In the recent years, the quality of semen has systematically been deteriorating. Due to the limited opportunities to obtain efficient aid within healthcare system, patients often search for alternative and complementary forms of therapy. Acupuncture is one of them. Unlike many other methods, acupuncture has been more and more acceptable for medical practitioners as the method which can be subject to evaluation. Whilst the present status of research over the efficiency and mechanisms of acupuncture in treatment of semen production disorders may be described as preliminary due to the few patients under treatment, the results of experiments already completed  are encouraging, there are also researches in the field of basic sciences, providing first indications concerning mechanisms of the influence of acupuncture on the parametres of male semen quality.

STRENGTH OF EVIDENCE
Power of arguments
Semen production disorders - effectiveness

In 2003, the results of the experiment carried out by Brasilian researchers, who applied acupuncture and moxibustion on acupoints using Arthemisium Moxae in patients with attention deficit disorders, disorders of mobility and/or morphology of sperm (source)1In comparison with the control group (in which the acupuncture and moxibustion was applied as well but different acupoints were used), the distinctive percentage increase of normal sperm cells in samples was achieved in the examined group. The research involved merely 19 patients so the findings must be regarded as preliminary.

Doctor Stefan Dieterle, with co-authors, in 2009 published the article describing their research of acupuncture impact on semen quality parametres in men with oligoasthenozoospermia (source)2In comparison with the control groups, in which the non-penetrating placebo needles were used, the distinctive improvement of sperm cells mobility was achieved in all categories. However, the improvement of sperm concentration or volume was not reported.

Also in 2009 the team of Israeli researchers published the paper on the effectiveness of acupuncture in patients with inflammation in the area of genitals (source)3

9 subjects qualified for this trial who volunteered for acupuncture treatment due to infertility.  The acupuncture was applied in conformity with the diagnoses made  according to Traditional Chinese Medicine (TCM). Half of 34 patients, who initially had higher scrotal temperature, noted the distinctive lowering of temperature. All the patients who experienced improvement had suffered from inflammatory diseases of the genital organs area. In 88% patients the improvement of semen parametres was noted. The authors conclude that the patients suffering from the inflammatory diseases of genital organs, including higher scrotal temperature, may benefit from acupuncture with lowering temperature and improvement of semen parameters. What is more, they suggest that longer therapy could also have impact on the condition of those patients with etiologically complex infertility problems, and higher scrotal temperature was more common than in the group in which the beneficial effects were observed.

Semen paramiters improvement

Wpływ akupunktury na jakość nasienia u mężczyzn z chorobami zapalnymi w obrębie narządów płciowych.

Semen production disorder - mechanisms

Acupuncture causes lowering of scrotal temperature in men suffering from inflammatory diseases of reproductive system. This effect is correlated with the improvement of their semen quality. Most probable mechanism includes the correction of blood flow in testicular artery, improved thermal exchange, decrease of local metabolism, lower oxygen demand,  cessation of peroxidation process and -as a result- increased semen production (source)4.

In 2005 another interesting article was published (source)5 describing the impact of acupuncture on sperm cell structure.  As a result of treatments the following aspects improved:

:

Normal location of acrosome
Przed akupunkturą 70%
Po akupunkturze 78%

Wzrost o 12%

Normal shape of acrosome
Przed akupunkturą 22%
Po akupunkturze 38%

72% growth

Normal nuclear shape
Przed akupunkturą 30%
Po akupunkturze 43%

42% growth

Normal accessory fibres
Przed akupunkturą 34%
Po akupunkturze 49%

44% growth

Normal fibrous sheath
Przed akupunkturą 33%
Po akupunkturze 41%

24% growth

Normal shape of axoneme
Przed akupunkturą 63%
Po akupunkturze 68%

6% growth

In concluding section the authors state that acupuncture is a minimally invasive technique improving the morphology of semen.

Blood flow in testicular artery is the next biological parametre correlated with male fertility, in connection with which the specificity of acupoints was proven. Doctor Yusuf Ozgur Cakmak, together with his team, demonstrated that the stimulation of acupoint ST-29, (which traditionally has been regarded as the point influencing fertility) using electroacupuncture, causes the increase of blood flow into testicular artery (sourceo)6This outcome was not achieved using the stimulation of ST-25 acupoint, traditionally related to digestion.

Chinese researchers suggested another experiment, checking on animal model how acupuncture influences spermatogenesis in rats, in which the semen production had been impaired with heat (source)7The outcome of acupuncture treatment was the equalization of B- inhibin level, which is linked with Sertoli cell’s functioning, and also the increase of proliferation of gametes, which means the acupuncture enhanced the spermatogenesis. On the basis of these findings, and also the available findings of basic sciences’ researches, the authors proposed the following neuroendocrinal mechanism of acupuncture actions:

Acupuncture increases the number of neurons secreting gonadoliberin (source)8 (GnRH). Most probably it induces the increased secretion of FSH, which- in turn- stimulates the production of follistatin and inhibin. As a result, the transformation of gonocytes into spermatogonia is enhanced, as well as the differentiation of spermatocytes into spermatids.

BIBLIOGRAPHY

1 Gurfinkel E et al. „Effects of acupuncture and moxa treatment in patients with semen abnormalities” Asian J Androl 2003 Dec; 5: 345-348

2 Stefan Dieterle et al. „A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia” Fertility and Sterility Vol. 92, No. 4, October 2009

3 Siterman S et al. „Success of acupuncture treatment in patients with initially low sperm output is associated with a decrease in scrotal skin temperature” Asian Journal of Andrology (2009) 11: 200–208.

4 Siterman S et al. „Success of acupuncture treatment in patients with initially low sperm output is associated with a decrease in scrotal skin temperature” Asian Journal of Andrology (2009) 11: 200–208.

5 Jian Pei et al. „Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility” Fertility and Sterility Vol. 84, No. 1, July 2005

6 Cakmak YO „Point- and frequency-specific response of the testicular artery to abdominal electroacupuncture in humans” Fertil Steril. 2008 Nov;90(5):1732-8

7 Jing Gao et al. „Electroacupuncture enhances spermatogenesis in rats after scrotal heat treatment” Spermatogenesis 2:1, 1–10; January/February/March 2012;

8 Lee SW, Liong ML, Yuen KH, Leong WS, Chee C, Cheah PY, Choong WP, Wu Y, Khan N, Choong WL, Yap HW, Krieger JN. Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. Am J Med . 2008;121:79.e1–e7

THE AUTHOR