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Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility

Objective
To evaluate the ultramorphologic sperm features of idiopathic infertile men after acupuncture therapy.

Design
Prospective controlled study.

Setting
Christian-Lauritzen-Institut, Ulm, IVF center Munich, Germany, and Department of General Biology, University of Siena, Siena, Italy.

Patient(s)
Forty men with idiopathic oligospermia, asthenospermia, or teratozoospermia.

Intervention(s)
Twenty eight of the patients received acupuncture twice a week over a period of 5 weeks. The samples from the treatment group were randomized with semen samples from the 12 men in the untreated control group.

Main Outcome Measure(s)
Quantitative analysis by transmission electron microscopy (TEM) was used to evaluate the samples, using the mathematical formula based on submicroscopic characteristics.

Result(s)
Statistical evaluation of the TEM data showed a statistically significant increase after acupuncture in the percentage and number of sperm without ultrastructural defects in the total ejaculates. A statistically significant improvement was detected in acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibers of sperm organelles. However, specific sperm pathologies in the form of apoptosis, immaturity, and necrosis showed no statistically significant changes between the control and treatment groups before and after treatment.

Conclusion(s)
The treatment of idiopathic male infertility could benefit from employing acupuncture. A general improvement of sperm quality, specifically in the ultrastructural integrity of spermatozoa, was seen after acupuncture, although we did not identify specific sperm pathologies that could be particularly sensitive to this therapy.

Study Design and Treatment Protocol
This study was a prospective, controlled trial, approved by the ethics committee of the University of Ulm, Germany. Forty patients who fulfilled the inclusion criteria were selected for the study. All of them were willing to use acupuncture, and each patient gave his written informed consent before the start of treatment in the study. The median age of patients was 33 years (range: 25 to 46 years). The experimental group consisted of 28 men who received acupuncture treatments twice a week over a period of 5 weeks. Semen samples of 12 patients with untreated idiopathic infertility, examined as the control group, were randomized with the treated idiopathic infertile men by an independent researcher using computer software. No further treatment was allowed in the study.

We used the following acupoints as main points: Guan Yuan (Ren 4), Shen Shu (UB 23, bilateral), Ci Liao (UB32, bilateral), Tai Cong (LR 3, bilateral), and Tai Xi (KI 3, bilateral). The secondary points were Zhu San Li (St 36, bilateral), Xue Hai (Sp 10, bilateral), San Yin Jiao (Sp6, bilateral), Gui Lai (St 29, bilateral), and Bai Hui (DU 20). The location of acupoints followed the international standardized location of acupoints

The needles (Viva, 0.25 × 25 mm, or 0.25 × 40 mm; Helio Medical Supplies, Inc. San Jose, CA) were made of sterile disposable stainless steel and were inserted in acupuncture point locations to a depth of 15–25 mm, depending on the region of the body undergoing treatment. To evoke the needle sensation, or De Qi, often described as variable feelings of soreness, numbness, tingling, warmness, and/or tension, the needles were rotated to activate the muscle-nerve afferents, the A delta and possibly C fibers When puncturing Shen Shu (UB 23, bilateral) and Ci Liao (UB32, bilateral), the needling sensation should be transmitted to the sacral or perineum area and anterior hypogastric zone. After 10 minutes the needles were manipulated to maintain needle sensation. The needles were left in acupuncture points for 25 minutes and then removed.

Authors; Jian Pei, Erwin Strehler, M.D., Ulrich Noss, M.D., Markus Abt, Ph.D., Paola Piomboni, Ph.D., Baccio Baccetti, Ph.D., Karl Sterzik, M.D., published in Fertility&sterility July 2005Volume 84, Issue 1, Pages 141–147

Quelle: https://www.fertstert.org/article/S0015-0282(05)00591-1/abstract

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