|Posted by Tanya on May 6, 2013 at 12:35 PM|
Unless a man asks, "Will this help? Will that help?" I know not how to help him.~ Confucius
Like women who feel a loss of identity and a sense of being less feminine when they cannot get pregnant, men can feel less virile and even ashamed if they can't father a child. Men are much better at hiding their feelings, but based on the joy you see in their eyes when fertility factors resolve and their partners become pregnant, leads one to believe that fertility is important to a man's self-worth.
In Canada, 15 percent of the population falls into the category of being unable to conceive. In these couples, male and female factors are equally accountable for that problem, and one in four couples has multiple factors contributing to their failure to conceive.
In men, infertility is defined as the inability to fertilize the ovum, whereas sterility is defined as the lack of sperm production.
Male fertility depends upon three things:
- adequate production of spermatozoa by the testes,
- unobstructed transit of sperm through the seminal tract, and
- satisfactory delivery to the ovum.
Diagnosing male infertility issues begins with a thorough medical history to see if there are any factors in the patient's past; followed by a physical exam, which the doctor looks for possible structural and/or congenital abnormalities that may cause obstruction of the seminal tract. After examing the genital area, the doctor usually conducts a general evaluation of secondary sex characteristics - breast size, amount of location of body hair, etc. Any results of the doctor's exam are usually confirmed with further tests, including a semen analysis, blood hormone levels, or radiographic exams to determine if there are any conditions that could prevent the sperm from being ejaculated.
Analysis of semen requires a sample of the ejaculate to be sent to a laboratory and analyzed for the following factors:
- deficient sperm count
- insufficient sperm motility
- poor sperm morphology
In 40 percent of cases of male infertility, sperm abnormalities are either a factor or the factor. In the last thirty-five years, sperm counts have dropped 50 percent. Environment influences such as radiation and other environmental toxins, undescended testis, trauma-induced or infectious testicular atrophy, drug effects, prolonged fever, and endocrine disorders affecting the hypothalamic-pituitary-gonadal axis. Low sperm counts can be aggrivated, if not caused, by factors such as tight-fitting underwear or hot baths, urogenital infections, poor diet, and prescription drugs (particular antihypertensives and anti-inflammatories). Even antihistamines, stress, lack of sleep, and overuse of nicotine, alcohol, and marijuana decrease sperm production.
In Western methods, male infertility factors are easier to diagnose than female infertility, but often harder to treat. In cases of mechanical obstruction, the only potential remedy is surgery. Microsurgical techniques have made it possible to repair obstructions and other issues within the narrow spaces of the vas deferens and the epididymis. Unfortunately, surgeries can worsen sperm counts because with every surgery there is a risk of scarring and adhesion formation.
In cases of poor sperm production or quality, some dietary and lifestyle changes can help. However, when it comes to hormonal abnormalities, Western medicine has little to offer, as supplementation with testosterone, FSH, LH, or other hormones rarely improves sperm production significantly. If a man has healthy sperm present, the doctor may recommend that he and his partner try either IUI or IVF.
The TCM View of Male Infertility
Some men are skeptical about treating their fertility with Chinese medicine.
From a Chinese perspective, the main causes of male infertility fall under two broad categories:
- deficiency of the Kidneys (Kidney Yin or Yang deficiency) or Spleen (Spleen Qi deficiency), or
- excess such as Qi stagnation, Blood stasis, or damp heat in the pelvic organs - usually superimposed upon or caused by Kidney deficiency.
Almost all aspects of male infertility can benefit from TCM treatment. Certainly, sperm production and quality can be increased, some mechanical blockages can be dissolved or reduced, and even hormonal factors can be resolved by restoring balance in the entire body.
Here are some general recommendations:
- To improve overall health: Take the antioxidant L-arginine and L-carnitine (see below)
- To improve morphology and decrese high levels of oxidants in the seminal fluid: Take antioxidants and superantioxidants like pycnogenol (125mg daily of either pine bark extract, red wine extract, grape seed extract, and bilberry extract).
- To increase sperm counts: Take Blood and Qi tonics and seeds like Lycium (Gou Qi Zi) and Cuscuta (Tu Si Zi).
- To improve testosterone levels: Take Qi tonics like ginseng (Ren Shen).
- To improve sperm motility: Tonify Qi and Yang. Take Cornus (Shan Zhu Yu).
- To improve liquefaction: Supplement Kidney Yin with asparagus root (Tian Men Dong), Ophiopogon (Mai Men Dong), or the formula Six Flavor Pill with Rehmannia (Liu Wei Di Huang Wan).
- To resolve varicoceles: Apply a cold pack to the scrotum twice per day and take a Blood-moving herbal formula like Cinnamon Twig and Poria Pill (Gui Zhi Fu Ling Wan).
Diet and Lifestyle Changes
- In many subfertile men, the seminal fluid may not contain protective elements such as fructose (which feeds the sperm), fibrinogen (which holds the fluid together), and prostaglandins (which help the sperm penetrate the cervix). Men with suboptimum sperm should include dietary sources of antioxidants like wheat and barley grass, sprouts, and dark-green vegetables.
- Adding unsaturated fatty acids like those found in sesame, almonds, flaxseed, hazelnuts, pecans, pumpkin seeds, sunflower seeds, pine nuts, walnuts, olives, avocados, soybeans, and quinoa as well as omega-3 fatty acids found in fish oil can improve sperm integrity.
- Eat only hormone-free meat, poultry, eggs, and dairy products, and drinking only purified water is suggested to eliminate excess synthetic estrogen, and produce healthy sperm.
- Men should consume organic fruits and vegetables whenever possible.
- Avoid saturated fats, hydrogenated oils, coconut, palm, and especially cottonseed oil (contains gossypol, a chemical inhibiting sperm formation). Include polyunsaturated vegetable oils and essential fatty acids like fish oil, flaxseed oil, and pumpkin-seed oil, as these contribute to healthy sperm and their production.
- Stay away from high-doses of soy concentrates, however, as too much estrogen from any source can be counterproductive. Soy, other legumes, nuts, and seeds also contain phytosterols that pomote testosterone production.
- Vitamin C: 2,000mg per day (divide dose)
- Vitamin E: 800 IU per day
- Beta-carotene: 100,000 IU per day
- Selenium 200 micrograms per day
- Zinc: 60 milligrams per day (for sperm and testosterone metabolism)
- Vitamin B12: 1,000mg per day (involved in replication of cells)
- L-arginine: 2 - 4 grams per day (promotes cellular replication)
- L-carnitine: 1,000 - 1,200mg per day (assists sperm motility)
- Keep scrotal temperatures between 94 and 96 degrees Fahrenheit by wearing loose underwear, avoiding hot baths, and applying daily cool packs (ice water in a plastic bag, wrapped in a thin towel, applied for ten to twenty minutes).
Acupuncture has been shown to help balance the hormonal system and restore higher levels of virility in men. A study conducted by the College of Acupuncture and Moxibustion at the Shanghai University of Traditional Chinese Medicine in China reported on thirty-five cases of infertility caused by sperm abnormalities and treated only with low frequency electroacupuncture. The men showed improvement in their symptoms of low back aching, frequent urination, and emission. Activity and quantity of sperm and semen quality also improved, as did spermatogenic environment. Equally, sex hormones (FSH, LH, estrogen, testosterone) normalized.
Chinese Herbal Treatment
As stated above, most cases of male infertility involve some element of Kidney deficiency (Kidney Yin or Yang), which can be treated effectively with Chinese herbs. A study at the Institute of Acupuncture and Meridians, Anhui College of TCM, Hefei, China, reported that eighty-seven cases of male infertility with semen abnormalities were treated with the herbal formula Kidney Qi Pill from Formulas to Aid the Living (Ji Sheng Shen Qi Qan). Semen analysis after treatment showed sperm parameters improved in eighty-three of the eighty-seven cases, or over 95 percent of the time. By the end of the study, forty-nine of the men's wives were pregnant.
When TCM is Not the Cure
Congenital absence of sperm, a condition known as azoospermia, has no known cure, and TCM treatments are not effective in resolving this condition. However, a lack of sperm production caused by extreme stress does respond to the TCM principles of pattern identification and treatment with lifestyle changes, acupuncture, and herbs.
Perhaps the greatest lesson from our struggle to bear children is to find peace inside ourselves no matter what. I do know that finding a place of peace is the best gift we can receive. Those we love come, and yes, they go. Some don't come at all. But no matter what, we are whole and at peace. May you find that place of peace within yourself. May you find happiness. And may that happiness be unconditional.