MALE FACTORS Fertility Enhancement Program II Presented by Advanced Acupuncture, Inc.
Male Reproductive Organs • Testes (gonads): • Sperm (exocrine) • Testosterone (endocrine) • Ducts • Glands
Testes • Size: 4 cm X 2.5 cm • Connective tissue capsule • Tunica albuginea • Seminferous tubules • Rete testis • Duct system • Epididymis • Interstitial cells-produces androgens & testosterone.
Male organs- Duct System • Transport sperm from the body: • Epididymis • Ductus deferens • Urethra
Male organs- Ductus Deferences • Enclosed tube along with blood vessels & nerves in sperm cord • Propel live sperm into urethra by peristaltic waves rapidly squeeze the sperm forward • Scrotal Sac • Vasectomy- cauterizing the vas deferens. Sperm is still produced but no longer reach the outside • Sterile- testosterone still produced and libido remained.
Male Organs- Epididymis • Highly coiled tube 6M • Caps superior of testes • 1st part of male duct • Storage site of immature sperm • Mature in 20 days • Ability to swim • Walls of epididymis contract to expel the sperm to ductus deference
Male Organs- Urethra • 3 main regions • Prostate Urethra • Membranous urethra • Spongy urethra • Carry urine and sperm to exterior • Ejaculation
Male Organs-Scrotum • Providing the testes with a temperature that is below body temp. • Cold->scrotum wrinkled ->testes closer to the body to maintain viable sperm production
Male Organs- Penis • To deliver sperm into the female reproductive tract • Circumcision- surgically removed after birth • 3 enlarged eretile tissue • Erection-blood flow
Testosterone Production • Produced by interstitial cells • Stimulated by LH • Testosterone stimulate the male reproductive organs develop & 2nd male characteristics • Lack of the testosterone will result in sexual infantilism & sterility.
Good Sperm Formation • Sperm takes 100 days to develop (70/30) • 3 main factors: • Sperm count: > 20 million/ml/ejaculate • Morphology (shape of the sperm) • Motility (How fast and straight the sperm swim)
Getting Tested • Urologist evaluation • Sperm analysis 2-3 Tx • Defect factors: • Azoospermia • Oligiospermia • Sperm motility decreases • Sperm morphology abnormalities
Male Infertility Assessment • Sperm count < 10million/ml ( 200 million) • Volume < 5 ml per ejaculate • Sperm motility < 60 % • Sperm Morphology < 50 % normal
Normal Sperm Analysis • Volume= 3 ml (2-6ml) • Concentration=20M/ml • Motility: 50 %> 2 hrs • Morphology: 60 % • Viscosity • Ejaculate normally liquefies < 1hr • pH= 7-8
Sperm abnormalities • Adequate • Aspermia • Azoospermia • Oligospermia • Poor motility & forward movement • High percent of abnormal sperm morphology • Antisperm antibodies
Infertility isn’t just the woman’s problem anymore • 40-50 % male infertility • Inadequate # of sperm • Inhibited ejaculation • Retrograde ejaculation • Failure of descend into the scrotum • Antibodies to the sperm
Diagnosis of Male infertility • Medical History • Physical Examination-structure • Secondary sex characteristics evaluation • Endocrine function test • Sperm analysis- 2-3 x
Radiation Environment toxins Undescended testis Varicocele Traumatic injury Infectious injury Testicular atrophy Drug effects Alcohol, nicotine, marijuana, cocaine Prolonged fever Endocrine disorders Congenital abnormalities Surgery of the lower abdominal region Tight underwear Stress, lack of sleep Causes of Male Infertility
Male Factors of infertility • Spermophlebectasia • Sperm dysfunction • Sexually transmitted disease • Physical damage • Genetic disease • Auto immune disease • Genetic disease
Spermophlebectasia varicose vein of the spermatic cord • Increases blood in the vein of the spermatic cord increases temp. in testicle decrease live sperm count and activity • Prolonged presence of the varicosity can result in poor blood circulation to the area & shrinkage/or dysfunction of the testicle unable to produce healthy sperm
Male age 20-30 Chief complain-pain Heaviness of scrotum Pain at testicles, groin and lower abdomen Standing and walking aggravates. Resting in supine position alleviates Signs: Scrotum enlarged and loose Vein is enlarged and purple Varicose veins are also present in the groin and inner thigh Press vein, it shrinks or disappears Symptoms of Spermophlebectasia
Acupuncture Acupuncture can stimulate histamine release to dilate the blood vessels to improve the blood circulation, thus reduces varicose veins in the region Herbal Formula Individualized formulas based on the etiology to improve blood circulation, resolve blockage, and promote healthy sperm TCM treatment for spermphelebectasia
Eating Healthily Taking Vitamins Drinking more water Copping Stress Staying active Enjoying regular sex Sleeping enough Liver Detox Weekly acupuncture Stop smoking Cut down alcohol Avoid drug intake Minimize caffeine Making Good Sperm
Chinese Medicine Improves semen morphology,motility, & count • Randomized clinical trial in Sydney, 2004 • Acupuncture and herbal medicine • Improve sperm normal form: p<0.038 • Improve semen motility: p<0.008 • Improve count: mean increase 220 million sperm
Normal Sperm • Head- C
Acupuncture Treatment • Acupuncture can stimulate histamine release to dilate the blood vessels to improve the blood circulation, thus reduces varicose veins in the region • Most commonly selected points are located on the back and leg areas. • Frequency at 1-2 tx/wk or based individualized treatment plan
Acupuncture in the treatment of Psychogenic Erectile Dysfunction • Randomized placebo-controlled pilots study, Austria, 2003 • 22 patients, satisfactory response =68.4% • Acupuncture can be effective option >2/3 of PED
Herbal Formulas • Classic Herbal formulas • Individualized herbal decoctions • Raw herbs • Concentrated granules
# 23 Men’s treasure Main ingredients: Ginseng, Deer horn, Sea horse, Hokuo, Epimedii, Angelica, Cinnamomi, Poria cocos Used for low sperm count, low motolity and morphology # 27 Men’s Power Main ingredients: Eucommiae, Epimedii, Achyrabthis,Cistanches, Cynomorii, Cuscutae. Used for impotency, low libido and early ejaculation Classic Herbal Formulas
High temperature ( best at 32 degrees C) Stress( testes malnourished) Alcohol( interferes of testosterone secretion) Smoking(40 % sperm damage by free radicals) Environmental Estrogen (meat, microwave plastics) Drugs ( reduces testosterone & libido) Caffeine (impair sperm production & cause chromosomal abnormalities) Toxins (pesticides, heavy metals) Pollutants Things to avoid
Friendly Advises • Diagnosed with infertility-behavior change • Low sperm count-less intercourse frequency • Abnormal hormones-balances • Take folic acid and zinc • Stress – acupuncture, meditation, yoga • Low sperm motilities- herbal formula • No sperm in semen-retrieve from the testicles. ( success rate is 65 %)
Macho Sperm Theory • Damaged sperm may still fertilize an egg. • Some toxins may alter the sperm’s chromosomes which carry genetic information • Results infertility and miscarriage to birth defects, learning disabilities and childhood cancer and kidney cancer
Intracytoplasmic sperm injectionICSI • For low sperm count & male infertility • Sperm & eggs are retrieved • Inject 1 sperm into an egg • Fertilized egg is then implanted