MALE FACTORS

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MALE FACTORS

• Fertility Enhancement Program II Presented by
• Advanced Acupuncture, Inc.

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Male Reproductive Anatomy
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Male Reproductive Organs

• Testes (gonads)
• Sperm (exocrine)
• Testosterone (endocrine)
• Ducts
• Glands

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Testes

• Size 4 cm X 2.5 cm
• Connective tissue capsule
• Tunica albuginea
• Seminferous tubules
• Rete testis
• Duct system
• Epididymis
• Interstitial cells-produces androgens
  testosterone.

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Testes Malfunction
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Male organs- Duct System

• Transport sperm from the body
• Epididymis
• Ductus deferens
• Urethra

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Male organs- Ductus Deferences

• Enclosed tube along with blood vessels nerves
  in sperm cord
• Propel live sperm into urethra by peristaltic
  waves rapidly squeeze the sperm forward
• Scrotal Sac
• Vasectomy- cauterizing the vas deferens. Sperm is
  still produced but no longer reach the outside
• Sterile- testosterone still produced and libido
  remained.

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Sperm Ascending
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Vas Deferens Blockage
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Male Organs- Epididymis

• Highly coiled tube 6M
• Caps superior of testes
• 1st part of male duct
• Storage site of immature sperm
• Mature in 20 days
• Ability to swim
• Walls of epididymis contract to expel the sperm
  to ductus deference

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Male Organs- Urethra

• 3 main regions
• Prostate Urethra
• Membranous urethra
• Spongy urethra
• Carry urine and sperm to exterior
• Ejaculation

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Male Organs-Scrotum

• Providing the testes with a temperature that is
  below body temp.
• Cold-gtscrotum wrinkled -gttestes closer to the
  body to maintain viable sperm production

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Male Organs- Penis

• To deliver sperm into the female reproductive
  tract
• Circumcision- surgically removed after birth
• 3 enlarged eretile tissue
• Erection-blood flow

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Spermatogenesis
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Testosterone Production

• Produced by interstitial cells
• Stimulated by LH
• Testosterone stimulate the male reproductive
  organs develop 2nd male characteristics
• Lack of the testosterone will result in sexual
  infantilism sterility.

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Good Sperm Formation

• Sperm takes 100 days to develop (70/30)
• 3 main factors
• Sperm count gt 20 million/ml/ejaculate
• Morphology (shape of the sperm)
• Motility (How fast and straight the sperm swim)

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Getting Tested

• Urologist evaluation
• Sperm analysis 2-3 Tx
• Defect factors
• Azoospermia
• Oligiospermia
• Sperm motility decreases
• Sperm morphology abnormalities

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Male Infertility Assessment

• Sperm count lt 10million/ml ( 200 million)
• Volume lt 5 ml per ejaculate
• Sperm motility lt 60
• Sperm Morphology lt 50 normal

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Normal Sperm Analysis

• Volume 3 ml (2-6ml)
• Concentration20M/ml
• Motility 50 gt 2 hrs
• Morphology 60
• Viscosity
• Ejaculate normally liquefies lt 1hr
• pH 7-8

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Sperm abnormalities

• Adequate
• Aspermia
• Azoospermia
• Oligospermia
• Poor motility forward movement
• High percent of abnormal sperm morphology
• Antisperm antibodies

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Infertility isnt just the womans problem
anymore

• 40-50 male infertility
• Inadequate of sperm
• Inhibited ejaculation
• Retrograde ejaculation
• Failure of descend into the scrotum
• Antibodies to the sperm

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Diagnosis of Male infertility

• Medical History
• Physical Examination-structure
• Secondary sex characteristics evaluation
• Endocrine function test
• Sperm analysis- 2-3 x

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Causes of Male Infertility

• Radiation
• Environment toxins
• Undescended testis
• Varicocele
• Traumatic injury
• Infectious injury
• Testicular atrophy
• Drug effects

• Alcohol, nicotine, marijuana, cocaine Prolonged
  fever
• Endocrine disorders
• Congenital abnormalities
• Surgery of the lower abdominal region
• Tight underwear
• Stress, lack of sleep

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Male Factors of infertility

• Spermophlebectasia
• Sperm dysfunction
• Sexually transmitted disease
• Physical damage
• Genetic disease
• Auto immune disease
• Genetic disease

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Spermophlebectasia varicose vein of the
spermatic cord

• Increases blood in the vein of the spermatic
  cord? increases temp. in testicle? decrease live
  sperm count and activity
• Prolonged presence of the varicosity can result
  in poor blood circulation to the area
  shrinkage/or dysfunction of the testicle? unable
  to produce healthy sperm

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Spermphelebectasia
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Symptoms of Spermophlebectasia

• Male age 20-30
• Chief complain-pain
• Heaviness of scrotum
• Pain at testicles, groin and lower abdomen
• Standing and walking aggravates.
• Resting in supine position alleviates

• Signs Scrotum enlarged and loose
• Vein is enlarged and purple
• Varicose veins are also present in the groin and
  inner thigh
• Press vein, it shrinks or disappears

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TCM treatment for spermphelebectasia

• Acupuncture
• Acupuncture can stimulate histamine release
  to dilate the blood vessels to improve the blood
  circulation, thus reduces varicose veins in the
  region
• Herbal Formula
• Individualized formulas based on the
  etiology to improve blood circulation, resolve
  blockage, and promote healthy sperm

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Making Good Sperm

• Eating Healthily
• Taking Vitamins
• Drinking more water
• Copping Stress
• Staying active
• Enjoying regular sex
• Sleeping enough

• Liver Detox
• Weekly acupuncture
• Stop smoking
• Cut down alcohol
• Avoid drug intake
• Minimize caffeine

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Chinese Medicine Improves semen
morphology,motility, count

• Randomized clinical trial in Sydney, 2004
• Acupuncture and herbal medicine
• Improve sperm normal form plt0.038
• Improve semen motility plt0.008
• Improve count mean increase 220 million sperm

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Normal Sperm

• Head- C

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Acupuncture Treatment

• Acupuncture can stimulate histamine release to
  dilate the blood vessels to improve the blood
  circulation, thus reduces varicose veins in the
  region
• Most commonly selected points are located on the
  back and leg areas.
• Frequency at 1-2 tx/wk or
• based individualized treatment plan

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Responds of Acupuncture treatment
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Acupuncture in the treatment of Psychogenic
Erectile Dysfunction

• Randomized placebo-controlled pilots study,
  Austria, 2003
• 22 patients, satisfactory response 68.4
• Acupuncture can be effective option gt2/3 of PED

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Herbs That Benefits for Sperm
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Herbal Formulas

• Classic Herbal formulas
• Individualized herbal decoctions
• Raw herbs
• Concentrated granules

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Classic Herbal Formulas

• 23 Mens treasure
• Main ingredients Ginseng, Deer horn, Sea horse,
  Hokuo, Epimedii, Angelica, Cinnamomi, Poria cocos
• Used for low sperm count, low motolity and
  morphology

• 27 Mens Power
• Main ingredients Eucommiae, Epimedii,
  Achyrabthis,Cistanches,
• Cynomorii, Cuscutae.
• Used for impotency, low libido and early
  ejaculation

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Things to avoid

• High temperature
• ( best at 32 degrees C)
• Stress ( testes malnourished)
• Alcohol ( interferes of testosterone secretion)
• Smoking (40 sperm damage by free radicals)
• Environmental Estrogen
• (meat, microwave plastics)

• Drugs ( reduces testosterone libido)
• Caffeine (impair sperm production cause
  chromosomal abnormalities)
• Toxins (pesticides, heavy metals)
• Pollutants

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Good Sperm Diet
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Nutrients for Sperm
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Friendly Advises

• Diagnosed with infertility-behavior change
• Low sperm count-less intercourse frequency
• Abnormal hormones-balances
• Take folic acid and zinc
• Stress acupuncture, meditation, yoga
• Low sperm motilities- herbal formula
• No sperm in semen-retrieve from the testicles. (
  success rate is 65 )

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Macho Sperm Theory

• Damaged sperm may still fertilize an egg.
• Some toxins may alter the sperms chromosomes
  which carry genetic information
• Results infertility and miscarriage to birth
  defects, learning disabilities and childhood
  cancer and kidney cancer

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Intracytoplasmic sperm injectionICSI

• For low sperm count male infertility
• Sperm eggs are retrieved
• Inject 1 sperm into an egg
• Fertilized egg is then implanted

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Artificial Insemination
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Options of male infertility
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Happy and healthy babies
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