• 155א': מאמרים על יעילות הרפואה הסינית בטיפול בפוריות גברים

    Altern Med Rev. 2000 Feb;5(1):28-38.

    Male infertility: nutritional and environmental considerations.
    Sinclair S.
    Green Valley Health, Hagerstown, MD 21742, USA.
    Studies confirm that male sperm counts are declining, and environmental factors, such as pesticides, exogenous estrogens, and heavy metals may negatively impact spermatogenesis. A number of nutritional therapies have been shown to improve sperm counts and sperm motility, including carnitine, arginine, zinc, selenium, and vitamin B-12. Numerous antioxidants have also proven beneficial in treating male infertility, such as vitamin C, vitamin E, glutathione, and coenzyme Q10. Acupuncture, as well as specific botanical medicines, have been documented in several studies as having a positive effect on sperm parameters. A multi-faceted therapeutic approach to improving male fertility involves identifying harmful environmental and occupational risk factors, while correcting underlying nutritional imbalances to encourage optimal sperm production and function.
    Publication Types:

    • Review
    • Review, Tutorial

    PMID: 10696117 [PubMed – indexed for MEDLINE]

     

    J Tradit Chin Med. 1997 Sep;17(3):190-3.

    Analysis on the therapeutic effect of combined use of acupuncture and mediation in 297 cases of male sterility.
    Zheng Z.
    Department of Acu-moxibustion, Guangdong Provincial TCM Hospital, Guangzhou.
    Of the 279 cases of male sterility treated by the combination of acupuncture, pilose antler essence injection to acupoints and oral administration of Chinese materia medica, 142 cases (47.8%) were cured, 81 cases (27.3%) markedly effective, 53 cases (17.8%) effective and 21 cases (7.1%) ineffective. The therapeutic effect of the combination of these three treatments was satisfactory.
    Publication Types:

    • Clinical Trial
    • Randomized Controlled Trial

    PMID: 10437193 [PubMed – indexed for MEDLINE]

     

    Arch Androl. 1997 Sep-Oct;39(2):155-61.

    Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality.
    Siterman S, Eltes F, Wolfson V, Zabludovsky N, Bartoov B.
    Institute of Chinese Medicine, Tel Aviv, Israel.
    The aim of this prospective controlled study was to assess the effect of acupuncture on the sperm quality of males suffering from subfertility related to sperm impairment. Semen samples of 16 acupuncture-treated subfertile patients were analyzed before and 1 month after treatment (twice a week for 5 weeks). In parallel, semen samples of 16 control untreated subfertile males were examined. Two specimens were taken from the control group at an interval of 2-8 months. The expanded semen analysis included routine and ultramorphological observations. The fertility index increased significantly (p < or = .05) following improvement in total functional sperm fraction, percentage of viability, total motile spermatozoa per ejaculate, and integrity of the axonema (p < or = .05), which occurred upon treatment. The intactness of axonema and sperm motility were highly correlated (corr. = .50, p < or = .05). Thus, patients exhibiting a low fertility potential due to reduced sperm activity may benefit from acupuncture treatment.
    Publication Types:

    • Clinical Trial
    • Controlled Clinical Trial

    PMID: 9272232 [PubMed – indexed for MEDLINE]

     

    Andrologia. 2000 Jan;32(1):31-9.

    Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study.
    Siterman S, Eltes F, Wolfson V, Lederman H, Bartoov B.
    Institute of Chinese Medicine, Tel Aviv, Israel.
    Classic therapies are usually ineffective in the treatment of patients with very poor sperm density. The aim of this study was to determine the effect of acupuncture on these males. Semen samples of 20 patients with a history of azoospermia were examined by light microscope (LM) and scanning electron microscope (SEM), with which a microsearch for spermatozoa was carried out. These examinations were performed before and 1 month after acupuncture treatment and revealed that the study group originally contained three severely oligoteratoasthenozoospermic (OTA), two pseudoazoospermic and 15 azoospermic patients. The control group was comprised of 20 untreated males who underwent two semen examinations within a period of 2-4 months and had initial andrological profiles similar to those of the experimental group. No changes in any of the parameters examined were observed in the control group. There was a marked but not significant improvement in the sperm counts of severely OTA males following acupuncture treatment (average = 0.7 +/- 1.1 x 10(6) spermatozoa per ejaculate before treatment vs. 4.3 +/- 3.2 x 10(6) spermatozoa per ejaculate after treatment). A definite increase in sperm count was detected in the ejaculates of 10 (67%) of the 15 azoospermic patients. Seven of these males exhibited post-treatment spermatozoa that were detected even by LM. The sperm production of these seven males increased significantly, from 0 to an average of 1.5 +/- 2.4 x 10(6) spermatozoa per ejaculate (Z = -2.8, P < or = 0.01). Males with genital tract inflammation exhibited the most remarkable improvement in sperm density (on average from 0.3 +/- 0.6 x 10(6) spermatozoa per ejaculate to 3.3 +/- 3.2 x 10(6) spermatozoa per ejaculate; Z = -2.4, P < or = 0.02). Two pregnancies were achieved by the IVF-ICSI procedure. It is concluded that acupuncture may be a useful, nontraumatic treatment for males with very poor sperm density, especially those with a history of genital tract inflammation.
    PMID: 10702864 [PubMed – indexed for MEDLINE]

     

    Arch Androl. 1999 Jul-Aug;43(1):13-25.

    Quantitative ultramorphological analysis of human sperm: fifteen years of experience in the diagnosis and management of male factor infertility.
    Bartoov B, Eltes F, Reichart M, Langzam J, Lederman H, Zabludovsky N.
    Male Fertility Laboratory, Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel.
    The advantages of quantitative ultramorphological (QUM) sperm analysis in the diagnosis and treatment of male infertility are presented. The QUM methodology is based on three elements: complementary scanning electron microscopy and transmission electron microscopy observations of 7 sperm cell subcellular organelles (acrosome, postacrosomal lamina, nucleus, neck, axoneme, mitochondrial sheath, and outer dense fibers); systematic classification of the specific ultramorphological malformations into 4 pathological and the normal categories, indicating the morphological state of each subcellular organelle; and comparison between well-defined reference groups with opposite fertility status or treatment conditions. QUM has established 2 indices for the in vivo and in vitro male fertility potential: (1) Natural Fertility Index (NFI), with accurate prediction (97% sensitivity and 90% specificity) of 80% of the male patients; and (2) IVF score, with prediction of 76% of the nonfertilizing and 90% of fertilizing IVF groups. QUM has enabled assessment of ultramorphological indications for varicocele and radiation exposure. Varicocele causes defects in sperm head organelles related to early spermatid development, whereas ionizing radiation causes amorphous head shape. QUM established criteria for specific non-in-vitro therapeutic interventions, including varicocelectomy, follicle-stimulating hormone (FSH) administration, and acupuncture. The varicocele index enabled correct classification of 79 and 89% of patients with and without varicocele. Males with idiopathic impairment of sperm acrosome and nucleus are potential responders to FSH treatment, whereas patients exhibiting low sperm activity are candidates for acupuncture treatment. Patients with a low Natural Fertility Index are recommended for an assisted reproduction technique (ART). based on the ultramorphology of the tail axoneme. Patients who achieved pregnancy following intrauterine insemination or in vitro fertilization and those whose wives conceived only following intracytoplasmic sperm injection were classified with accuracy of 78 and 74%, respectively. QUM sperm analysis is clinically informative, nontraumatic, and cost-effective, and is recommended when the male infertility factor cannot be clearly diagnosed by routine tests prior to first ART trial.
    PMID: 10445101 [PubMed – indexed for MEDLINE]

     

    Arch Androl. 1999 May-Jun;42(3):161-77.

    Quantitative ultramorphological (QUM) analysis of human sperm: diagnosis and management of male infertility.
    Bartoov B, Eltes F, Reichart M, Langzam J, Lederman H, Zabludovsky N.
    Department of Life Sciences, Bar-Ilan University, Ramat Gan, Israel.
    The advantages of quantitative ultramorphological (QUM) sperm analysis in the diagnosis and treatment of male infertility are presented. QUM methodology is based on three elements: (1) complementary SEM and TEM observations of 7 sperm cell subcellular organelles: acrosome, postacrosomal lamina, nucleus, neck, axoneme, mitochondrial sheath, and outer dense fibers; (2) systematic classification of the specific ultramorphological malformations into 4 pathological and the normal categories, which indicate the morphological state of each subcellular organelle; and (3) comparison between well-defined reference groups with opposite fertility status or treatment conditions. QUM analysis has enabled the establishment of two indices that optimally express the in vivo and in vitro male fertility potential: The Natural Fertility Index (NFI), which allowed an accurate prediction (97% sensitivity and 90% specificity) of 80% of the naturally fertile and suspected infertile male patients, and the in vitro fertilization (IVF) score, which enabled prediction of 76% of the nonfertilizing and 90% of the fertilizing IVF groups. Validation tests confirmed these data. QUM also enabled assessment of ultramorphological indications for varicocele and radiation exposure: Both male factor etiologies indicated a persistent effect on the natural fertility potential, as expressed by structural changes in the nucleus. Varicocele was found to cause defects in the sperm head organelles related to early spermatid development, whereas ionizing radiation resulted in amorphous head shape. Criteria for specific non-in vitro therapeutic interventions such as varicocelectomy, follicle-stimulating hormone (FSH) administration, and acupuncture treatment were established. A varicocele index, which enabled the correct classification of 79 and 89% of the patients pre- and post-high ligation, respectively, was suggested to be a good indicator for varicocele which affects the fertility potential. Males exhibiting idiopathic impairment of sperm acrosome and nucleus were found to be potential responders to FSH treatment, whereas patients exhibiting low sperm activity proved to be good candidates for acupuncture treatment. Indications for selecting the optimal appropriate assisted reproduction technique (ART) procedure were found: Patients with a low Natural Fertility Index should be recommended for ART. A first choice ART selection should be performed according to an ART index based on the ultramorphological examination of the tail axoneme. The above index enabled correct prediction of 78% of the patients who achieved pregnancy following conventional ART (intrauterine insemination or IVF) and 74% of those whose wives conceived only following intracytoplasmic sperm injection. QUM sperm analysis is clinically informative, nontraumatic, and in the long run also cost-effective. This analysis should be performed when the male infertility factor cannot be clearly diagnosed by routine tests and prior to the first ART trial.
    PMID: 10407647 [PubMed – indexed for MEDLINE]

     

    J Huazhong Univ Sci Technolog Med Sci. 2002;22(3):228-30.

    Influence of acupuncture on idiopathic male infertility in assisted reproductive technology.
    Zhang M, Huang G, Lu F, Paulus WE, Sterzik K.
    Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030.
    The clinical effects of acupuncture on idiopathic male infertility in sperm parameter and on therapeutic results in assisted reproductive technology were investigated. 22 patients failed in intracytoplasmic sperm injection (ICSI) with idiopathic male infertility were treated with acupuncture twice weekly for 8 weeks, followed by ICSI treatment again. The sperm concentration, motility, morphology, fertilization rates and embryo quality were observed. Quick sperm motility after acupuncture (18.3% +/- 9.6%) was significantly improved as compared with that before treatment (11.0% +/- 7.5%, P < 0.01). The normal sperm ratio was increased after acupuncture (21.1% +/- 10.4% vs 16.2% +/- 8.2%, P < 0.05). The fertilization rates after acupuncture (66.2%) were obviously higher than that before treatment (40.2%, P < 0.01). There was no significant difference in sperm concentration and general sperm motility between before and after acupuncture. The embryo quality after acupuncture was improved, but the difference between them was not significant (P > 0.05). Acupuncture can improve sperm quality and fertilization rates in assisted reproductive technology.
    PMID: 12658811 [PubMed – in process]

    Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis.

    Manheimer E, Zhang G, Udoff L, Haramati A, Langenberg P, Berman BM, Bouter LM.
    British Medical Journal. 2008 Mar 8;336(7643):545-9. Epub 2008 Feb 7.
    "CONCLUSIONS: Current preliminary evidence suggests that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing in vitro fertilisation."

    Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial.
    Westergaard LG, Mao Q, Krogslund M, Sandrini S, Lenz S, Grinsted J.
    Fertility and Sterility. 2006 May;85(5):1341-6. Epub 2006 Apr 5.
    "CONCLUSION(S): Acupuncture on the day of ET significantly improves the reproductive outcome of IVF/ICSI, compared with no acupuncture. Repeating acupuncture on ET day +2 provided no additional beneficial effect."

    Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility
    Jian Pei, Ph.D.abCorresponding Author Informationemail address, Erwin Strehler, M.D.b, Ulrich Noss, M.D.c, Markus Abt, Ph.D.d, Paola Piomboni, Ph.D.e, Baccio Baccetti, Ph.D.e, Karl Sterzik, M.D.b
    Fertiliy and Sterility: Volume 84, Issue 1, Pages 141-147 (July 2005)
    "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."

    Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study
    S. Dieterle, G. Ying, W. Hatzmann, A. Neuer
    Fertility and Sterility, Volume 85, Issue 5, Pages 1347-1351Conclusion(s)
    "Luteal-phase acupuncture has a positive effect on the outcome of IVF/ICSI."

    Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility
    Jian Pei, Ph.D.abCorresponding Author Informationemail address, Erwin Strehler, M.D.b, Ulrich Noss, M.D.c, Markus Abt, Ph.D.d, Paola Piomboni, Ph.D.e, Baccio Baccetti, Ph.D.e, Karl Sterzik, M.D.b
    Fertiliy and Sterility: Volume 84, Issue 1, Pages 141-147 (July 2005)
    "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."

    Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K. Influence of acupuncture on the pregnancy rates in patients who undergo assisted reproduction therapy. Fertility & Sterility 2002 Apr;77(4):721-4.

    Pei J, Strehler E, Noss U, Abt M, Piomboni P, Baccetti B, Sterzik K. Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertility & Sterility 2005 July;84(1):141-7.

    Gurfinkel E, Cedenho AP, Yamamura Y, Srougi M. Effects of acupuncture and moxa treatment in patients with semen abnormalities. Asian Andrology 2003 Dec;5(4):345-8.

    Bartov B, Eltes F, Reichart M, Langzam J, Lederman H, Zabludovsky N. Quantitative ultramorphological analysis of human sperm: fifteen years of experience in the diagnosis and management of male factor infertility. Arch Andrology 1999 July-Aug;43(1):13-25.

    Siterman S, Eltes F, Wolfson V, Lederman H, Bartov B. Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study. Andrologia 2000 Jan;32(1):31-9.

    Zhang M, Huang G, Lu F, Paulus WE, Sterzik K. Influence of acupuncture on idiopathic male infertility in assisted reproductive technology. J Huazhong Univ Sci Technology Med Sci 2002;22(3):228-30.

    Sinclair S. Male Infertility: nutritional and environmental considerations. Alternative Medical Review 2000 Feb; 5(1):28-38.

    Larson K, De Jonge C, Barnes A, Jost L, Evenson D. Relationship between assisted reproductive techniques (ART) outcome and status of chromatin integrity as measured by the sperm chromatin structure assay. Hum Reprod 2000;15:1717-1722.

    Tsujimura A, Matsumiya K, Takahashi T, Yamanaka M, Koga M, Miura H, Nishimura K, Takeyama M, Fujioka H, Okamoto Y, Iwamoto T, Okuyama A..Effect of lifestyle factors on infertility in men. Arch Androl. 2004 Jan-Feb;50(1):15-7.

    Mehta RH, Kumar TC. Traffic Pollutants affecting male fertility. Hum Reprod. 2003 Sep;18(9):1981.

    Goverde HJM, Dekker HS, Janssen HJG, et al. Semen quality and frequency of smoking and excessive alcohol consumption – an explorative study. Int J Fertility 1995;40:135-8.

    Abell A, Ernst E, Bonde JP. High sperm density among members of organic farmers’ association. Lancet 1994;343:1498.

    Furuya Y, Akashi T, Fuse H. Treatment of traditional Chinese medicine for idiopatic male infertility. Hinyokika Kiyo 2004 Aug;50(8):545-8.

    Suzuki M, Kurabayashi T, Yamamoto Y, Fujita K, Tanaka K. Effects of antioxidant treatment in oligospermic and asthenozoospermic men. J Reprod Med 2003 Sep;48(9):707-12.

    Ma HG, Xu JX, Zhang JF, Zhang F, Wang QT, Xiong CL. The Effect of Chinese medicine yi qi huo xue tang on T-lymphocyte subpopulation in peripheral blood of infertile men with antisperm antibodies. Zhonghua Nan Ke Xue 2003 Apr;9(2):154-6.

    Amano T, Hirata A, Namiki M. Effects of Chinese herbal medicine on sperm motility and fluorescence spectra parameters. Arch Androl 1996 Nov-Dec;37(3):219-24.

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