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A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia

In this first prospective, randomized, single-blind, placebo-controlled study, 28 infertile patients with severe oligoasthenozoospermia received acupuncture according to the principles of traditional Chinese medicine (TCM) and 29 infertile patients received placebo acupuncture. A significantly higher percentage of motile sperm (World Health Organization categories A–C), but no effect on sperm concentration, was found after acupuncture compared with placebo acupuncture

Method: This acupuncture trial was in accordance with the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA). Patients were randomized to receive either acupuncture or placebo acupuncture twice weekly for 6 weeks. For acupuncture 0.30 × 30 mm acupuncture needles (Asia-Med, Pullach, Germany) were inserted to a depth of 15–30 mm, depending on the region of the body. They were rotated manually to evoke the Deqi sensation. Ten minutes later, all needles were manipulated again for the Deqi sensation. Nonpenetrating 0.30 × 3.0 mm placebo acupuncture needles (Asia-Med) were used for placebo acupuncture. Acupuncture and placebo acupuncture were applied for 45 minutes. No explanations were given to the patients. Acupuncture and placebo acupuncture were carried out by two acupuncture specialists from Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China. Both acupuncturists had a university TCM education and acupuncture training, clinical experience, and expertise. No cointerventions were applied.

Acupuncture protocol:According to an earlier acupuncture study on sperm morphology in male infertility. the following acupoints were chosen for both groups: Zusanli (ST-36, bilateral), Sanyinjiao (SP-6, bilateral), Taixi (KI-3, bilateral), Taichong(LIV-3, bilateral), Shenshu (BL-23, bilateral), Ciliao (BL-32, bilateral), Guilai (ST-29, bilateral), Xuehai (SP-10, bilateral), and Guanyuan (Ren-4). Bai Hui (GV-20) was omitted because the fixation of a placebo needle is problematic at this acupoint.

Results:The present study showed a significant effect of acupuncture on the percentage of total motile sperm (P=.035). There were no significant differences in each category (A, B, or C) before and after acupuncture. The decrease in semen volume after acupuncture (P=.041) has to be investigated. There was a significant increase in sperm concentration after placebo acupuncture (P=.018), but not after acupuncture. These results might be due to the number of patients included in this study. Forty-five patients would have been required in the acupuncture group for a statistically significant difference in sperm concentration.

Other Studies done on topic:
Uncontrolled case reports and nonrandomized case control studies suggested that acupuncture might have an effect on male infertility (Zhang et al.)reported that there was a significant increase in the percentages of rapid motile and of morphologically normal sperm after acupuncture in 22 patients with idiopathic male infertility and unsuccessful intracytoplasmic sperm injection.

In a prospective nonrandomized case-control study by Sitermann et al. 16 subfertile patients were treated with acupuncture twice a week for 5 weeks. The control group consisted of 16 matched subfertile patients without treatment. The percentage of viability, the total motile sperm count per ejaculate, and the percentage of ultramorphologically normal sperm were significantly higher 1 month after acupuncture compared with the control group.

In a prospective controlled pilot study, Siterman et al. examined patients with very low sperm concentrations. Twenty patients received acupuncture twice a week for 5 weeks. Twenty patients were not treated. The authors concluded that acupuncture may be useful for patients with very low sperm concentrations.

In a prospective, randomized, controlled, single-blind study by Gurfinkel et al.19 patients with semen abnormalities in concentration, morphology, and/or progressive motility received acupuncture and moxa treatment at therapeutic or indifferent points for 10 weeks. The percentage of morphologically normal sperm increased significantly after acupuncture and moxa treatment at therapeutic points compared with indifferent points.

In a prospective controlled study, Pei et al. compared 28 infertile men with oligozoospermia, asthenozoospermia, and/or teratozoospermia who received acupuncture twice a week for 5 weeks with 12 untreated infertile men. Sperm morphology was quantitatively analyzed by transmission electron microscopy. Significantly more sperm without ultrastructural defects were found after acupuncture compared with no treatment.

In a recent systematic review of the role of acupuncture in male subfertility, Yu Ng et al. did not find sufficient evidence of a significant effect.

Autoren:Stefan Dieterle, Chunfang Li, B.Sc. Robert Greb, M.D., Felix Bartzsch, M.D., Wolfgang Hatzmann, M.D., Dongmei Huang, M.D. published in Fertil Steril 2009;92:1340–3. 2009 by American Society for Reproductive Medicine

Quelle: https://www.fertstert.org/article/S0015-0282(09)00431-2/fulltext

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