The rising issue of male infertility
There is increasing awareness and concern about the global decline in sperm quality. Traditional Chinese Medicine (TCM) can offer much to combat this worrying trend.
Troublingly, a whole gamut of reproductive problems in men is increasing. This includes declining sperm counts, decreasing testosterone levels, increasing rates of erectile dysfunction and testicular cancer. In a recent review of global trends in sperm count, Levine et al (2023) found that sperm counts have fallen on average by 1.2% per year between 1973 to 2018. From the year 2000, this rate of decline sped up to more than 2.6% per year.
It is thought that Per- and Polyfluoroalkyl Substances (PFAS), also called ‘forever chemicals’, found in plastics, fire retardants and common household items are behind this decline. Although some of these chemicals have been banned in many countries, they persist in the environment for decades or longer. PFAS are found in water, soil and living organisms. They have even been found in human breast milk. A recent study detected PFAS contamination in American women’s breast milk in all 50 samples tested, and at levels nearly 2,000 times higher than is thought to be safe (Zheng et al 2021).
Studies have proved that these chemicals can disrupt our hormones, reduce sperm motility and cause an increase in DNA fragmentation (Summer et al 2019).
It is also thought that this decline in sperm health may be due to epigenetic changes, which is around how genes work, caused by environmental or lifestyle factors (Rotondo et al 2021). There is also evidence that these epigenetic changes can be inherited across generations (Kaneshiro et al 2022).
In Australia, male factor contributes to infertility in around 50% of couples who are not able to conceive (Katz, Shoshany & Teloken 2017). We also know that sperm health impacts the risk of miscarriage. In a study investigating the sperm quality of 50 men whose partners had suffered three or more consecutive miscarriages, it was found that the sperm of those involved in the study had higher levels of DNA damage, when compared to men whose partners had not experienced miscarriages (Jayasena et al 2019).
In TCM, we our approach in supporting male fertility is to strengthen Kidneys, replenish Jing, tonify and invigorate Blood and Qi. We also look at addressing any pathogenic factors that may be present, such as Damp-Heat.
A small study found that Chinese herbs can reduce aneuploidy (incorrect chromosomal make-up) in sperm (Tempest, Homa & Zhai 2005). It is thought that the antioxidants contained in Chinese herbs help improve the integrity of DNA and sperm manufacture. However, more high-quality research is needed to prove what TCM doctors have known for thousands of years.
A male’s body is constantly manufacturing sperm, but sperm do not regenerate immediately. On average, it takes around 74 days (2.5 months) to produce new sperm. Therefore, we recommend three months of regular TCM treatments to improve sperm quality. This includes acupuncture and/or Chinese herbs.
When a heterosexual couple is experiencing challenges in becoming pregnant, the focus can often be on the female. However, fertility is a shared journey. The research behind declining sperm quality shows that our men need support too.
References
Jayasena, C.N., Radia, U.K., Figueiredo, M., Revill, L.F., Dimakopoulou, A., Osagie, M., Vessey, W., Regan, L., Rai, R., Dhillo, W.S., 2019, Reduced Testicular Steroidogenesis and Increased Semen Oxidative Stress in Male Partners as Novel Markers of Recurrent Miscarriage, Clinical Chemistry, vol. 65, no. 1.
Kaneshiro, K.R., Egelhofer, T.A., Rechtsteiner, A., Strome, D., 2022, Sperm-inherited H3K27me3 epialleles are transmitted transgenerationally in cis, Developmental Biology, vol. 119, no. 40.
Levine, H., Jorgensen, N., Martino-Andrade, A., Mendiola, J., Weksler-Derri, D., Jolles, M., Pinotti, R., Swan, S.H., 2023, Temporal trends in sperm count: a systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries, Human Reproduction Update, vol. 29, no. 2.
Rotondo, J.C., Lanzillotti, L., Mazziotta, C., Tognon, M., Martini, F., 2021, Epigenetics of Male Infertility: The Role of DNA Methylation, Frontiers in Cell and Developmental Biology, vol. 9.
Summer, R.N., Tomlinson, M., Craigon, J., England, G.C.W., Lea, R.E., 2019, Independent and combined effects of diethylhexyl phthalate and polychlorinated biphenyl 153 on sperm quality in the human and dog, Scientific Reports, vol. 9.
Zheng, G., Schreder, E., Dempsey, J.C., Uding, N., Chu, V., Andres, G., Sathyanarayana, S., Salamova, A., 2021, Per- and Polyfluoroalkyl Substances (PFAS) in Breast Milk: Concerning Trends for Current-Use PFAS, Ecotoxicology and Public Health, vol. 55, no. 11.