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Case Study in the Treatment of Male Infertility

 

by Dr. Li-man Yang

Department of Traditional Chinese Medicine, Tainan Municipal Hospital

 

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Factors such as the increasing age at which people marry, environmental pollution, and increasing stress have affected the quality of many men’s sperm leading to an increase in many couples inability to conceive children. According to investigations on infertility done by WHO in 2004, one out of every four couples has had issues with infertility. Chinese herbal medicine can improve the quality of sperm, and in particular can reduce the percentage of abnormal sperm cells as well as markedly increase their motility. Chinese medicine has the potential to play an important role in reproductive health.

 

 

From a medical perspective there are numerous causes of male infertility. Nevertheless, these various causes are independent of each other and the etiology, pathology and treatment for each is unique and specific. Male infertility is best seen as a combination of causes, or a syndrome, that encompasses many pathological factors. Consequently, it is important when diagnosing to properly identify the primary factors involved.

 

In the Principles of Women’s Health (Furen Gui) it says, “In regards to illnesses associated with fertility, men’s illnesses have to do with essence, whereas women’s with blood.” It also says, “In most cases of men with deficiency, the problems include; leakage of essence, dilute essence, and cold essence. Also included are those who cannot get firm when the time arrives, those whose essence flows out but cannot be discharged forcefully, those who often have nocturnal emissions, or those with strangury and cloudy urine.” These statements point to the causes of male infertility being due to poor sexual organ development, low sperm count, low sperm motility, high levels of morbid sperm, impotence, premature ejaculation, frequent involuntary loss of semen, turbid strangury, and anejaculation.   

 

According to Chinese medicine the most common reasons for infertility include Kidney Yang deficiency, Kidney Yin damage, deficiency of Yin and Yang, damp heat accumulation, Qi and blood stagnation and deficiency.

  

Clinical Case Study

 

【Patient Information】

 

 

【Chief Complaint】

No children after three years of marriage.

 

【Patient History】

The patient was a 45-year-old man who had been diagnosed as having low sperm count, low sperm motility, and a high percentage of abnormal sperm cells. He had been married for three years and his wife had already undergone three unsuccessful attempts at artificial fertilization and one unsuccessful attempt at in vitro fertilization. The patient came to the Tainan Municipal Hospital because his doctor recommended he strengthen his constitution with Chinese medicine before trying in vitro fertilization again.

 

Pattern of Spleen and Stomach Qi Deficiency/Sinking of Qi

 

【Chinese medicine diagnosis】

Inspection: Average build (height 178cm, weight 74kg). He had a pale complexion, pink lips, and a pink tongue with a thin white coating.

Listening and smelling: No unusual odors. Normal speech.

Inquiry: The patient is a laborer and often gets very fatigued because of his work. He complains of lumbar soreness. His bowel movements, urination, and appetite and sleep are all normal, with no bitter taste or dryness in his mouth.

Palpation: Blood pressure: 134/78

Pulse: deep

 

【Diagnosis】

Western medical diagnosis: Infertility

TCM diagnosis: Infertility due to debilitated Kidney Yang and Spleen Qi deficiency  

 

【Analysis】

Despite being married for three years the patient and his wife had yet to conceive. The patient had a pale complexion and complained that he often felt fatigued and had lumbago. He had no complaints of dry mouth or unusual sweating and his appetite was fine. His pulse was deep and his tongue was pink with a thin white coating. Such signs indicate Qi deficiency as well as kidney deficiency. An initial examination of the patient’s sperm showed that he had low sperm motility, a low sperm count and a high rate of abnormal sperm. The combination of these factors indicated debilitated Kidney Yang and Spleen Qi deficiency.

 

【Treatment Plan】

Supplement Kidney Yin and Yang, fortify the Spleen and raise the Yang.

 

【Prescription】 

Formula	Ginseng & Astragalus Combination (Bu Zhong Yi Qi Tang)	Supplements Qi and fortifies the Spleen, benefits those who are weak with lumbar soreness and low sperm motility.
Single herbs	Epimedium (Yin Yang Huo), Psoralea Fruit (Bu Gu Zhi), Cistanche (Rou Cong Rong), Cuscuta (Tu Si Zi), Curculigo (Tian Xian Mao), and Eucommia Bark (Du Zhong)	Medicinals to warm and supplement Kidney Yang
	Taxilli (Sang Ji Sheng), Dendrobium (Shi Hu), Eclipta (Han Lian Cao), Asparagus (Tian Men Dong)	Medicinals to enrich and supplement Kidney Yin.
	Astragalus (Huang Qi)	Medicinals to supplement Qi.

 

 

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【Treatment Course】for members only

【Treatment Results】for members only

【Discussion】for members only

【Conclusion】for members only

【Commonly Used Formulas and Herbs for Treating Male Infertility】for members only