Blue Poppy: Low Sperm Count

abstracted & translated by

Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

Keywords: Chinese medicine, Chinese herbal medicine, infertility, low sperm count, oligospermia

Approximately six percent of males between 15 and 50 struggle with infertility, and low sperm count is the leading cause of male infertility. Ninety percent of male infertility is caused by the failure to produce enough sperm. Azoöspermia occurs when no sperm is produced, while oligospermia is diagnosed when few sperm are produced. Since most sperm are destroyed before ever reaching the egg, the more sperm there are the better the chances that one will successfully fertilize the egg. Low sperm count can be temporary or permanent. Temporary reduction in sperm production may be due to excessive bicycling, exposure to extreme heat, ill-fitting underwear, insomnia, performance pressure, or emotional stress. However, over the last few decades, sperm count has been declining steadily. Many studies have linked this alarming trend to our modern high-fat, nutrient-deficient diet. Since sperm are highly vulnerable to free radical and oxidative damage, healthy sperm formation requires an adequate and ready supply of the proper nutrients and antioxidants. Other possible reasons for low sperm count include varicoceles, environmental factors (pollution and exposure to heavy metals), and exposure to synthetic estrogens such as those found in birth control pills and in livestock. For instance, men who work as painters, decorators, and printers are much more likely to have a low sperm count compared with other male professionals due to their repeated exposure to organic solvents, such as paint thinner and turpentine. A count of below 20 million sperm per milliliter is a low sperm count and may need to be treated as it reduces a man’s fertility and may affect a couple’s chances of conception. Simple treatment of low sperm count may include wearing looser underwear and reducing the intake of cigarettes and alcohol. On page 50 of issue #1, 2005 of the Shi Yong Zhong Yi Nei Ke Za Zhi (Journal of Practical Chinese Medical Internal Medicine), Zhang Jun published an article titled, "The Treatment of 156 Cases of Oligospermia with Sheng Jing Qiang You Tang (Engender Essence & Strengthen Fertility Decoction)." A summary of this article is presented below.

Cohort description:

All 156 patients enrolled in this study were between 23 and 40 years of age. Fifty-four had been unable to impregnate their partner for 1-2 years, 69 had been unable to impregnate their partner for 3-4 years, and 33 had been unable to impregnate their partner for 5-10 years. One hundred three cases suffered from primary infertility, while the remaining 53 suffered from secondary infertility. The external reproductive organs and testes of all these men were normal. Each man’s semen was analyzed three times, with a 7-10 day interval between tests. All these men had a sperm count of less than 20 X 10⁶/ml and, as such met the diagnostic criteria for oligospermia. None of the men had taken any medication to increase their sperm within three months of the start of this study.

Treatment method:

All 156 men were orally administered Sheng Jing Qiang You Tang (Engender Essence & Strengthen Fertility Decoction) which consisted of:

Gui Ban Jiao (Gelatinum Plastri Testudinis), 15g

Lu Jiao Jiao (Gelatinum Cornu Cervi), 10g

Ze Xie (Rhizoma Alismatis Orientalis), 10g

Tu Si Zi (Semen Cuscutae Chinensis), 15g

Gou Qi Zi (Fructus Lycii Chinensis), 30g

Shan Zhu Yu (Fructus Corni Officinalis), 15g

Fu Ling (Sclerotium Poriae Cocos), 15g

Yin Yang Huo (Herba Epimedii), 10g

Shan Yao (Radix Dioscoreae Oppositae), 20g

Huang Qi (Radix Astragali Membranacei), 20g

Dang Gui (Radix Angelicae Sinensis), 15g

Chuan Xiong (Radix Ligustici Wallichii), 10g

If there was kidney yang depletion and vacuity, Ba Ji Tian (Radix Morindae Officinalis), Rou Gui (Cortex Cinnamomi Cassiae), and Rou Cong Rong (Herba Cistanchis Deserticolae) were added.

If there was kidney yin insufficiency, He Shou Wu (Radix Polygoni Multiflori) and Shu Di (cooked Radix Rehmanniae Glutinosae) were added.

If there was deep-lying or hidden heat in the essence chamber, Lu Jiao Jiao, Yin Yang Huo, and Shan Zhu Yu were removed, and Huang Bai (Cortex Phellodendri), Che Qian Zi (Semen Plantaginis), uncooked Yi Yi Ren (Semen Coicis Lachryma-jobi), Bai Jiang Cao (Herba Patriniae Heterophyllae), and Long Dan Cao (Radix Gentianae Scabrae) were added.

If there was spermatic vessel stasis and obstruction, Dan Shen (Radix Salviae Miltiorrhizae), Chi Shao (Radix Rubrus Paeoniae Lactiflorae), Tao Ren (Semen Pruni Persicae), and Hong Hua (Flos Carthami Tinctorii) were added

One packet of these medicinals was decocted in water and administered warm per day in two divided doses. Continuous administration for three months equaled one course of therapy. During the course of treatment, patients were not allowed to use any other treatment or medication for this problem. They were also forbidden to smoke, drink alcohol, or engage in sex.

Study outcomes:

Cure was defined as successful impregnation of the patient’s partner. Marked effect meant that the sperm count was in excess of 20 X 10⁶/ml. Some effect meant that the patient’s sperm count was still less than 20 X 10⁶/ml but had increased compared to before treatment. No effect meant that there was no change in sperm count from before to after treatment. Based on these criteria, after 1-2 courses of treatment, 38 men were cured, 59 got a marked effect, 35 got some effect, and 24 got no effect, for a total effectiveness rate of 85.9%.

Discussion:

According to Dr. Zhang, the kidneys are the former heaven root which govern reproduction and the storage of essence, and male infertility due to oligospermia is mostly the result of kidney depletion and lack of essence. Therefore, its treatment should mainly regulate and supplement yin and yang, boost the kidneys and engender essence. Within the above formula, Gui Ban Jiao and Lu Lu Jiao are two bloody-meaty ingredients. These are the sovereign ingredients in this prescription. One is yin and the other is yang. One is still and the other is stirring. Together, these two medicinals regulate and supplement original yin and original yang. Gou Qi Zi and Tu Si Zi enrich the kidneys and engender essence. Yin Yang Huo supplements kidney yang. Modern research has shown that it markedly promotes the secretion of testosterone, increase spermatogensis, and promotes the secretion of seminal fluid. Shan Zhu Yu fosters the essence and secures the kidneys. Huang Qi and Shan Yao boost the qi and fortify the spleen, thus strengthening the latter heaven in order to nourish the former heaven. Dang Gui and Chuan Xiong nourish and quicken the blood. Thus they improve the circulation to the testicles and associated organs. This also indirectly increases the testes spermatogenesis. Fu Ling and Ze Xie disinhibit dampness and dispel turbidity. Taken as whole, this formula is warm but is not drying. It enriches the kidneys but is not slimy. It secures the kidneys but does not retain evils. It downbears and drains, but it does not damage the righteous. It supplements the kidneys at the same time as fortifies the spleen and boosts the qi, nourishes and quickens the blood. This leads to the regulation and harmonization of yin and yang as well as the filling of the qi and engenderment of essence. Thus the disease is cured. Further, when this basic formula is modified based on individualized pattern discrimination, its effects are even better.