If you and your spouse have been actively but unsuccessfully trying for a child, please know that you are definitely not alone. According to the World Health Organization (WHO), infertility will be the third most serious health condition after cancer and cardiovascular diseases plaguing humanity in the 21st century. About 40 per cent of married Singaporean couples who are actively trying for a baby are “not happy” with their progress, according to a recent survey on fertility health released in July 2019.
While women traditionally bore the stigma of infertility and childlessness, the man’s role in infertility issues is gaining awareness. Recent statistics show that married couples experiencing infertility are due to problems arising from the male partner.1 While there is a lack of nationwide data regarding male reproductive health, doctors say rising male infertility rates here mirror the global phenomenon of declining sperm quality in the last 40 years.
How is infertility defined?
Infertility is defined as a failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.
(1): Semen analysis report
The first step to understanding male infertility involves making sense of the semen analysis report. According to the 5th edition of the WHO laboratory manual for the examination and processing of human semen, a normal semen sample should fulfil the parameters below:
(2): Understand the root cause issues from a TCM perspective
Male infertility can be due to many factors ranging from congenital factors, dietary habits, emotional extremes, external pathogenic factors, external injuries and maltreatment among various others. However, not every male exposed to the same external factors results in infertility. This can be attributed to the health of the individual’s Kidneys. With this understanding, modern eminent TCM andrologists like Professor Xu Fu Song (徐福松) and Wang Qi (王琦) have successfully treated numerous patients for many decades by combining continual research in TCM and use of scientific advances in semen analysis and endocrine testing.
TCM believes that the Kidneys govern the pre-natal essence or Jing (精) in the human body. This pre-natal essence is what determines the quality of our reproductive ability to carry on the family line. Having said that, the quality of the Kidney essence depends largely on the surplus Qi (气) which our other organs produce.
TCM handles male infertility by understanding if there are excess or deficiencies in the body. Tonifying deficiency and removing excess is a fundamental technique used to restore balance and harmony to the body. The semen analysis content is first divided into classifications of excess or deficiency. For example, when there is a diminished sperm concentration, it could signify a deficiency in the body resulting in Kidney deficiency. When the percentage of sperm with normal morphology is low, it usually signifies that there is an excess in pathogenic factors that have to be cleared in order to restore balance to the body.
Other than the semen analysis, the sexual function of the male is also assessed as different symptoms of erectile dysfunction or premature ejaculation could provide clues as to which organs are not functioning optimally. Examples like erectile dysfunction during stressful periods is a signal of Liver Qi stagnation whereas premature ejaculation combined with frequent sweating alludes to Lung Qi deficiency.
Types of TCM treatments that can help with male fertility
TCM physicians will go through with you your body condition, daily habits and so on to gain a better understanding about the root causes of the imbalances in your body.
For example, if the root cause is due to spleen deficiency and dampness, physicians may prescribe Bai Zhu, Fu Ling and Yi Yi Ren to tonify the Spleen and remove dampness. If the issues are more related to Kidney Yin deficiency, the physicians may use Gou qi zi, Shu Di Huang, Shan Zhu Yu to replenish Kidney Yin. As for damp-heat, Tu Fu Ling, Bi Xie and Che Qian Zi to clear heat and drain dampness.
For infertility patients, common herbs that are prescribed to help boost the quality of sperm include Gou Qi Zi, Tu Si Zi, Wu Wei Zi, Fu Pen Zi and Che Qian Zi. These 5 herbs combine to form a decoction called Wu Zi Yan Zong Wan, the premier fertility decoction of ancient and modern times. However, the components of each infertility patient’s medication would differ based on the root cause(s) and deficiencies they may have.
Acupuncture uses very fine needles into specific points along the meridians to correct the imbalances of the various organs.
In one study regarding acupuncture and abnormal semen parameters, acupuncture was used to stimulate 4 points on the body namely, BL23 (Shen Shu), ST36 (Zu San Li), CV1 (Hui Yin) and CV4 (Guan Yuan). A placebo control group together with a blank control group were included in the study. The researchers found that the patients who underwent the acupuncture treatment with electro-stimulation at 2Hz reported a significant improvement in sperm count and motility compared with the 2 control groups.
- Alcohol must be totally removed from the diet. Mitochondria are the “batteries” of the sperm (and all cells in general) and since alcohol is a mitochondrial toxin, without proper functioning mitochondria, the sperm would be unable to propel itself forward as it would lack the proper “batteries” to do so.
- Nicotine from smoking constricts the peripheral vessels thereby limiting blood flow into the organs. Over time, this can result in loss of flexibility and elasticity of the vessels, and thus impair the proper functioning of the testes as both blood flow in and out is affected.
- Exposure to excess heat should also be limited to a minimum as spermatogenesis (production of sperm) is a temperature-sensitive process. Lifestyle modification includes avoidance of sauna and steam-baths as well as any tight-fitting clothes and undergarments. The temperature of the testes should ideally be 2 degrees celsius below body temperature.
- A proper diet of fresh food eaten at regular time intervals is also greatly beneficial. Fresh produce contains fewer preservatives compared to canned or preserved food, thus lowering the toxicity load on our liver. Certain medications can affect spermatogenesis, so do clarify with your doctor to ascertain that the medication you are on does not decrease your fertility.
- Lastly, find ways to relax and stay positive. Trying for a child can be a tiring process, lowering stress will help both you and your partner achieve a more robust and passionate relationship together and increase the chances of a natural pregnancy.
Article by Physician Lim Jing Yang
Physician Lim clinched the prestigious China Government Scholarship to pursue a 3-year Master’s course in BUCM. His exposure to the wards and outpatient clinics in Dongzhimen Hospital, granted him vast knowledge of integrative approaches used in China, both in TCM and western medicine.
Physician Lim’s utmost passion is to help patients in their male sexual function, fertility and health. He is also knowledgeable about female menstrual issues and fertility due to the strong working connections he has with his colleagues in the gynecology department in Dongzhimen Hospital. We look forward to helping more parents conceive happy babies with Physician’s Lim expertise.
Place of Practice: Oriental Remedies Group