## Movember Men's Health Special, Part 1

#### The infertility rate here in Australia is estimated to be one in six couples. However the focus on fertility treatments always seems to be skewed towards treating the female. Marketing of fertility treatments seems to be directed at women, reminding them that the clock is ticking. Even in IVF, a lot of stress is placed on the woman to follow strict schedules. Somewhere along the line, it is forgotten that men too play an equally important role in conception.

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![rawpixel1075725unsplash.jpg](https://files.steempeak.com/file/steempeak/metametheus/GPXRVXVp-rawpixel-1075725-unsplash.jpg)Photo by [rawpixel](https://unsplash.com/photos/VAWOw4hN1rA?utm_source=unsplash&utm_medium=referral&utm_content=creditCopyText) on [Unsplash](https://unsplash.com/search/photos/male-fertility?utm_source=unsplash&utm_medium=referral&utm_content=creditCopyText)

On the other hand, holistic fertility treatments focus on both men and women, never assuming that the inability to conceive is due to a woman’s age or egg production alone. Studies are showing the increasing effect of the male on all conception, embryonic/foetal/infant health and pregnancy issues.

It takes between 80-116 days for a single sperm to be created. Going through five cycles of six stages, it is this 3-4 month period before ejaculation where the sperm is susceptible to many threats, before it even takes the journey towards (possible) conception in the uterus of the woman. Because they are smaller and more exposed to environmental factors, sperm are indeed more vulnerable than eggs.

Of the known causes of male infertility, the most common (affecting some 66% of cases) are *issues with production*. The usual causes are factors such as:
* heat
* pressure
* infections
* genetic problems
* exposure to drugs, chemicals, or radiation
* age
* testicular torsion
* undescended testes
* previous vasectomy

15% of cases are due to *blockage of tubes* (ejaculatory problems), and the third most common aetiology is *anti-sperm antibodies* which attack the sperm whilst in the uterus.

Less than 1% of infertility cases are due to sexual problems, which are usually secondary to illnesses such as diabetes, pelvic/prostate surgery, nerve damage from spinal cord injury, anti-depressants and anti-hypertension medication, infrequent intercourse, or age.

Pre-conception health-care for males is therefore essential, especially during the 3-4 months where sperm is being created. 

The factors leading to male infertility need to be identified, and then appropriate diet/lifestyle changes and treatment need to continue throughout this period. Potential dads need to re-consider how they lead their lives and how they treat themselves and their bodies, as their health can impact the health of their offspring. Leukemia, asthma, respiratory disease, mental development/disease have all been linked to the health of the father and his sperm.

Healthy sperm should ideally have a concentration of at least **100 million/ml**. Motility should be **at least 75%**, and normal morphology rates of **no less than 30%** are considered acceptable for natural conception. In the past few years, the details of what is considered acceptable sperm for making the next generation have been significantly revised downwards. Many laboratories now consider 5 million sperm, 45% motility and 97% abnormally formed sperm to be acceptable.

https://www.ccrmivf.com/wp-content/uploads/2017/10/Male-factor-infertility-e1508377894315.jpg

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### TCM male fertility
In Chinese Medicine, there are several physiological factors that must come together to enable a man to be fertile. 

There must be adequate 精 *jīng*, or Essence, which is reflected in a general robustness and vitality, good quality hair that isn't greying, strong nails, no sweating at night or sticking feet outside of the doona, no reflux meds or asthma medication. 

The 命門 *mīngmèn* "gate of destiny" in the lower abdomen must be warm enough to power spermatogenesis. This will show in a strong lower back that doesn't ache, good circulation, hands and feet that don't get cold, and a good strong libido. 

Liver-qì must be free-flowing and Kidney-qì must be abundant enough to promote healthy sperm production and maintain normal ejaculation. When the Liver and Kidney are functioning well there will be a moderate temperament without anger, good vitality, clear eyes without dark circles or puffiness underneath. 

A man must also have adequate vitality and general nutrition, to promote the quality and liveliness of his sperm which contain a blueprint that gives his offspring the best foundation to life possible.

If prostate issues are suspected, or there is a blockage interfering with normal ejaculation, TCM looks for "phlegm" or "blood stasis", which tend to obstruct the seminal pathways and allow normal ejaculation. 

Issues that damage or interfere with the normal shape of the sperm (morphology) are often classified as "damp-heat" or "heat-toxins". These can be present in the body due to exposure to toxins, chemicals, radiation, infections and STD’s. Checking the semen for Human Papilloma virus (HPV), cytomegalovirus (CMV), herpes simplex virus (HSV), human herpes virus type-6 (HHV-6), Epstein-Barr virus, hepatitis-B, and Chlamydia trachomatis can be useful; at the sub-clinical level, there may be no visible signs or symptoms, but the DNA of these viruses will show up in the semen.

Of course, there are other factors which we would also look at addressing, such as the physiological factors involved when men are over-weight or suffering from obesity. When there are prostate issues, these presenting patterns usually combine also to create infertility, as would any of the patterns involved with more psycho-emotional conditions involving low libido, erectile dysfunction, or other issues related to performance. 

Psychological and emotional well-being is also important, as how we as men feel will also affect our partners’ moods, thus affecting the deep connection which also is important in the act of conception.

http://media.healthplus.vn/thumb_x650x382/Images/Uploaded/Share/2017/10/05/dieu-tri-roi-loan-cuong-duong-hieu-qua-bang-cach-tap-yoga11507192987.jpg

In treating male infertility, both acupuncture/moxibustion and Chinese herbal medicine can be of great benefit. However it also vital to look at one’s diet, and make the appropriate modifications, depending in the individual. Antioxidants such as zinc, folate, vitamins E & C, and beta-carotene have been found to be useful to improve fertility; these are best taken in supplement form, the therapeutic levels required to achieve positive changes in sperm often exceed what is possible in a normal diet.

Lifestyle issues also need to be taken into account with appropriate modifications, such as reducing the exposure of the scrotum to heat due to tight and synthetic-fibre underwear, hot baths, and so on. 

The ancient Chinese also knew that maintaining regular — but not excessive — sexual activity is important, as it ensures the free-flow of 氣 *Qì* (energy), 血 Blood, and 精 Essence, thus maintaining fertility. 

Psychological and emotional well-being is also important, as how we as men feel will also affect our partners’ moods, thus affecting the deep connection which also is important in the act of conception.

Overall, a holistic approach is best and involves utilising modern testing methods with ancient Chinese treatments and augmentation practices such as diet, lifestyle, and gentle or mindful exercise such as Qigong, Yoga, or Taichi.

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