Male infertility doesn’t make many headlines, so you may be surprised to learn that when a couple struggles to conceive, it’s almost as likely to be due to male fertility problems as to female infertility. Fortunately, most male infertility cases respond to treatment of the underlying issue, or to fertility treatments. The fact is that, when these treatments are ineffective, a couple may turn to a sperm donor to have their own child, or to adoption.
How Common Is Male Infertility?
As many as 10% to 15% of couples who are trying for a baby will fail to conceive after one year of unprotected intercourse. Of these :
- 30% to 40% will be due to fertility issues in the female partner.
- Approximately 20% will be due to fertility issues in only the man.
- 30% to 40% will discover fertility problems in both partners.
- About 10% will have unexplained infertility, where a cause cannot be found in either partner.
When the man has fertility problems, in 10% to 15% of cases, this will be Azoospermia or a complete lack of sperm. Azoospermia affects about 1% of the general population. In the remainder, subfertility issues relating to low sperm count or low motility of sperm may respond to treatment. If you have been trying for a baby for over a year without success, both partners should be checked for fertility problems.
Causes Of Subfertility
From the western medicine point of view
- The most common cause of subfertility in males is a varicocele. These result from abnormal dilation of the veins inside the testes, preventing drainage of blood and resulting in blood pooling in the scrotum. This results in a high intrascrotal temperature, which can interfere with sperm morphology (the size and shape of sperm) causing misshapen sperm unable to swim to or penetrate the egg, or to a low sperm count.
- Infections such as urinary tract infections or prostatitis can affect the sperm count and cause low motility in sperm, and cause white blood cells to be present in the semen, all of which contribute to subfertility.
- Male accessory gland (prostate gland & seminal vesicles) disorders or infections can interfere with liquefaction. When this happens, the semen is thick and sticky, as it remains coagulated and so sperm is not released after ejaculation properly.
- Other causes of male subfertility include smoking, exposure to chemicals or immune system abnormalities, which can interfere with the production of sperm, and systemic disorders such as diabetes or hypertension that can lead to erectile dysfunctions.
From the Chinese medicine point of view
- Excess Heat
Subfertility symptoms include low sperm quantity and high abnormal sperm forms. Other symptoms include high blood pressure, irritability, insomnia and flushed complexion. Causes include drinking too much alcohol, eating too many spicy foods, smoking or high caffeine intake, as well as prolonged periods of stress or emotional instability.
- Yin or Essence Deficiency
Subfertility symptoms include low sperm count and low sperm volume. Other symptoms include night sweats, prematurely greying hair, dry eyes, and lower back pain. Causes include ‘burning the candle at both ends,’ inadequate nutrition, acute or chronic illness, long-term emotional instability or stress. Excess heat left untreated can cause yin deficiency as the essence ‘dries up.’
- Stagnant Qi
Subfertility symptoms include a high abnormal form count. Other symptoms include headaches and tight or stiff muscles that are relieved after exercise, and a tendency to anger or irritability. Causes include stress, overwork, lack of exercise, depression, and an inability to vent or regulate anger or frustration in a healthy manner.
- Yang Deficiency
Subfertility symptoms include reduced motility and low sperm count. Other symptoms include lower back pain, fatigue, poor circulation leading to feeling cold and a pale complexion. Causes include overwork, chronic illness, inadequate nutrition, prolonged exposure to cold and a tendency toward depression.
Treatments of Subfertility
With western medicine
Western medicine offers little hope when dealing with male infertility. Little can be done to improve sperm quality and quantity, and treatment is often unsuccessful. Subfertile men may be prescribed a 3-4 month course of clomiphene citrate, which can improve the quantity of sperm, though it doesn’t seem to improve sperm morphology or motility, and there have been no studies to date suggesting improved fertility after treatment. The Introduction of ICSI (Intracytoplasmic Sperm Injection) to IVF procedures has more or less resolved the issue of poor sperm quality in IVF treatment. However, there have been suggestions that there may be a higher incidence of birth defects when ICSI uses subprime sperm.
With acupuncture and Chinese herbal medicine
Unlike Western medicine, Chinese medicine takes a holistic approach to patient health, which can offer an obvious improvement in sperm quantity and quality like liquefaction, motility, and morphology. It can treat infertility problems like retrograde ejaculation, anti-sperm antibodies, and varicoceles very well. Studies have shown that both acupuncture and herbal medicines can affect hormonal changes and improve testicular blood flow, promoting healthy sperm growth. Some herbs improve liquefaction rates by stimulating the secretion of important enzymes into the prostatic fluid. In Chinese medicine, fertility for both males and females depends on strong kidney energy, with the majority of infertility cases diagnosed as Kidney Yin or Yang Deficiency. In any case, since sperm can take 3 months to form, a course of treatment should be prolonged for several months for the best effect. As with female infertility, the practitioner will devise a natural healthcare program of acupuncture, herbal medicine, and nutrition. This is designed to improve the patient’s overall health and treat underlying issues as well as improve the quality and quantity of sperm.
Herbal remedies will underpin the treatment, as they are effective in replenishing kidney energy. Acupuncture is also beneficial, especially when timed to coincide with your partner’s ovulation, as at least one study has suggested acupuncture treatment at this time greatly enhances the sperm’s activity.