the number of structural abnormalities in sperm and increased the overall number of normal sperm in a group of men with infertility problems.

They say the results suggest that acupuncture may complement traditional infertility treatments and help men reach their full reproductive potential.

Acupuncture May Ease Male Infertility

An estimated 10% of men are infertile, and the male partner is a factor in up to 50% of infertile couples, write the researchers. In many cases, the cause of male infertility is unknown.

Previous studies of acupuncture and male infertility have suggested that acupuncture can improve sperm production and motility (a measure of sperm movement).

In this study, researchers looked at the effects of acupuncture on the structural health of sperm in men with infertility of unknown cause. The findings appear in the July issue of Fertility and Sterility.

Twenty-eight infertile men received acupuncture treatments twice a week for five weeks, and 12 received no treatment and served as a comparison group.

Researchers analyzed sperm samples at the beginning and end of the study and found significant improvements in sperm quality in the acupuncture group compared with the other group.

Acupuncture treatment was associated with fewer structural defects in the sperm and an increase in the number of normal sperm in ejaculate.

But other sperm abnormalities, such as immature sperm or sperm death, were unaffected by acupuncture.

The researchers write that acupuncture treatment is a simple, noninvasive method that can improve sperm quality.


________________________________________

SOURCE: Pei, J. Fertility and Sterility, July 2005; vol 84: pp 141-147.