Infertility in Men
Definition
Western
Generally, infertility is defined as not being able to conceive after inhabiting together for at least a year with unprotected sexual intercourse. Infertility is also further defined as not being able to conceive at all or not being able to conceive again after the first birth. Both the male and female play important roles in infertility, though in some cases, the cause remains unknown. Experiencing infertility can also bring on a range of painful emotions in one or both members of the couple.
Traditional Chinese Medicine (TCM)
In TCM, emotions play a crucial part in infertility in both men and women, especially to those medically unexplained cases. As the human body is a piece of holistic machinery, its physiological processes in the body are sometimes affected by the individual’s fluctuating emotions, such as chronic depression or low self-esteem. Even staying in different environment may decrease the chance of success in conceiving, e.g. stressful working environment, relationship burdens or even changes in the climate. These factors can impact on the loss of certain essential fluids in the body, as well as affecting the energy levels in which the body processes rely on to stay at their tiptop conditions.
Classifications in TCM Context
Relating to the Kidney System
Apart from the role in water metabolism, the Kidney system also plays an important role in human reproduction. It governs two vital issues, mainly the materialised essence (i.e. sperm, egg and suspended bodily fluids), and the energy required for the respective cells to grow and develop into motile sperm cells to facilitate fertilisation when a female egg becomes viable. Sperm quality can also be affected by other key factors, such as congenital or genetic disorders, malnutrition, environmental pollution and overexertion on sexual activities. Common symptoms displayed include poor sperm quality, low sperm count, infertile, occasional dizzy spells, declined memory, ringing in the ears, fatigue, experience frequent erectile dysfunction or premature ejaculation, sore lower back, weak knees, cold limbs and weak pulse.
Relating to the Liver System
The Liver system helps individuals cope with daily stress and keep it under control. When one overworks or constantly loses control of temper or emotions, the vital organs in the body will be thrown out of balance in attempt to cope with these unexpected changes. This, in turn, affects the production rate of the essential fluids in the body. TCM believes that these fluids are important in the development of healthy sperm cells as well as their ability to travel to the available egg, in order to induce fertilisation. Common symptoms displayed include infertile for years for unexplained reasons, uncontrolled penile erection, nocturnal ejaculation (also known as wet dreams), thick and sticky semen, unsettled sleep, dizzy spells, constantly feel nervous or experience palpitation, warm flushes especially in the late afternoon, constantly burning sensation in the palms and soles, irritated or get angry easily and fast pulse.
Relating to the Spleen System
This is usually brought upon by the types of food consumed and the way it is consumed. For instant, constant oily or spicy foods or excessive amount of alcohol consumed could add burden to the digestive system and this may affect the time duration of the food in the body to be absorbed effectively. Cold or raw foods also slow down the rate of digestion. Common symptoms displayed include infertile for years, declined volume of semen, low sperm count, erectile dysfunction, constant fatigue or general weakness, bloated abdomen, poor appetite, unsettled sleep, giddy spells, pale complexion, overweight, loose stools and weak pulse.
Causes & Risk Factors
Abnormalities in the Characteristics of Sperm
· Little or absence of healthy sperms in each male sexual discharge
· Altered or missing structures in the shape of the sperm cells
· Difficulties in forming mature sperm cells for fertilisation
· Congenialities or genetic abnormalities
· Emotional factors, such as depression or lack of self confidence
Disorders of the Male Reproductive Organs
· Sperm blocked from being released, due to infections or inflammations of the testes or epididymis
· Varicocele occurs when the veins in the scrotum are enlarged and may contribute to the cause for low sperm count or poor sperm quality
Environment or Lifestyle Factors
· Environmental pollutants
· Obesity or being overweight
· Heavy use of alcohol, cigarettes or recreational and prescription drugs such as marijuana, cocaine, cimetidine and nitrofurantoin
Treatments
Herbs commonly used in prescriptions:
1. Du Zhong – 杜仲
|
English/ Common name
|
Eucommia bark, Hardy rubber tree bark
|
|
Latin species
|
Eucommia ulmoides Oliv. [3-7]
|
|
Park of plant used
|
Bark
|
|
Action/s
|
Helps to boost functions of the Kidney and Liver systems, and strengthen development of bones and tendons. Research also found that Eucommia might also help in pregnant and hypertensive individuals.
|
|
Precaution/s
|
Those who keep regular late nights or working night shifts are to be consumed with caution.
|
2. Ying Yang Huo – 淫羊藿
|
English/ Common name
|
Epimedium, Rowdy Lamb Herb, Barrenwort, Bishop's Hat, Fairy Wings, Horny Goat Weed
|
|
Latin species
|
Epimedium brevicornum Maxim. [8-10]
E. sagittatum (S. et Z.)
E. pubescens Maxim.
|
|
Park of plant used
|
Whole organism
|
|
Action/s
|
Helps to boost libido (sex drive) and increase energy levels. Also generally used to treat weak bones.
|
|
Precaution/s
|
Those who keep regular late nights or working night shifts are not recommended to consume. Kindly consult your practitioner if intended for prolonged use.
|
3. Tu Si Zi – 菟丝子
|
English/ Common name
|
Cuscuta Seeds, Chinese Dodder Seeds
|
|
Latin species
|
Cuscuta Chinensis Lam. [19-20]
|
|
Park of plant used
|
Seeds
|
|
Action/s
|
Commonly used for lower back discomforts and weak knees, erectile dysfunction, premature ejaculation, infertility, diabetes, urinary incontinence, dizziness, ringing in the ears, pregnancy discomforts, miscarriages and chronic diarrhoea.
|
|
Precaution/s
|
Those who keep regular late nights or working night shifts, or suffering with chronic constipation or urinary tract infections are not recommended to consume.
|
4. Suo Yang – 锁阳
|
English/ Common name
|
Cynomorium
|
|
Latin species
|
Cynomorium songaricum Rupr. [11-12]
|
|
Park of plant used
|
Succulent stems
|
|
Action/s
|
Help individuals with erectile dysfunction and premature ejaculation, weak lower limbs and chronic constipation.
|
|
Precaution/s
|
Those who keep regular late nights or working night shifts, or suffering with chronic diarrhoea or acute constipation are not recommended to consume.
|
5. Huang Qi – 黄芪
|
English/ Common name
|
Chinese Astragalus
|
|
Latin species
|
Astragalus memeranaceus (Fisch.) Bge. var. mongholicus (Bge.) Hsiao or A. memeranaceus (Fisch.) Bge. [13-18]
|
|
Park of plant used
|
Roots
|
|
Action/s
|
Helps to boost immunity and aids digestion.
|
|
Precaution/s
|
No significant side effects. If unsure, consult a practitioner before consumption.
|
Test & Diagnosis [2]
Semen Analysis
Semen analysis is a test to measure the amount and quality of a man's semen and sperm. This test is also known as the sperm count test. Analysis of the following factors will be carried out accordingly:
- Fluid coagulation (thickening into a solid) and liquefaction
- Fluid thickness, acidity, and sugar content
- Resistance to flow (viscosity)
- Sperm movement or motility
- Number and structure of the sperm
- Volume of semen
Testicular Biopsy
Testicular biopsy is a surgical process to remove tissues from the testicles for microscopic examination. A small surgical cut is made through the skin, and a small piece of the testicle tissue is removed. If necessary, the procedure is repeated for the other testicle.
Home Remedies
Du Zhong + Lian Zi (lotus seeds) + Tu Si Zi + choice of red meat
a) Put all ingredients in a cooking pot and pour enough water to fill half the pot.
b) Bring to boil for 10 minutes.
c) Simmer for a further 40 minutes.
d) Remove from heat. Best serve warm.
e) Alternatively, grind the dried herbs into powder. Mix with a cup of hot water. Stir well and leave to sit for a minute. Serve warm.
Dietary Considerations
Diets rich in fresh fruits, vegetables and whole grains are recommended to maintain good health. Antioxidant vitamins, such as vitamin C and E, and the dietary supplements L-carnitine and L-acetylcarnitine are helpful, but there is no conclusive evidence to date that they are effective.
Other Lifestyle Changes
Avoid smoking or taking drugs that may affect sperm count or reduce sexual function. Overweight or obese men are often associated with infertility. Get sufficient rest and exercise regularly. Men should avoid hot baths or stay in steam rooms to prevent overheating of the testes.
Dealing with Stress
Stress may contribute to reduced sperm quality. Fertility treatment process presents a roller coaster of emotions. There are almost no sure ways to predict which couples will eventually conceive. Fertility treatments are expensive. A successful pregnancy often depends on repeated attempts. A pregnancy that results in a multiple birth introduces new complexities and emotional problems.
References
|
3. Deyama T, Nishibe S, Nakazawa Y. Constituents and pharmacological effects of Eucommia and Siberian ginseng. Acta Pharmacol Sin. (Dec 2001), 22(12): pp1057-70.
4. Yongqiang Zhou, Min Liang, Weize Li, Kai Li, Ping Li, Yuzhu Hu, Zhonglin Yang.Protective effects of Eucommia ulmoides Oliv. bark and leaf on amyloid β-induced cytotoxicity. Environmental Toxicology and Pharmacology (Nov 2009), 28(3): pp342-349.
5. Chiu-Yin Kwan, Wen-Bo Zhang, Takeshi Deyama and Sansei Nishibe. Endothelium-dependent vascular relaxation induced by Eucommia ulmoides Oliv. bark extract is mediated by NO and EDHF in small vessels. Naunyn-Schmiedeberg's Archives of Pharmacology 2004, 369(2): pp206-211.
6. Gow-Chin Yen, Chiu-Luan Hsieh. Reactive Oxygen Species Scavenging Activity of Du-zhong (Eucommia ulmoides Oliv.) and Its Active Compounds. J. Agric. Food Chem. 2000, 48 (8): pp3431–3436.
7. Victor YC Ong, Benny KH Tan. Novel phytoandrogens and lipidic augmenters from Eucommia ulmoides.BMC Complementary and Alternative Medicine2007, 7: pp3.
8. Kam Ming Ko, Hoi Yan Leung. Enhancement of ATP generation capacity, antioxidant activity and immunomodulatory activities by Chinese Yang and Yin tonifying herbs.Chinese Medicine 2007, 2: pp3.
9. J-H Chiu, K-K Chen, T-M Chien, W-F Chiou, C-C Chen, J-Y Wang, W-Y Lui and C-W Wu. Epimedium brevicornum Maxim extract relaxes rabbit corpus cavernosum through multitargets on nitric oxide/cyclic guanosine monophosphate signaling pathway. International Journal of Impotence Research 2006,18: pp335–342.
10. Zhang G, Wang X-L, Sheng H, Xie X-H, He Y-X, et al. Constitutional Flavonoids Derived from Epimedium Dose-Dependently Reduce Incidence of Steroid-Associated Osteonecrosis Not via Direct Action by Themselves on Potential Cellular Targets. PLoS ONE (2009),4(7): e6419.
11. H. A. Abd El-Rahman, A. A. El-Badry, O. M. Mahmoud, F. A. Harraz. The effect of the aqueous extract of Cynomorium coccineum on the epididymal sperm pattern of the rat. Phytotherapy Research (May 1999), 13(3): pp248–250.
12. Woong Mo Yang, Ha Young Kim, Soo Yeon Park, Hyung-Min Kim, Mun Seog Chang, Seong Kyu Park. Cynomorium songaricum induces spermatogenesis with glial cell-derived neurotrophic factor (GDNF) enhancement in rat testes. Journal of Ethnopharmacology (Apr 2010), 128(3): pp693-696.
14. Sun Hao and Wang Zhaobao. Effects on exercise endurance capacity and antioxidant properties of astragalus membranaceus polysaccharides (APS). Journal of Medicinal Plants Research (May 2010), 4(10):pp982-986.
16. Chen KT, Su CH, Hsin LH, et al. Reducing fatigue of athletes following oral administration of huangqi jianzhong tang. Acta Pharmacol Sin 2002 Aug;23(8):pp757-61.
17. Zi-Qing Hei, He-Qing Huang, Jing-Jun Zhang, Bing-Xue Chen, Xiao-Yun Li. Protective effect of Astragalus membranaceus on intestinal mucosa reperfusion injury after hemorrhagic shock in rats. World J Gastroenterol2005;11(32):pp4986-4991.
18. William Chi Shing Cho, Kwok Nam Leung. In vitro and in vivo immunomodulating and immunorestorative effects of Astragalus membranaceus. Journal of Ethnopharmacology (Aug 2007), 113(1):pp132-141.
19. Xingfeng Bao, Zhan Wang, Jinian Fang, Xiaoyu Li. Structural Features of an Immunostimulating and Antioxidant Acidic Polysaccharide from the Seeds of Cuscuta chinensis. Planta Med 2002; 68(3): 237-243.
20. Yen FL, Wu TH, Lin LT, Lin CC. Hepatoprotective and antioxidant effects of Cuscuta chinensis against acetaminophen-induced hepatotoxicity in rats. J Ethnopharmacol. 2007 Apr 20;111(1):123-8.
21. Xia Rong. Treating Infertility using TCM. 2005. Candid Creation Publishing LLP.
|