In the last post, we talked about conventional causes of male infertility. I mentioned in cases of known causes, it’s 50-50 between men and women. Here we talk about what men can do to improve fertility naturally.
What can men do to improve fertility from a conventional approach?
Besides the lifestyle factors mentioned in the previous post, sadly there’s not much that men can do. If there is a known structural issue, such as a blockage from a varicocele, you can consider an outpatient surgical procedure. However, the common male factors are problems with sperm count, movement, and shape – and there is not much to do about these. Conventionally, that is.
Reproductive specialists suggest you bypass these issues with assisted reproductive techniques (ART), such as insemination or in-vitro fertilization. Indeed, this is a route that many couples choose.
However, there are things men can do from Functional and Chinese medical approaches to improve sperm count, motility, and morphology, as well as seminal fluid.
What can men do alternatively?
After you’ve had your workup with your urologist, and you decide to work unconventionally, you start with a full workup. Here I describe Chinese and Functional medicine approaches.
In both these systems of medicine, we look for root causes of infertility, causes that may be outside the box of conventional medicine, but are nonetheless real.
Chinese medicine has a rich history of male fertility treatment that goes back hundreds of years. A skilled practitioner assesses your pattern of imbalance through the lens of Chinese medicine and treats accordingly with acupuncture and herbs.
Functional medicine uncovers factors such as nutrient deficiencies, hormone imbalances, and oxidative stress – all which affect sperm and semen production.
A Functional medicine take on male factor infertility
Functional medicine, like conventional, is based on science and evidence-based medicine. The difference is that functional practitioners use a systems analysis of your “disease.” We don’t take a reductionist point of view and only look at male genitalia problems.
Diet and Nutrient Repletion
Generally, Functional medicine practitioners start with lifestyle factors, with diet being key. This researcher writes:
For optimum nutrition it is necessary to remove grains, processed foods, sugars and starches from the diet, and obtain necessary carbohydrates from vegetables, some fruits and starchy sources like sweet potatoes and squash. The healthy fats in the diet especially from sources like coconuts, coconut oil, olives and olive oil, butter, grass-fed meats, eggs, avocado and nuts need to be increased. Proteins especially from grass fed meats, eggs, and nuts are also helpful. There is a need to eat vegetables, especially green leafy varieties and to avoid processed dairy products.”
Even with the above dietary recommendations, which are spot on, it’s possible to have nutrient deficiencies that affect sperm.
This paper summarizes the nutrients that affect sperm: calcium, magnesium, chromium, zinc, vitamin B12, folic acid, inositol (B8), vitamin B6, selenium, and manganese. Interestingly, clinical testing for these substances is not routinely offered. In Functional medicine, we test for micronutrient deficiencies.
Oxidative Stress and DNA Damage
Oxidation Is the natural “rusting” process in your body. It results in reactive oxygen species (ROS or “free radicals”) which need to be in the Goldilocks range. Some ROS are needed, but too much will damage sperm DNA. Fortunately, this is reversible!
We find the sources of over-oxidation, test oxidative stress, and use antioxidants if needed.
The sources could be anything from too much sugar or bad fats in your diet, to infections, inflammation, chronic disease, or toxic exposures, among others.
I recommend using the Organix® test (urine sample of organic acids) to assess oxidative stress. If you find out you have oxidative stress, you can take antioxidants to squelch it while resolving the source. Antioxidants that are proven to help improve sperm include:
L-carnitine, selenium, vitamin C and vitamin E, selenium, N-acetyl-cysteine , and coQ10
Take a combined organic acids test (urine) along with a micronutrient evaluation (blood) to determine your particular needs for these so that you are not just guessing. I prefer the NutriEvail® test. If you do this test, you can skip the Organix® test.
Any hormone that’s significantly out of balance can affect sperm production. This includes insulin (often controlled by how you eat), and cortisol (regulated by sleep and stress). It also includes all sex hormones, including testosterone, estrogen, DHEA, and even LH (luteinizing hormone). Men have “female hormones” in small amounts.
I like to start with a comprehensive functional medicine hormone panel that goes beyond what you normally get from your conventional doctor. Is stress raising your cortisol? Are your diet and your genes elevating your insulin and causing insulin resistance? Do you have low testosterone? All your hormones work in concert, and when we dig into imbalances and address them, we can improve sperm production.
Do not underestimate the power of all of your hormones, and the need to check them out comprehensively.
How does Chinese medicine fit in?
Chinese herbs and acupuncture have been used for hundreds of years to improve male fertility. Now with modern science, we can review studies that show that Chinese herbs are effective in improving sperm and seminal fluid.
In Chinese medicine, like Functional medicine, there is not a one-size-fits-all approach. In the clinic, we do our physical exam and thorough intake to assess your pattern of imbalance.
You can’t self-treat with acupuncture or Chinese herbs. The Western herbal market is highly unregulated and I recommend you never purchase over-the-counter or online herbs without a practitioner’s recommendation. The Chinese herbal market is even less regulated, and you don’t know what you are getting if you order something online or from China towns. Please work with a trusted practitioner and only get herbs that are tested for contaminants.
There is no Chinese herbal formula that fits all patterns of male infertility. It depends on your presentation! You have to get an accurate diagnosis of the herbal formula to work. For example, two common formulas I use for male infertility are Virility Factors and Astra Essence. Virility factors would be better for motility, and Astra Essence better for count.
In other cases, the imbalance caused by stress, which requires a different treatment. Or, if there are hormone imbalances or autoimmune factors,* again different herbs are used. This is a highly sophisticated form of medicine, which takes years of study to master.
Acupuncture can certainly help male fertility! The studies on acupuncture and male infertility have mixed results. This tends to be the case with acupuncture studies in general. It’s very difficult to do a double-blind placebo study, as there is no placebo acupuncture!
Deeper roots to pull up
After you address the three aspects of Functional medicine above (nutrients, oxidative stress, and hormone imbalance) plus include acupuncture and Chinese herbs, it’s likely you will see results. Men can produce millions of sperm per day, but it takes 2.5-3 months for them to mature. So give it three months of treatment and then redo your semen analysis.
Sometimes we need to look deeper into what is causing oxidative stress and sperm DNA damage. Causes we look for include:
- Chemical, mold, and metal toxins that damage mitochondria and sperm DNA.
- Infections such as sexually transmitted diseases, gut bugs, or chronic infections that cause inflammation and oxidation.
- Autoimmune issues such as anti-sperm antibody production, which you can test with a semen analysis.
The next post will be on Functional Fertility: Female Factors. Stay tuned!