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Wang S, Lu R, Shi H, Chen J, Sun M, Ding J, Lv Q, Wang C, Ren J, Zhou G, Tang Z. Safety and efficacy of acupuncture for varicocele-induced male infertility: a systematic review protocol. BMJ Open 2022; 12:e063381. [PMID: 36456023 PMCID: PMC9716984 DOI: 10.1136/bmjopen-2022-063381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Varicocele (VC) is a common clinical disease in andrology. Among a number of ways for VC treatment, surgery is the most common one, but the measurable benefit of surgical repair was slight. A growing exploration of complementary therapies has been conducted in clinical research on acupuncture for VC, but there is no relevant systematic review and meta-analysis to assess the efficacy and safety of acupuncture for VC. METHODS AND ANALYSIS All relevant publications published from database inception through August 2022 will be searched in three English-language databases (Embase, CENTRAL, MEDLINE) and four Chinese-language databases (China National Knowledge Infrastructure, China Science and Technology Journal Database, Chinese Biomedical Literature Database and Wanfang Data). Randomised controlled trials in English and Chinese concerned with acupuncture for patients with VC will be included. The input clinical data will be processed by the Review Manager software (RevMan). The literature will be appraised with the Cochrane Collaboration risk of bias tool. The Grading of Recommendations Assessment, Development and Evaluation system (GRADE system) will be used to evaluate the quality of evidence. ETHICS AND DISSEMINATION This study is a secondary study based on clinical studies so it does not relate to any individual patient information or infringe the rights of participants. Hence no ethical approval is required. The results will be reported in peer-reviewed journals or disseminated at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42022316005.
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Affiliation(s)
- Sijia Wang
- Department of Traditional Chinese Medicine, Yixing People's Hospital, Yixing, Jiangsu, China
| | - Rongchen Lu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Hongshuo Shi
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jiangnan Chen
- Department of Traditional Chinese Medicine, Yixing People's Hospital, Yixing, Jiangsu, China
| | - Miaomiao Sun
- Department of Traditional Chinese Medicine, Yixing People's Hospital, Yixing, Jiangsu, China
| | - Jing Ding
- Department of Traditional Chinese Medicine, Yixing People's Hospital, Yixing, Jiangsu, China
| | - Qiang Lv
- Department of Traditional Chinese Medicine, Yixing People's Hospital, Yixing, Jiangsu, China
| | - Chenyao Wang
- Department of Traditional Chinese Medicine, Yixing People's Hospital, Yixing, Jiangsu, China
| | - Jianjun Ren
- Department of Traditional Chinese Medicine, Yixing People's Hospital, Yixing, Jiangsu, China
| | - Guangming Zhou
- Department of Traditional Chinese Medicine, Yixing People's Hospital, Yixing, Jiangsu, China
| | - Zhian Tang
- Department of Traditional Chinese Medicine, Yixing People's Hospital, Yixing, Jiangsu, China
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Feng J, He H, Wang Y, Zhang X, Zhang X, Zhang T, Zhu M, Wu X, Zhang Y. The efficacy and mechanism of acupuncture in the treatment of male infertility: A literature review. Front Endocrinol (Lausanne) 2022; 13:1009537. [PMID: 36329891 PMCID: PMC9624472 DOI: 10.3389/fendo.2022.1009537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/21/2022] [Indexed: 11/23/2022] Open
Abstract
Fertility, a social, cultural, and medical issue, has aroused public attention because of its potential to predict future health. In recent years, the incidence of male infertility has increased significantly, and various risk factors, such as congenital factors, acquired factors, and idiopathic factors, have led to this situation. Male infertility causes substantial psychological and social distress in patients. With the implementation of the two-child policy, male infertility has brought enormous psychological and social pressure and huge economic burden to patients and the healthcare system. This has attracted the attention of not only men of childbearing age but also many male experts. The conventional therapeutic approaches for treating male infertility, including drugs, varicocele surgery, intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection, can restore fertility to a certain extent, but their efficacy is far from satisfactory, not to mention some adverse events. Therefore, acupuncture has been chosen by many men to treat their infertility and produced significant effects. In the present paper, the efficacy and mechanism of acupuncture in the treatment of male infertility were analyzed from different perspectives such as regulating hormone secretion, reducing inflammation, and improving semen parameters. The existing literature shows that acupuncture can effectively treat male infertility.
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Affiliation(s)
- Jiaxing Feng
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Hui He
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yu Wang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xu Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiuying Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Tiantian Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Mengyi Zhu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiaoke Wu
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
- Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, China
| | - Yuehui Zhang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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Jia W, Wang C, Yin Y. Acupuncture for oligospermia and asthenozoospermia: A systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e27816. [PMID: 35049183 PMCID: PMC9191280 DOI: 10.1097/md.0000000000027816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 10/29/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Acupuncture is widely used for oligospermia and asthenozoospermia in China, but its effect is unclear. We aimed to determine the effectiveness and safety of acupuncture in treating oligospermia and asthenozoospermia. METHODS An electronic search for randomized controlled trials evaluating acupuncture treatment in patients with oligospermia and asthenozoospermia published from database inception to October 2018 was conducted in PubMed, EMBASE, the Chinese Biomedical Literature Database, the Chinese Scientific Journal Database (VIP Database), the Wan-Fang Database, the China National Knowledge Infrastructure and the Cochrane Library. We established search terms related to 3 areas (oligospermia, asthenozoospermia, and acupuncture). Two authors independently screened all identified citations and extracted the data. The methodological quality of the included trials was assessed using the Cochrane criteria. RESULTS Seven studies with a total of 527 subjects were screened according to inclusion and exclusion standards, and most of the studies had significant methodological weaknesses. Seven randomized controlled trials tested the effects of acupuncture compared with placebo acupuncture and conventional medications in patients with oligospermia and asthenozoospermia. The results of this study suggest that acupuncture alone has no clear superiority in improving sperm motility (standard mean difference [SMD] = 1.13, 95% confidence interval [CI]: -0.64 to 2.89), the sperm concentration (SMD = 0.32, 95% CI: 0.27-0.92) or semen volume compared with placebo acupuncture. No significant difference was found between acupuncture alone and conventional medications in improving sperm motility (SMD = -0.53, 95% CI: -2.54 to 1.48), the sperm concentration (SMD = -1.10, 95% CI: -1.48 to -0.72) or semen volume. However, adjuvant acupuncture may enhance the effect of medications on improving sperm motility (SMD = 4.10, 95% CI: 1.09-7.12) and the sperm concentration (SMD = 1.07, 95% CI: 0.739-1.40), but the study heterogeneity was too high to establish robust conclusions. CONCLUSION These results suggest that the current evidence does not support acupuncture as an effective treatment for oligospermia and asthenozoospermia; therefore, acupuncture is not currently recommended as a treatment for these conditions. However, owing to the high risk of bias among the included studies, the evidence is limited, and more large-scale, high-quality clinical trials are needed in the future. TRIAL REGISTRATION NUMBER PROSPERO CRD42018083885.
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Zhang Y, Xu H, Wu Y, Chen X. Treatment of subclinical varicocele with acupuncture: A case report. Explore (NY) 2021; 18:604-607. [PMID: 34315686 DOI: 10.1016/j.explore.2021.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/19/2021] [Accepted: 07/03/2021] [Indexed: 11/18/2022]
Abstract
Varicocele is a vascular lesion characterized by abnormal dilatation and/or tortuosity of the veins of the pampiniform plexus, which sometimes manifests as chronic, dull pain in the scrotum, testicle or inguinal area. Subclinical varicocele (SCV) is as an early phase in the progression of its clinical analog. Given the lack of relevant studies on treatment strategies, no conclusive answer exists regarding how SCV should be managed. In this case report, a 40-year-old male patient visited our acupuncture outpatient clinic for left-sided scrotal pain and heaviness caused by SCV. After ten sessions of acupuncture treatments (acupuncture was performed at Zhongji (CV3), Guanyuan (CV4), qihai (CV6) and bilateral Guilai (ST29), Hegu (LI4), Taichong (LR3), Zusanli (ST36), Sanyinjiao (SP6), with electroacupuncture (EA) stimulation at Qihai (CV6) and Zhongji (CV3) as well as Guilai (ST29) on both sides), the patient was symptom-free. More unexpectedly, ultrasound reexamination showed no obvious abnormalities in bilateral spermatic veins. From this case, we conclude that acupuncture may be an effective alternative therapy for SCV treatment.
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Affiliation(s)
- Yanyan Zhang
- Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Huaqiang Xu
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China
| | - Yue Wu
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China
| | - Xiaojun Chen
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China.
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Jin ZR, Fang D, Liu BH, Cai J, Tang WH, Jiang H, Xing GG. Roles of CatSper channels in the pathogenesis of asthenozoospermia and the therapeutic effects of acupuncture-like treatment on asthenozoospermia. Am J Cancer Res 2021; 11:2822-2844. [PMID: 33456575 PMCID: PMC7806476 DOI: 10.7150/thno.51869] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/13/2020] [Indexed: 02/06/2023] Open
Abstract
Rationale: Idiopathic asthenozoospermia (iAZS) is one of the major causes of male infertility and has no effective therapeutic treatment. Understanding the potential mechanisms that cause it may be helpful in seeking novel targets and treatment strategies for overcoming the problem of low sperm motility in iAZS individuals. Methods: Computer-assisted semen analysis (CASA) was utilized to assess the sperm motility. RT-qPCR, Western blot, immunofluorescence staining, and calcium imaging analysis were performed to examine the expression and function of CatSper channels. Hyperactivation and acrosome reaction were used to evaluate the functional characteristics of epididymal sperm. In vivo fertility assay was applied to determine the fertility of rats. CatSper1 knockdown and overexpression experiments were performed to confirm the roles of CatSper channels in the pathogenesis of iAZS and the therapeutic effects of electroacupuncture (EA) treatment on AZS model rats. Results: Here, we reported a functional down-regulation of CatSper channel from CatSper1 to CatSper 4 in the sperm of both iAZS patients and ornidazole (ORN)-induced AZS model rats, and an impaired sperm function characterized by a reduction of protein tyrosine phosphorylation, hyperactivation, and acrosome reaction in the epididymal sperm of AZS rats. Knockdown of CatSper1 in the testis tissues is sufficient to induce AZS in normal rats, and this action was validated by the reversal effects of CatSper1 overexpression. Transcutaneous electrical acupoint stimulation (TEAS) and electroacupuncture (EA) at 2 Hz frequency improve the sperm motility via enhancing the functional expression of CatSper channels in the sperm. Gene silencing CatSper1 in the sperm abolishes the therapeutic effects of 2 Hz-EA treatment on AZS rats. Conclusions: We conclude that a functional down-regulation of CatSper channel in the sperm may be a contributor or a downstream indicator for a portion of AZS, especially iAZS, while 2 Hz-TEAS or EA treatment has a therapeutic effect on iAZS through inducing the functional up-regulation of CatSper channels in the sperm. This study provides a novel mechanism for the pathogenesis of some AZS especially iAZS, and presents a potential therapeutic target of CatSper for iAZS treatment. Acupuncture treatment like TEAS may be used as a promising complementary and alternative medicine (CAM) therapy for male infertility caused by iAZS in clinical practice.
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Yu Y, Sha SB, Zhang B, Guan Q, Liang M, Zhao LG, Zhang QY, Wen J, Sun W. Effects and mechanism of action of transcutaneous electrical acupuncture point stimulation in patients with abnormal semen parameters. Acupunct Med 2019; 37:25-32. [PMID: 30942613 DOI: 10.1136/acupmed-2017-011365] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objective: To evaluate the effect of transcutaneous electrical acupuncture point stimulation (TEAS) on sperm parameters and the underlying molecular mechanisms. Methods: A total of 121 patients diagnosed with oligozoospermia, asthenozoospermia or oligoasthenozoospermia were randomised into four groups (three treatment groups, one control): the TEAS groups were treated with 2 Hz (n=31), 100 Hz (n=31), or mock stimulation (n=29) at acupuncture points BL23, ST36, CV1 and CV4 for 2 months. The control group (n=30) was provided with lifestyle advice only. Results The changes in total sperm count and motility in the 2 Hz TEAS group were significantly greater than those in the mock group and the control group. The change in neutral α-glucosidase (NAG) and zinc levels in the 2 Hz group were significantly greater than those in the mock group and control group, and the changes in fructose levels of the 2 Hz group were significantly greater than those in the control group. Significant increases in calcium and integrin-binding protein 1 (CIB1) and reduction of cyclin-dependent kinase 1 b (CDK1) were also found after 2 Hz TEAS treatment. Conclusions The present findings suggest that 2 Hz TEAS can improve sperm count and motility in patients with abnormal semen parameters, and is associated with increases in seminal plasma zinc, NAG and fructose. The upregulation of CIB1 and downregulation of CDK1 by TEAS may be associated with its positive effects on sperm motility and count. Trial registration: http://www.chictr.org ; registration no. ChiCTR-TRC-11001775.
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Affiliation(s)
- Yan Yu
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Shu-Bin Sha
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Bin Zhang
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Qun Guan
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Ming Liang
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Lu-Gang Zhao
- Reproductive Medicine Research Centre, 6th Affiliated Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Qi-Yao Zhang
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Ji Wen
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Wei Sun
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
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Effect of Electroacupuncture on Spermatogenesis in Rats with Oligozoospermia of Insufficiency of Shen (Kidney) Essence Syndrome. Chin J Integr Med 2018; 25:292-297. [DOI: 10.1007/s11655-018-2915-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2018] [Indexed: 01/01/2023]
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Jo J, Kim H, Jerng UM. Improvements in Scrotal Thermoregulation in Patients with Varicoceles Treated by Using Traditional Korean Medicine: Two Case Reports. J Acupunct Meridian Stud 2016; 9:156-60. [PMID: 27342890 DOI: 10.1016/j.jams.2015.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 11/24/2015] [Accepted: 12/01/2015] [Indexed: 10/22/2022] Open
Abstract
A varicocele is a dilatation of the pampiniform venous plexus within the spermatic cord. The incidence of varicoceles is 15%, and it occurs in more than 40% of men in infertile couples. Traditional Korean medicine (TKM) has been used to treat male infertility in Korea. We present two cases of men with varicoceles diagnosed via physical examination and scrotal thermography. We treated these men for two months by using TKM techniques, which included acupuncture, pharmacopuncture, and herbal medicine. We used scrotal thermography to evaluate the varicoceles before and after TKM treatment. After TKM treatment, the scrotal thermoregulation of both patients improved. In Patient 1, the temperature difference between the left and the right pampiniform plexus (i.e., ΔTP) was 2.8°C before treatment. It decreased to 1.3°C after treatment. In addition, the temperature difference between the testicles (ΔTT) was 1.5°C before treatment; it decreased to 0.2°C after treatment. In Patient 2, the ΔTP was 1.5°C before treatment; it decreased to 0.2°C after treatment. This report is the first to show that TKM may be an option for treating patients with varicoceles, as determined by using a scrotal thermography evaluation.
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Affiliation(s)
- Junyoung Jo
- Department of Korean Gynecology, Graduate School, Kyung Hee University, Seoul, South Korea; Department of Korean Gynecology, Conmaul Hospital, Seoul, South Korea.
| | - Hyunho Kim
- Department of Biofunctional Medicine and Diagnostics, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Ui Min Jerng
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea.
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Successful Treatment of Oligoasthenozoospermia Using Traditional Korean Medicine Resulting in Spontaneous Pregnancy: Two Case Reports. Explore (NY) 2016; 12:136-8. [DOI: 10.1016/j.explore.2015.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Indexed: 02/02/2023]
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10
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The effects of traditional Korean medicine in infertile male patients with poor semen quality: A retrospective study. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2016.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Kucuk EV, Bindayi A, Boylu U, Onol FF, Gumus E. Randomised clinical trial of comparing effects of acupuncture and varicocelectomy on sperm parameters in infertile varicocele patients. Andrologia 2016; 48:1080-1085. [PMID: 26791438 DOI: 10.1111/and.12541] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2015] [Indexed: 01/20/2023] Open
Abstract
The aim of the study was to evaluate the effect of the acupuncture treatment on sperm parameters and pregnancy rates in patients with primary infertility. Between January 2008 and May 2010, 30 men with the primary infertility (one year of unprotected intercourse, healthy wife) and varicocele with normal hormone levels and abnormal semen analysis were randomised into two groups. Group 1 underwent subinguinal microscopic varicocelectomy, and Group 2 underwent acupuncture treatment twice a week for 2 months. Both groups were evaluated with semen analysis at 6 months after the treatment. Patients in both groups evaluated with telephone calls and e-mail in terms of pregnancy. The mean age of the patients was 27.2, and groups were comparable regarding the age (P = 0.542). The pre-treatment sperm concentration, motility and morphological characteristics were similar in both groups. Sperm concentration and motility improved significantly in both groups after the treatment. Increase in sperm concentration was higher in the acupuncture group compared to the varicocelectomy group (P = 0.039). The average follow-up was 42 months, and pregnancy rates were emphasised 33% in both groups. Acupuncture treatment in primary infertile varicocele patients with semen abnormalities seems to be effective and has comparable results with the varicocelectomy treatment.
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Affiliation(s)
- E V Kucuk
- Umraniye Education & Research Hospital, Istanbul, Turkey
| | - A Bindayi
- Umraniye Education & Research Hospital, Istanbul, Turkey
| | - U Boylu
- Umraniye Education & Research Hospital, Istanbul, Turkey
| | - F F Onol
- Umraniye Education & Research Hospital, Istanbul, Turkey
| | - E Gumus
- Umraniye Education & Research Hospital, Istanbul, Turkey
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Ho LM, Chui SL, Hum SC, Foo JQM, Fook-Chong SMC, Chong SF, Geng M, Loh KG, Loh KY, Lee SN, Yu SL, Yong TT. A single-arm pilot study on effects of acupuncture treatment on semen parameters of subfertile Singaporean men. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2015. [DOI: 10.1016/j.apjr.2015.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Jerng UM, Jo JY, Lee S, Lee JM, Kwon O. The effectiveness and safety of acupuncture for poor semen quality in infertile males: a systematic review and meta-analysis. Asian J Androl 2015; 16:884-91. [PMID: 25038176 PMCID: PMC4236334 DOI: 10.4103/1008-682x.129130] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The aim of this review is to evaluate the effectiveness and safety of acupuncture for poor semen quality in infertile men. We searched for relevant trials registered up to May 2013 in 14 databases. We selected randomized controlled trials (RCTs) that compared acupuncture, with or without additional treatment, against placebo, sham, no treatment, or the same additional treatment. Two reviewers independently performed the study selection, data extraction, risk of bias and reporting quality appraisal. Risk of bias and reporting quality were appraised by the Cochrane risk of bias tool, the consolidated standards of reporting trials and Standards for Reporting Interventions in Clinical Trials of Acupuncture. The outcomes were sperm motility, sperm concentration, pregnancy rate, and adverse events. Pregnancy was defined as a positive pregnancy test. Four RCTs met the eligibility criteria. Acupuncture increased the percentage of sperm with rapid progression (mean difference - 6.35, 95% confidence interval (CI): 4.38-8.32, P< 0.00001) and sperm concentration (mean difference - 6.42, 95% CI: 4.91-7.92, P< 0.00001), but these two outcomes were substantially heterogeneous among the studies (I² = 72% and 58%, respectively). No differences in pregnancy rate were found between acupuncture and control groups (odds ratio 1.60, 95% CI: 0.70-3.69, P= 0.27, I² = 0%). No participants experienced adverse events. The current evidence showing that acupuncture might improve poor semen quality is insufficient because of the small number of studies, inadequacy of procedures and/or insufficient information for semen analysis, high levels of heterogeneity, high risk of bias, and poor quality of reporting. Further large, well-designed RCTs are required.
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Affiliation(s)
| | | | | | | | - Ohmin Kwon
- Medical History and Literature Group, Korea Institute of Oriental Medicine, Daejeon, Korea
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Gao J, Zuo Y, So KH, Yeung WSB, Ng EHY, Lee KF. Electroacupuncture enhances spermatogenesis in rats after scrotal heat treatment. SPERMATOGENESIS 2014; 2:53-62. [PMID: 22553490 PMCID: PMC3341246 DOI: 10.4161/spmg.19282] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Spermatogenesis is regulated by a cascade of steroid regulated genes in the testis. Recent studies suggested that acupuncture may improve fertility in men with abnormal semen parameters. Yet, the underlying mechanisms in which acupuncture enhances spermatogenesis remain largely unknown. Here we used a scrotal heat-treated rat model to study the effect of electroacupuncture (EA) on recovery of spermatogenesis. In this model, spermatogenesis was disrupted by 30 min scrotal heat treatment at 43°C. Ten sessions of EA were given at Baihui (GV20), Guanyuan (CV4), Zusanli (ST36) and Sanyinjiao (SP6) from day 9 to day 36 post-treatment. Sperm motility and production, morphology of the germinal epithelium by Johnsen’s scoring, germ cell apoptosis by TUNEL staining, proliferation by proliferating cell nuclear antigen (PCNA) staining, as well as serum testosterone and inhibin B levels by immunoassays were evaluated on day 0, 1, 9, 25, 37, 46, 56 and 79. When compared with the heat-treated (H) group, the heat-treated plus EA (H+EA) group showed a significant increase (p < 0.05) in PCNA-positive cells and inhibin B levels on days 37 and 46, and a higher Johnsen’s score till day 56. On day 79, motile spermatozoa could be found in the vas deferens of H+EA group only. Consistently, there was a trend of improved motility and increased number of motile epididymal spermatozoa in the H+EA group than the H group; while apoptosis of germ cells and serum testosterone levels were similar between the two groups. Taken together, EA enhanced germ cell proliferation through improvement of Sertoli cell functions. This may facilitate the recovery of spermatogenesis and may restore normal semen parameters in subfertile patients.
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Zhang XZ, Liu JH, Sheng HQ, Wu HJ, Wu Y, Yao KS, Lu JC, Zhang FB. Seasonal variation in semen quality in China. Andrology 2013; 1:639-43. [PMID: 23682039 DOI: 10.1111/j.2047-2927.2013.00092.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 03/07/2013] [Accepted: 04/01/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Xin-Zong Zhang
- Family Planning Research Institute of Zhejiang; Hangzhou; China
| | - Jin-Hao Liu
- The First Affiliated Hospital of Zhengzhou University; Zhengzhou; China
| | - Hui-Qiang Sheng
- Family Planning Research Institute of Zhejiang; Hangzhou; China
| | - Hong-Jun Wu
- Family Planning Research Institute of Zhejiang; Hangzhou; China
| | - Ying Wu
- Family Planning Research Institute of Zhejiang; Hangzhou; China
| | - Kang-Shou Yao
- Family Planning Research Institute of Zhejiang; Hangzhou; China
| | - Jin-Chun Lu
- PLA Institute of Clinical Laboratory Medicine; Nanjing University Medical College; Nanjing General Hospital of Nanjing Command; Nanjing; China
| | - Feng-Bin Zhang
- Women's Hospital School of Medicine Zhejiang University; Hangzhou; China
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Franconi G, Manni L, Aloe L, Mazzilli F, Giambalvo Dal Ben G, Lenzi A, Fabbri A. Acupuncture in clinical and experimental reproductive medicine: a review. J Endocrinol Invest 2011; 34:307-11. [PMID: 21297382 DOI: 10.1007/bf03347091] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Acupuncture has been used as treatment for infertility for hundreds of years, and recently it has been studied in male and female infertility and in assisted reproductive technologies, although its role in reproductive medicine is still debated. AIM To review studies on acupuncture in reproductive medicine, in experimental and clinical settings. METHODS Papers were retrieved on PubMed and Google Scholar and were included in the review if at least the abstract was in English. RESULTS There is evidence of benefit mainly when acupuncture is performed on the day of embryo transfer (ET) in the live birth rate. Benefit is also evident when acupuncture is performed for female infertility due to polycystic ovary syndrome (PCOS). There is some evidence of sperm quality improvement when acupuncture is performed on males affected by idiopathic infertility. Experimental studies suggest that acupuncture effects are mediated by changes in activity of the autonomic nervous system and stimulation of neuropeptides/neurotransmitters which may be involved in the pathogenesis of infertility. CONCLUSIONS Acupuncture seems to have beneficial effects on live birth rate when performed on the day of ET, and to be useful also in PCOS as well as in male idiopathic infertility, with very low incidence of side effects. However, further studies are necessary to confirm the clinical results and to expand our knowledge of the mechanisms involved.
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Affiliation(s)
- G Franconi
- Endocrinology Unit, S. Eugenio and CTO Hospitals, Tor Vergata University, Rome, Italy.
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17
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Protection from scrotal hyperthermia in laptop computer users. Fertil Steril 2011; 95:647-51. [DOI: 10.1016/j.fertnstert.2010.10.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Revised: 10/07/2010] [Accepted: 10/12/2010] [Indexed: 11/23/2022]
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18
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Abstract
Acupuncture is increasingly being used in reproductive medicine. This review summarizes the evidence of acupuncture in pain relief for oocyte retrieval, improving pregnancy outcomes of in vitro fertilization treatment, management of ovulation disorders, male subfertility, primary dysmenorrhea, endometriosis and menopausal symptoms. However, most of the studies are nonrandomized uncontrolled trials, case reports or case series. For randomized controlled trials, the sample size is underpowered and blinding of assessors is lacking. Different acupuncture protocols and controls are used. These heterogeneities make it difficult to compare studies and draw any firm conclusions. Further studies should also evaluate the cost-effectiveness of acupuncture and investigate the underlying mechanism of acupuncture treatment.
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Affiliation(s)
- Emily Wing Sze So
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong
| | - Ernest Hung Yu Ng
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong
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Bovey M, Lorenc A, Robinson N. Extent of acupuncture practice for infertility in the United Kingdom: experiences and perceptions of the practitioners. Fertil Steril 2010; 94:2569-73. [PMID: 20452588 DOI: 10.1016/j.fertnstert.2010.03.072] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 03/25/2010] [Accepted: 03/29/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate acupuncture practitioners' experience and perceptions of supporting patients presenting with fertility issues. DESIGN Questionnaire survey. SETTING British Acupuncture Council. PATIENT(S) British Acupuncture Council acupuncture practitioners. INTERVENTION(S) Questionnaire designed for the study, by post and online. MAIN OUTCOME MEASURE(S) Questions on education and training, size and nature of practice, liaison with conventional care, and perceptions about use of acupuncture for fertility issues. RESULT(S) Questionnaires were sent to 2,580 practitioners. Of 861 responses, 15% of practitioners supporting fertility issues said this constituted a large proportion of their case load. Eighty percent of practitioners reported most fertility work was related to assisted conception. More than 60% had specialist training. Practitioners' perceived benefits included stress reduction, relaxation, regulation of menstrual cycle, and emotional support. Emotional burden on both patients and practitioners was recognized and the limits of therapy. Point-specific acupuncture protocols were common (70%). Thirteen percent reported problems working with physicians. Use of acupuncture for male fertility issues was uncommon. CONCLUSION(S) A minority of acupuncturists have become specialists in supporting fertility issues. The use of an acupuncture protocol is common but does not conform to traditional acupuncture as it is taught and practiced for other conditions.
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Affiliation(s)
- Mark Bovey
- Acupuncture Research Resource Centre, Thames Valley University, Brentford, Middlesex, United Kingdom
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