Male Factor Infertility – It Takes 2 to Spark the Miracle of Conception!

Men are integral to the process, you know?
male factor infertility semen analysis

Male Factor Infertility: The Miracle of Conception is a Collaborative Process

Male Factor Infertility? It can’t be an issue with the sperm, can it?

The process toward conception is often a collaborative process, whether or not both partners are aware of it. In Chinese reproductive medicine, there is a strong suggestion to ‘treat both male and female’, and this suggestion is corroborated by the fact that the quality of the sperm is as important as the quality of the ovum as well as the terrain of the host (the mother-to-be).

We know that sperm count has fallen in the last 50 years. In the 90s, a Danish group of researchers published in the British Medical Journal that there was a 50% fall in global sperm counts from 1940 to 1990. A most recent study used 26,600 French men between 1989 and 2005 as the population — the researchers found a drop from 73.6 to 49.9 million sperm per millilitre!

The most important thing the male partner can do, apart from contributing the sperm for conception to happen, is to at least do a Semen Analysis. Cases where the lady comes regularly for treatment thinking she is ‘the problem’ are not unique. The male just needs to do the test and if numbers are above 20 million/ml, then he knows his contribution is secure.

If his numbers are slightly compromised, he can consider using some supplements or herbs too. In most cases, treatment and diagnosis of the male is less complicated than treatment and diagnosis of the female. That said, it is important that he is diagnosed and ‘cleared’.


  1. Carlsen, Giwercman, Keiding, Skakkebaek. Evidence for decreasing quality of semen during the past 50 years. BMJ 1992;305:609
  2. Rolland, Le Moal, Wagner, Royere, De Mouzon. Decline in semen concentration and morphology in a sample of 26609 men close to general population between 1989 and 2005 in France. Hum Reprod (2013) 28 (2): 462-470.

Male Factor Infertility – Low Sperm Count


One reason why a couple decides to go to an IVF clinic is when the male is tested to have very low sperm count — either severe oligozoospermia or azoospermia. The IVF process includes the ICSI procedure which helps inject a ‘strong’ and ‘good looking’ sperm into an unfertilized egg.

We still don’t know enough about how this intervention is different from the competitive process of fertilization that happen in a natural conception. But many dads-to-be would also want to assist the process by using natural means to improve reproductive function.

How do we know?

What actually happens is that the male provides a sample of his semen, which then undergoes a “semen analysis”. The results of the semen analysis can be that he has normozoospermia (normal count, strength and shape) or some or all of the below:

  • oligozoospermia: this means that the concentration of sperm is not within ‘normal’ levels, and is called ‘low sperm count’ by some.
  • asthenozoospermia: this mean that not enough sperm are swimming with enough strength, and can be called ‘weak’ sperm.
  • teratozoospermia: this means that that is a high proportion of sperm that are mutated.

You may also test for DNA Fragmentation. The DFI or DNA fragmentation index will tell you the percentage of sperm cells containing damaged DNA.

All these tests tell you that perhaps you may want to do something to enhance your reproductive function as a guy if you and your wife want to conceive a healthy and happy baby.

Male Factor Infertility – You Want Less of These!

male factor infertility singapore things to do to improve sperm count

Put less of these in your body (Reduce or Eliminate!):

Alcohol: It is good to drink in moderation as an excess of alcohol will have harmful effects on semen quality.
Caffeine: When you are drinking too much coffee, e.g. 3 cups a day, it will have deleterious effects on sperm DNA. Other sources of caffeine like fermented tea or yerba mate are possible substitutes.
Smoking: Both tobacco and marijuana have a negative effect on semen quality. Acupuncture and hypnotherapy are possible ways to help you quit.
Drugs: If you are using heart medication, anti-depressants, anti-fungals, painkiller or immunosuppressant, note that some may have a deleterious effect on semen quality.

Expose yourself to less of these (Environmental Stress):

Thermal Stress: Spermatogenesis is not aided by high temperatures. Therefore, cooks who frequently stand near the fire, or motor bikers who are often sitting on a heated vehicles have to be careful. Exercise fanatics who love cycling will have to be careful for the same reason. For this reason, it is also good to stay off tights and tight jeans, and to ‘hang loose with your boxers as much as possible.

Chemical Stress: Men who have repeated exposure to fumes or chemicals at their workplace are also liable to experience a reduction in sperm concentration and an increase in abnormal morphologies.

Electronic Stress: Laptops and mobiles phones are common sources of electromagnetic radiation, which is detrimental to reproductive function. So it is advisable not to leave your laptop on your lap for too long, and please kick the habit of leaving your mobile phone in your pants pocket!

Male Factor Infertility – You Want More of These!

Male Factor Infertility Things to Do - Healthy Food Acupuncture supplements Weight Stress

Get more of these!

Healthy Food: Healthy and wholesome food is advisable, and there is not particular diet to stick to for most coming in. However, if you are of a damp-heat constitution, then it is advisable for you to stay off red meats and spicy foods, and alcohol for that matter.

Herbs and Supplements: Vitamins A, C and E, as well as zinc, selenium and CoQ10 are known to be useful for male fertility. Antioxidants in the seminal fluid protect the sperm from reactive oxygen species during the process of spermatogenesis. Chinese herbs are also a great form of supplementation, many of which work as a tonic for enhancing reproductive function.

Acupuncture: Acupuncture is able to help the woman underdoing an IVF cycle; it is also able to help with male factor fertility, and is especially good if there are issues with sperm count, motility and with mild to moderate erectile dysfunction.

No, we will not be putting needling into your genitals; the needles are placed mostly on the abdomen and the legs. How does it work? It is likely that acupuncture over time will increase microcirculation in the testes, hence facilitating the growth and development of sperm.

At Soma Clinic, we do not ask every male to do acupuncture, but we do recommend a customized herbal interventions as it has often been helpful even in tandem with Profertil or other supplements.

Try to manage these (Things you may have some control over):

Mental and Emotional Stress: Stress is the silent killer, especially in modern society where it is a huge component of all diseases. Manage stress and you manage your fertility. Do so by taking some time out each day to spend time with people you love, or by working out the stress in a gym or with a sport. Some men also benefit from receiving acupuncture or myofascial release, which then helps them reduce stress levels and sleep better.

Weight Management: Excess adipose tissue in the body results in accumulation of estrogen and a reduction in testosterone in the body. Diet and exercise is crucial to effective weight management.

Sex: There is a reason for why a few days of abstinence is advised before doing the semen analysis test. Abstinence builds up sperm count, but it is frequent ejaculations that actually aids in improvements in motility and morphology! Frequent sex every alternate day before the day of expected ovulation is one way to take advantage of that window of opportunity.

Male Factor Infertility – What to Do with Varicocele?

male factor infertility - varicocele affects spermatogenesis

What are Varicoceles?

Varicoceles are created when veins become abnormally enlarged inside your scrotum. These veins are called the pampiniform plexus. Ten to 15 of every 100 males have a varicocele which can start growing as soon as they hit puberty. It is like getting a varicose vein in your leg and hardly carries any symptoms.

The adverse effect of varicocele on spermatogenesis can be attributed to many factors such as an increased testicular temperature, increased intra-testicular pressure, hypoxia due to reduction of blood flow, reflux of toxic metabolites from the adrenal glands and hormonal profile abnormalities.

Varicocele may be the cause of male fertility problems in about 4 out of 10 men who have problems fathering their first child, according the American Urological Association. Varicocele, being the second most common cause in male infertility, has affected 35–50% of patients with primary infertility and up to 81% of men with secondary infertility.

The surprisingly high incidence of varicocele in secondary infertility suggests that varicoceles cause progressive decline in testicular function over time.

  • A varicocele causes an increase in the temperature of the testicles, which affects sperm development. Sperm counts decrease by an estimated 40% for every degree the testicles rise in temperature.
  • Also, varicocele is related to lower testosterone levels, which may result in a number of long-term health conditions and can also affect sex drive.
  • It has moreover been associated with DNA damage in sperm. Studies suggest that men with varicocele have more damaged sperm than men who do not suffer from the problem. Testicular inflammation, swollen veins in the scrotum, and abnormally developed testicles can cause abnormal sperm.

Acupuncture Treatment for Varicocele?

The aim of acupuncture is to increased sperm count and improve the quality of motile sperm. According to a study by Kyung Hee University in Korea, the use of acupuncture and herbs helps improve the scrotal thermoregulation, reducing the heat in the scrotum. A recent study in 2016 compared surgical versus acupuncture treatment of men who were infertile due to varicocles in the testes.

It was found that both methods were successful in improving sperm parameters although acupuncture was superior to surgery when performed twice a week for 2 months. Sperm concentration and motility improved significantly in both groups after the treatment. Increase in sperm concentration was higher in the acupuncture group compared to the varicocelectomy group.

Natural therapies may be complementary to support the health of the tissues and vein walls, improve circulation to the testes, and improve cellular health to protect the sperm and reproductive tissues from free radical and toxin damage through specific nutrient and herbal support.

Supplements for Varicocele?

  • CoQ10 (or Ubiquinol) is an antioxidant that protects the sperm as well as the delicate DNA within the sperm from free radical damage.
  • Selenium is a mineral necessary for proper sperm formation. It is easy to get adequate selenium intake by eating 2-5 Brazil nuts a day. A trial confirmed that selenium supplementation in subfertile men with low selenium status can improve sperm motility and the chance of successful conception by up to 56%. Lastly, L
  • Carnitine is also important to sperm health. L-Carnitine is a potent antioxidant that has been reported to increase sperm health by providing the protection the body needs to counteract free radical damage and increase libido naturally. Antioxidants protect cellular health, including the health of a man’s sperm and the DNA contained within each sperm.

When it comes to varicocele and male infertility, these are some of the ways in which you can intervene, whether or not you are going ahead with surgical intervention.


  1. Male infertility and varicocele: myths and reality. P D Kantartzi, Ch D Goulis, G D Goulis, and I Papadimas
  2. The Role of Varicocele Repair in the New Era of Assisted Reproductive Technology. Marcello Cocuzza, Mariana Amora Cocuzza, Frances Monette Papa Bragais, and Ashok Agarwal
    Loss of fertility in men with varicocele. Gorelick JI, Goldstein M Fertil Steril. 1993 Mar; 59(3):613-6.
  3. Varicocele: a progressive or static lesion? Witt MA, Lipshultz LI Urology. 1993 Nov; 42(5):541-3.
  4. Improvements in Scrotal Thermoregulation in Patients with Varicoceles Treated by Using Traditional Korean Medicine: Two Case Reports. Junyoung Jo, Hyunho Kim, Ui Min Jerng
  5. Randomised clinical trial of comparing effects of acupuncture and varicocelectomy on sperm parameters in infertile varicocele patients. Kucuk EV, Bindayi A, Boylu U, Onol FF, Gumus E.
  6. The effect of oral selenium supplementation on human sperm motility. Scott R, MacPherson A, Yates RW, Hussain B, Dixon J.
  7. A placebo-controlled double-blind randomized trial of the use of combined L-carnitine and L-acetyl-carnitine treatment in men with asthenozoospermia. Fertility and Sterility p. 1578–1584, Vol. 81, Issue 6, June.
 Lenzi, Andrea, M.D., et al. (2004).
  8. Use of carnitine therapy in selected cases of male factor infertility: a double-blind crossover trial. Fertility and Sterility p. 292–300, Vol. 79, No. 2, February. Lenzi, Andrea, M.D., et al. (2003).