So much of fertility and related support is focused on the female and very few males seek out TCM support. On top of that, a trip to the fertility specialist might leave male patients feeling flustered and confused – What do the abbreviations like PR, NP, IM in a semen examination report mean? Terms like low motility, low volume and low concentration might be uttered by the doctor. Does this experience seem familiar to you?
We have previously discussed ways to improve fertility, and in this article, we will zoom in specifically into providing support to men going through IVF and outline how TCM can help the male patient in your IVF journey.
Note: All words in Italics refer to the TCM organ-system or TCM terminology and not the anatomical organ referenced in western medicine.
What is IVF?
IVF (In-vitro fertilization) is a kind of ART (Assisted-reproduction therapy) commonly used today to help couples conceive when natural methods fail. There are 4 generations of IVF in the world today:
- IVF-ET (In-vitro fertilization-embryo transfer)
- ICSI (Intracytoplasmic sperm injection)
- PGD/PGS (Preimplantation Genetic Diagnosis/Preimplantation genetic screening)
- GVT (Germinal vesicle transfer)
In Singapore, the first 2 procedures are often done. Between PGS and PGD, only PGD is done in Singapore if either parent has a family member with a genetic condition to prevent said hereditary disease from being passed down to the future child. Due to issues concerning medical ethics, GVT is currently not being done in Singapore.
Who requires IVF?
Men undergoing IVF usually have one or several issues associated with:
- Semen quality
- Poor sperm motility (asthenozoospermia) means that the sperm do not swim properly.
- Sperm morphology refers to the size and shape of the sperm in a given semen sample. You want at least 4% of sperm to be a normal shape. Otherwise, you could have fertility problems because of abnormal sperm morphology
- Semen quantity
- Sexual function
Typical semen analysis results for to-be IVF candidates:
- Poor motility in their sperm sample – Grade A sperm lower than 25% or Grade A+B lower than 32%
- Sperms lower than 4% normal morphology
- Diminished sperm concentration – between 10 x 106 to 15 x 106 sperm/ml
In couples who have had recurrent miscarriages, failure to conceive despite having near to normal sperm parameters or if both parties have normal parameters [1], the male would be recommended to undergo testing for sperm DNA fragmentation or DFI (DNA fragmentation index). There are many ways and methods by which DFI is measured but it is usually presented as a percentage. A person with DFI value above 30% is thought to be a viable candidate for ICSI. [2]
A major cause of high DFI values are excessive oxidative stress caused by ageing, improper lifestyle choices, or exposure to chemicals and radiation. [3] DFI testing is not done routinely in a semen analysis yet. However, from our observations over the years, high DFI values can result in recurrent miscarriages and be the missing piece to explain increasing infertility whereby a cause cannot be found in either party.
Typical DFI readings
Source: www.researchgate.net
After proper diagnosis, men with moderate to severe reduction in sperm concentration also known as Oligozoospermia, ICSI will be the better choice to increase the chance of fertilization. ICSI involves the insemination of an ovum from the female using just one sperm chosen from the semen sample from the male. This is done using a special needle which can penetrate the zona pellucida and insert a sperm directly without the sperm having to push its way through the Zona pellucida – a thick transparent membrane surrounding the ovum.
ICSI involves the insemination of an ovum from the female using just one sperm chosen from the semen sample from the male.
Source: www.researchgate.net
How can men prepare for IVF
Having to watch one’s female partner endure IVF can be a stressful period for the male. The procedure is costly and puts a physiological, emotional, psychological and financial toll on the couple. In addition, the female has to undergo painful self-injections during the ovarian stimulation period which can result in her experiencing severe mood swings. As a result, there is a change in family dynamics and the male might feel guilty for putting their wife through such a gruelling ordeal especially if the fertility issue was not hers to begin with. It is important for the male to prepare mentally to manage these stresses to prepare adequately for IVF.
If the male is overweight, it is also necessary for him to control his diet so as to reduce the amount of visceral fat which can disrupt the balance of endocrine hormones in the body. [4] Additionally, TCM views lifestyle habits like smoking, drinking, improper diet or eating habits, and sleeping late as detrimental to proper sperm development.
To get more tips on improving fertility in general, you can read more on Improving Male Fertility Using Traditional Chinese Medicine (TCM).
How can Oriental Remedies Group help men undergoing IVF?
Herbal Medication & Dietary Changes
TCM believes that issues of infertility are generally related to the Kidney. That being said, the Kidney can only produce good quality sperm if the Five Organs are also well-nourished and have surplus to provide for the Kidney. Hence, tonifying and nourishing the Five Organs is the basis of infertility treatment with emphasis placed in the provision of surplus Qi for the Kidney.
- Herbs like Wolfberries 枸杞子 and Chinese dodder seed菟丝子 have been used over many centuries to help increase quality of sperm by tonifying the Kidney and Liver.
- Codonopsis root党参 and Astragalus 黄芪 are also commonly used herbs which tonify both Spleen and Lung Qi
Acupuncture
Other than typical acupoints used to help with infertility, acupuncture can also be done to manage emotional stresses during one’s IVF cycle. Excessive stress can result in Liver Qi stagnation and eventually Spleen Qi deficiency resulting in emotional disturbances and decreased appetite
- TaiChong太冲 and ZuSanli足三里 are commonly used points that help to remove Liver Qi stagnation and Tonify the Spleen. Needles are left in the points for up to 30minutes to increase the stimulatory effects of acupuncture
- Acupoints are tailored based on patient’s individual condition
LIV 3 Tai Chong
ST 36 Zu San Li
Hear from patients treated by our Senior Physician Lim specializing in male infertility!
“After taking the [herbal] medicine by Physician Lim, not only have my headaches and nausea subsided, my sleep has improved a whole lot and my wife is now 4 weeks pregnant! Thank you for the advice given and the care from the team!”
– Mr Pan
Your healing is the most important!
In Oriental Remedies Group, we have more than 10 certified bi-lingual TCM Physicians. Each of them has been trained in both Nanyang Technological University (Singapore) and China for a minimum of 5-8 years, in both Biomedical Science and TCM before being certified to practice in Singapore.
Specifically, we have Senior Physician Lim who have worked with numerous couples suffering from infertility in both Singapore and China. By combining Traditional Chinese Medicine therapies and expertise with modern integrative therapies, we strive to provide the best care possible in your journey with us.
If you or a loved one is suffering from infertility, we would like to help.
Please contact us at +65 8742 2163 for a personalized consultation.
This article is written by Senior Physician Lim Jing Yang, Oriental Remedies Group
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References
[1] Oleszczuk K, Augustinsson L, Bayat N, et al. Prevalence of high DNA fragmentation index in male partners of unexplained infertile couples[J]. Andrology, 2013, 1(3): 357-60.
[2] Bungum M, Humaidan P, Axmon A, et al. Sperm DNA integrity assessment in prediction of assisted reproduction technology outcome[J]. Hum Reprod, 2007, 22(1): 174-9.
[3] 徐志鹏, 孙海翔, 张宁媛. 精子DNA损伤与辅助生殖技术[J]. 中华男科学杂志, 2008, (03): 259-263.
[4] https://www.health.harvard.edu/staying-healthy/abdominal-fat-and-what-to-do-about-it.
[5] Wdowiak A, Bakalczuk S, Bakalczuk G. Decreased activity of superoxide dismutase in the seminal plasma of infertile men correlates with increased sperm deoxyribonucleic acid fragmentation during the first hours after sperm donation[J]. Andrology, 2015, 3(4): 748-55.