Enhancing Sperm Motility Parameters in Patients with Asthenospermia: A Combined Approach of Acupuncture at Fusiguan Point and Tamoxifen Citrate Tablets.

OBJECTIVE: To explore the effect of acupuncture at Fuguan point combined with tamoxifen citrate tablet on sperm motility parameters. METHODS: A total of 115 individuals with asthenospermia were categorized based on different treatment regimens: 53 patients in the control group (receiving tamoxifen citrate tablets) and 62 patients in the observation group (undergoing acupoint acupuncture in conjunction with tamoxifen citrate tablets). Both groups underwent a 3-month treatment period. The computer-assisted sperm analysis system was employed to measure various motility parameters of human sperm, including sperm motility rate, average path velocity (VAP), lateral swing amplitude (ALH), percentage of class a sperm, and percentage of class a + b sperm. RESULTS: Prior to treatment, no statistically significant differences were observed between the two groups in terms of sperm motility rate, VAP, ALH, percentage of class a sperm, and percentage of class a + b sperm (p > 0.05). Following treatment, both groups exhibited significant enhancements in sperm motility rate, VAP, ALH, percentage of class a sperm, and percentage of class a + b sperm compared to pretreatment levels (p < 0.05). Furthermore, all measured indicators in the observation group demonstrated significantly superior improvements than those of the control group, with the differences proving statistically significant (p < 0.05). CONCLUSIONS: The combination of acupuncture at Fusiguan point and tamoxifen citrate tablets exerts a notably positive effect on sperm motility in individuals diagnosed with asthenospermia.

Moxibustion prevents tripterygium glycoside-induced oligoasthenoteratozoospermia in rats via reduced oxidative stress and modulation of the Nrf2/HO-1 signaling pathway.

Oligoasthenoteratozoospermia (OAT) decreases male fertility, seriously affecting the production of offspring. This study clarified the preventive impact of different moxibustion frequencies on OAT and selected the optimal frequency to elucidate the underlying mechanism. An OAT rat model was constructed by gavage of tripterygium glycosides (TGS) suspension. Daily moxibustion (DM) or alternate-day moxibustion (ADM) was administered on the day of TGS suspension administration. Finally, we selected DM for further study based on sperm quality and DNA fragmentation index, testicular and epididymal morphology, and reproductive hormone level results. Subsequently, the oxidative stress (OS) status was evaluated by observing the OS indices levels; malondialdehyde (MDA), 8-hydroxy-deoxyguanosine (8-OHdG), total antioxidant capacity (T-AOC), and total superoxide dismutase (T-SOD) in testicular tissue using colorimetry and enzyme-linked immunosorbent assay. Furthermore, heme oxygenase 1 (HO-1) and nuclear factor erythropoietin-2-related factor 2 (Nrf2) were evaluated using Western blotting. Immunohistochemistry was employed to locate and assess the expression of HO-1 and Nrf2 protein, while quantitative real-time polymerase chain reaction was utilized to detect their mRNA expression. MDA and 8-OHdG levels decreased following DM treatment, while T-SOD and T-AOC increased, suggesting that DM may prevent TGS-induced OAT in rats by decreasing OS in the testis. Furthermore, protein and mRNA expression of Nrf2 and HO-1 in the testis were elevated, indicating that DM may reduce OS by activating the signaling pathway of Nrf2/HO-1. Therefore, DM could prevent OAT in rats via the Nrf2/HO-1 pathway, thereby presenting a promising therapeutic approach against OAT.

A Case Report of Idiopathic OAT Syndrome, Associated with Necrospermia and Hypospermia, Reversed with Individualized Homeopathy.

BACKGROUND: Oligo-astheno-teratozoospermia (OAT) syndrome is one of the causes of male infertility, characterized by a decreased number of sperms (oligospermia), poor sperm motility (asthenospermia), and abnormal sperm shape (teratospermia). In necrospermia, spermatozoa in the ejaculated semen are dead, and in hypospermia, semen volume is less than 2 mL. The present case may be unique because of the association of all these features together in a single patient. METHOD: This idiopathic case was treated, from November 2016 to April 2017 in the National Homeopathy Research Institute in Mental Health, with the homeopathic medicine Natrium muriaticum. The Modified Naranjo Criteria for Homeopathy (MONARCH) score was used to assess the likelihood of causal attribution of the clinical outcome to the homeopathic medicine. RESULT: By the third month of starting homeopathic treatment, there was a marked improvement in sperm count from 14.4 to 77.4 million, semen volume from 0.8 to 2.2 mL, and normal forms from 14 to 75%. His wife became pregnant by the 5th month and delivered a healthy baby girl at full term. A MONARCH score of +9/13 indicates a positive causal relationship between the medicine prescribed and the treatment outcome. CONCLUSION: The present case report suggests a positive effect of individualized homeopathic medicine in treating a rare presentation of male infertility due to OAT syndrome.

Effectiveness of acupuncture for asthenozoospermia: A protocol for systematic review and meta-analysis.

BACKGROUND: According to the World Health Organization, the global incidence of infertility is about 15%, and more than 50% of infertility cases are caused by male infertility. Asthenozoospermia is caused by male fertility decline and male infertility. Due to work pressure, environmental pollution, sexual diseases, and other factors, the number of patients with asthenozoospermia has increased in recent years. It has been confirmed that acupuncture has a certain effect on patients with asthenozoospermia. Acupuncture and moxibustion can be an adjuvant treatment plan for the treatment of asthenozoospermia in addition to drug treatment. METHODS: Randomized controlled trials of acupuncture for asthenozoospermia will be searched in the relevant database, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), and Chinese Scientific Journal Database (VIP database). The studies of electronic searches will be exported to EndNote V.9.1 software. We will run meta-analyses using the Review Manager (RevMan) V.5.3 software. Any disagreements will be solved in consultation with a third reviewer. RESULTS: Our study aims to explore the efficacy of acupuncture for asthenozoospermia and to provide up-to-date evidence for clinical of asthenozoospermia. CONCLUSION: This study will perform a comprehensive systematic review and meta-analysis on the efficacy of acupuncture for asthenozoospermia, making up for the lack of relevant evidence of the clinical use of acupuncture. INPLASY REGISTRATION NUMBER: INPLASY 202140032.

Efficacy of electroacupuncture for the treatment of asthenozoospermia: A protocol for systematic review and meta-analysis.

INTRODUCTION: Infertility has affected millions of couples aged 15 to 44 years worldwide. Recently, some studies suggest that abnormal semen quality is the main cause of male infertility and asthenozoospermia accounts for 19% of the infertility of men. The situation has brought a huge burden to the patient with asthenozoospermia and society. Acupuncture is a part of traditional Chinese medicine. Electroacupuncture (EA) has gained in popularity. Although a positive effect of manual acupuncture and EA on sperm parameters has been documented in several studies, there still a lack of more solid evidence. We hope to provide a convincing study for EA. METHODS AND ANALYSIS: The electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, Cochrane Library, Clinicaltrials. org, China National Knowledge Infrastructure Database (CNKI), Wan fang Database, China Biology Medicine Database (CBM), VIP Science Technology Periodical Database, Chinese Clinical Trial Registry will be retrieved. All the randomized controlled trials of rESWT for patients with CP/CPPS will be included. We will evaluate the outcomes including NIH-CPSI, VAS, IPSS, IIEF-5, and conduct this study strictly according to the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: The present study is a protocol for systematic review and meta-analysis without results, and data analysis will be carried out after the protocol. We will share our findings on October 31st, 2021. CONCLUSIONS: EA for asthenospermia is a microtrauma surgery with less pain. EA can effectively improve sperm motility; however, its efficacy has not been assessed scientifically and systematically. To address this limitation, this study will inspect the efficacy and safety of the EA in patients with asthenospermia. ETHICS AND DISSEMINATION: Formal ethical approval is not required in this protocol. We will collect and analyze data based on published studies, and since there are no patients involved in this study, individual privacy will not be under concerns. The results of this review will be disseminated to peer-reviewed journals or submit to related conferences. PROTOCOL REGISTRATION NUMBER: INPLASY2020100071.

Roles of CatSper channels in the pathogenesis of asthenozoospermia and the therapeutic effects of acupuncture-like treatment on asthenozoospermia.

Rationale: Idiopathic asthenozoospermia (iAZS) is one of the major causes of male infertility and has no effective therapeutic treatment. Understanding the potential mechanisms that cause it may be helpful in seeking novel targets and treatment strategies for overcoming the problem of low sperm motility in iAZS individuals. Methods: Computer-assisted semen analysis (CASA) was utilized to assess the sperm motility. RT-qPCR, Western blot, immunofluorescence staining, and calcium imaging analysis were performed to examine the expression and function of CatSper channels. Hyperactivation and acrosome reaction were used to evaluate the functional characteristics of epididymal sperm. In vivo fertility assay was applied to determine the fertility of rats. CatSper1 knockdown and overexpression experiments were performed to confirm the roles of CatSper channels in the pathogenesis of iAZS and the therapeutic effects of electroacupuncture (EA) treatment on AZS model rats. Results: Here, we reported a functional down-regulation of CatSper channel from CatSper1 to CatSper 4 in the sperm of both iAZS patients and ornidazole (ORN)-induced AZS model rats, and an impaired sperm function characterized by a reduction of protein tyrosine phosphorylation, hyperactivation, and acrosome reaction in the epididymal sperm of AZS rats. Knockdown of CatSper1 in the testis tissues is sufficient to induce AZS in normal rats, and this action was validated by the reversal effects of CatSper1 overexpression. Transcutaneous electrical acupoint stimulation (TEAS) and electroacupuncture (EA) at 2 Hz frequency improve the sperm motility via enhancing the functional expression of CatSper channels in the sperm. Gene silencing CatSper1 in the sperm abolishes the therapeutic effects of 2 Hz-EA treatment on AZS rats. Conclusions: We conclude that a functional down-regulation of CatSper channel in the sperm may be a contributor or a downstream indicator for a portion of AZS, especially iAZS, while 2 Hz-TEAS or EA treatment has a therapeutic effect on iAZS through inducing the functional up-regulation of CatSper channels in the sperm. This study provides a novel mechanism for the pathogenesis of some AZS especially iAZS, and presents a potential therapeutic target of CatSper for iAZS treatment. Acupuncture treatment like TEAS may be used as a promising complementary and alternative medicine (CAM) therapy for male infertility caused by iAZS in clinical practice.

Acupuncture for oligospermia and asthenozoospermia: A systematic review and meta-analysis.

BACKGROUND: Acupuncture is widely used for oligospermia and asthenozoospermia in China, but its effect is unclear. We aimed to determine the effectiveness and safety of acupuncture in treating oligospermia and asthenozoospermia. METHODS: An electronic search for randomized controlled trials evaluating acupuncture treatment in patients with oligospermia and asthenozoospermia published from database inception to October 2018 was conducted in PubMed, EMBASE, the Chinese Biomedical Literature Database, the Chinese Scientific Journal Database (VIP Database), the Wan-Fang Database, the China National Knowledge Infrastructure and the Cochrane Library. We established search terms related to 3 areas (oligospermia, asthenozoospermia, and acupuncture). Two authors independently screened all identified citations and extracted the data. The methodological quality of the included trials was assessed using the Cochrane criteria. RESULTS: Seven studies with a total of 527 subjects were screened according to inclusion and exclusion standards, and most of the studies had significant methodological weaknesses. Seven randomized controlled trials tested the effects of acupuncture compared with placebo acupuncture and conventional medications in patients with oligospermia and asthenozoospermia. The results of this study suggest that acupuncture alone has no clear superiority in improving sperm motility (standard mean difference [SMD] = 1.13, 95% confidence interval [CI]: -0.64 to 2.89), the sperm concentration (SMD = 0.32, 95% CI: 0.27-0.92) or semen volume compared with placebo acupuncture. No significant difference was found between acupuncture alone and conventional medications in improving sperm motility (SMD = -0.53, 95% CI: -2.54 to 1.48), the sperm concentration (SMD = -1.10, 95% CI: -1.48 to -0.72) or semen volume. However, adjuvant acupuncture may enhance the effect of medications on improving sperm motility (SMD = 4.10, 95% CI: 1.09-7.12) and the sperm concentration (SMD = 1.07, 95% CI: 0.739-1.40), but the study heterogeneity was too high to establish robust conclusions. CONCLUSION: These results suggest that the current evidence does not support acupuncture as an effective treatment for oligospermia and asthenozoospermia; therefore, acupuncture is not currently recommended as a treatment for these conditions. However, owing to the high risk of bias among the included studies, the evidence is limited, and more large-scale, high-quality clinical trials are needed in the future. TRIAL REGISTRATION NUMBER: PROSPERO CRD42018083885.

[Yishen Tongluo Recipe combined with minimally invasive surgery for the treatment of varicocele-associated asthenospermia].

OBJECTIVE: To observe the clinical effect of Yishen Tongluo Recipe (YTR) combined with minimally invasive surgery (MIS) in the treatment of varicocele-associated asthenospermia (of the kidney-deficiency and collateral-obstruction type). METHODS: We randomly divided 116 patients with varicocele-associated asthenospermia and up to the inclusion criteria into three groups and treated them by YTR combined with MIS (low spermatic vein ligation at the external inguinal ring orifice under the microscope) (the YTR+MIS group, n = 39), YTR alone (the YTR group, n = 38), or MIS alone (the MIS group, n = 39). At 12 weeks after treatment, we compared the total effectiveness rate, the percentage of progressively motile sperm (PMS), sperm straight line velocity (VSL), sperm DNA fragmentation index (DFI) and symptoms among the three groups of patients. RESULTS: After treatment, the total effectiveness rate was significantly higher in the YTR+MIS than in the YTR and the MIS group (89.74% vs 63.16% and 64.10%, P < 0.05), and so were the percentage of PMS (31.67 ± 3.93 vs 24.48 ± 3.15 and 25.57 ± 3.37, P < 0.05) and VSL (ï¼»30.19 ± 5.32ï¼½ vs ï¼»27.19 ± 5.48ï¼½ and ï¼»27.55 ± 5.24ï¼½ µm/s, P < 0.05), but the DFI was remarkably lower in the former than in the latter two groups (11.25 ± 8.27 vs 15.87 ± 5.45 and 15.26 ± 4.36, P < 0.05). The symptoms were improved more significantly in the YTR+MIS than in the YTR and MIS groups (P < 0.05). CONCLUSIONS: Yishen Tongluo Recipe combined with minimally invasive surgery, as an effective and safe strategy, can significantly improve sperm quality and sperm DNA integrity in patients with varicocele-associated asthenospermia.

Changes in the Level of DNA Fragmentation in Sperm Cells detected by Acridine Orange Test in Men with Sub/infertility Treated with Nutritional Supplement PAPA.

BACKGROUND: When diagnosing and treating male infertility it is important to determine whether there are defects in the maturation process of sperm nuclei. Using nutritional supplements can improve the morphological and physiological condition of the spermatozoa. In recent years there has been an increase in the usage of supplements with different compositions which strives to determine the best combination and avoid side effects. AIM: To study the effect of PAPA nutritional supplement on the levels of DNA fragmentation of sperm cells tested with acridine orange test (single stranded DNA against double stranded DNA) in men with sub/infertility. MATERIALS AND METHODS: 48 men with confirmed sub/infertility underwent treatment for three months with nutritional supplement PAPA containing 9 micronutrients. The differences in levels of DNA fragmentation were determined with acridine orange test, which was conducted before and after the treatment. RESULTS: The results were statistically significant (p<0.001) showing an increase in the number of green spermatozoa (normal DNA), and a decrease of damaged ones (orange and red). After treatment the level of sperm DNA fragmentation decreased by 10.2%. CONCLUSION: Men with confirmed sub/infertility that took nutritional supplement PAPA for three moths showed a decrease in DNA fragmentation levels of 10.2% determined by AO test which implies an improvement of male fertility levels.

[Clinical effect of acupuncture combined with traditional Chinese medicine in treatment of oligozoospermia/asthenozoospermia: a meta-analysis].

OBJECTIVE: To evaluate the clinical effect of acupuncture combined with Chinese medicine in the treatment of oligozoospermia/asthenozoospermia. METHODS: Randomized controlled trials (RCTs) of acupuncture combined with traditional Chinese medicine (TCM) in the treatment of oligozoospermia/asthenozoospermia published up to February 15, 2019 were searched from databases of CNKI, CBM, Wanfang Data, VIP, PubMed, Embase, and The Cochrane Library. Two reviewers independently performed quality assessment and data extraction of the studies, and RevMan5.3 was used to perform the meta-analysis. RESULTS: A total of 13 articles with 12 RCTs were included, with a total of 1 183 patients. The meta-analysis showed that acupuncture combined with TCM achieved a significantly higher pregnancy rate than TCM alone in the treatment of oligozoospermia/asthenozoospermia(risk ratio [RR] ＝1.46, 95% confidence interval [CI]: 1.13－1.90，P＝0.004). The patients treated with acupuncture combined with TCM had a significantly higher effective rate than those treated with TCM alone (RR＝1.17, 95% CI：1.10－1.24, P<0.000 01). Compared with TCM alone, acupuncture combined with TCM achieved significantly better improvements in sperm survival rate (mean difference [MD]＝8.28, 95% CI: 6.48－10.08, P<0.000 01), sperm motility (MD＝17.01, 95%CI：11.06－22.96, P<0.000 01), sperm concentration (MD＝8.71, 95%CI：5.92－11.50, P<0.000 01), and number of grade A sperms (MD＝6.39, 95%CI：5.27－7.50, P<0.000 01). CONCLUSION: Acupuncture combined with TCM has a better clinical effect than TCM alone in the treatment of oligozoospermia/asthenozoospermia. Due to the low methodological quality of the studies included in this analysis, acupuncture combined with TCM in the treatment of oligozoospermia/asthenozoospermia should be used based on patients' conditions in clinical practice.

Efficacy and safety of acupuncture for the treatment of oligoasthenozoospermia: A systematic review.

Oligoasthenozoospermia is a common factor leading to male infertility. Acupuncture has been applied for treating male infertility for several thousand years in China, but clinical evidence of its efficacy and safety in treating oligoasthenozoospermia is yet to be established. This review aimed to systematically assess the evidence on the effect of acupuncture in males with oligoasthenozoospermia. Databases (PubMed, EMBASE, SINOMED, CNKI, Wanfang database and Cochrane Library) were searched to identify related studies published before 30th June 2019. The Cochrane risk of bias tool and Jadad score was adopted to assess the methodological quality of included studies. Twelve randomised controlled trials (RCTs) with 1,088 participants were included in this review. The aim of this study was to perform a meta-analysis, but it was not possible due to considerable clinical heterogeneity among the included studies. According to the narrative analysis, acupuncture or acupuncture combined with another intervention was effective in improving the semen quality based on the included studies. However, this result should be interpreted with caution due to high risk. The methodological quality of most included studies was low. The current evidence on acupuncture for oligoasthenozoospermia is inadequate to draw a solid conclusion due to the poor methodological quality. Rigorous full-scale RCTs are needed to validate the therapeutic efficacy and safety of acupuncture in treating oligoasthenozoospermia.

Effects and mechanism of action of transcutaneous electrical acupuncture point stimulation in patients with abnormal semen parameters.

OBJECTIVE: To evaluate the effect of transcutaneous electrical acupuncture point stimulation (TEAS) on sperm parameters and the underlying molecular mechanisms. METHODS: A total of 121 patients diagnosed with oligozoospermia, asthenozoospermia or oligoasthenozoospermia were randomised into four groups (three treatment groups, one control): the TEAS groups were treated with 2 Hz (n=31), 100 Hz (n=31), or mock stimulation (n=29) at acupuncture points BL23, ST36, CV1 and CV4 for 2 months. The control group (n=30) was provided with lifestyle advice only. RESULTS: The changes in total sperm count and motility in the 2 Hz TEAS group were significantly greater than those in the mock group and the control group. The change in neutral α-glucosidase (NAG) and zinc levels in the 2 Hz group were significantly greater than those in the mock group and control group, and the changes in fructose levels of the 2 Hz group were significantly greater than those in the control group. Significant increases in calcium and integrin-binding protein 1 (CIB1) and reduction of cyclin-dependent kinase 1 b (CDK1) were also found after 2 Hz TEAS treatment. CONCLUSIONS: The present findings suggest that 2 Hz TEAS can improve sperm count and motility in patients with abnormal semen parameters, and is associated with increases in seminal plasma zinc, NAG and fructose. The upregulation of CIB1 and downregulation of CDK1 by TEAS may be associated with its positive effects on sperm motility and count. TRIAL REGISTRATION: http://www.chictr.org ; registration no. ChiCTR-TRC-11001775.

Supplementation of cryopreservation medium with TAT-Peroxiredoxin 2 fusion protein improves human sperm quality and function.

OBJECTIVE: To investigate the potential effects of TAT-PRDX2 protein supplementation to the cryopreservation medium on post-thaw sperm quality and function. DESIGN: In vitro prospective study. SETTING: Medical university hospital. PATIENT(S): Fifty normozoospermic, 50 asthenozoospermic, and 50 oligoasthenozoospermic men undergoing semen analysis for couple infertility. INTERVENTION(S): Each semen sample was divided into three aliquots: fresh, cryopreserved control (without additive), and cryopreserved with TAT-PRDX2 protein. MAIN OUTCOME MEASURE(S): Sperm motility, viability, mitochondrial potential, and DNA damage as well as reactive oxygen species (ROS) levels and lipid peroxidation were analyzed. Acrosome reaction and zona-free hamster oocyte penetration tests were performed to assess the fertilization ability of cryopreserved spermatozoa. RESULT(S): In normozoospermic and asthenozoospermic groups, the addition of 150 µg/mL TAT-PRDX2 significantly reduced intracellular ROS and malondialdehyde levels and enhanced post-thaw sperm motility and viability when compared with the cryopreserved control of the respective groups but did not produce any significant protective effect in the oligoasthenozoospermic group. Mitochondrial potential was significantly increased, whereas DNA fragmentation was significantly decreased, after TAT-PRDX2 supplementation only in the asthenozoospermic group when compared with the cryopreserved control. Although the penetration rate and the penetration index were not markedly improved, TAT-PRDX2 supplementation obviously reduced spontaneous acrosome reaction and increased calcium ionophore-induced acrosome reaction in the normozoospermic and asthenozoospermic groups. CONCLUSION(S): TAT-PRDX2 protein effectively exerted cryoprotective effects on spermatozoa by reducing intracellular ROS level and thereby improved post-thaw sperm quality and function, especially for asthenozoospermic samples. TAT-PRDX2 protein is a promising additive for developing a new and highly efficient semen cryoprotectant.

[Acupuncture treatment of oligoasthenozoospermia].

Studies show that acupuncture can significantly elevate the level of serum testosterone (T), reduce the concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2), initiate spermatogenesis, enhance testicular blood flow, maintain a relative low temperature in the testis, increase the concentration, motility and antioxidative injury capability of spermatozoa by raising the levels of seminal α-glucosidase, fructose and super oxide dismutase, and eventually improve semen quality and the rate of conception in the treatment of oligoasthenozoospermia. Currently, the quality of the clinical studies of acupuncture treatment of oligoasthenozoospermia is relatively poor, the existing evidence remains at a low level, its clinical application is limited, and its therapeutic effect has to be further verified. The present paper summarizes the literature from domestic and international databases about acupuncture treatment of oligoasthenozoospermia, and offers an overview of the effects of acupuncture on the reproductive endocrine system, testicular blood flow, semen quality, and rate of conception in the treatment of the patient.

Thoughts and Approaches of Integrated Chinese and Western Medicine for the Treatment of Oligo-astheno-teratozoospermia.

Oligo-astheno-teratozoospermia (OAT) which perplexes doctors and patients due to its complicated etiology, atypical symptoms and poor clinical efficacy, is a general term for the three pathological states of abnormal semen. OAT is the main factor of male infertility. It is also a hot and difficult point in present studies. Empiric drug is the most popular treatment of this disease in the modern medicine. Chinese medicine (CM) is one of the main methods for the treatment of this disease, and it has certain clinical effect. The author believes that the use of modern medical technology to make the diagnosis as clear as possible is the key to treat OAT. The combination of syndrome and disease differentiation is the main mode in the treatment of OAT. Microscopic syndrome differentiation and macroscopic evidence embodies the basic principle of "Si Wai Chuai Nei" and broadens the perspective of CM syndrome differentiation. Classification and treatment are basic methods for the treatment of OAT. The treatment should not be limited to the Shen (Kidney), instead it should focus on the whole body condition. At different stages, the treatment should also pay attention to strengthening the Pi (Spleen), nourishing the Gan (Liver) and promoting blood circulation. Complementing Chinese and Western medicine, and highlighting the characteristics and advantages of CM treatment, have a great guiding value for the treatment of OAT.

Effect of in vitro selenium supplementation on sperm quality in asthenoteratozoospermic men.

Sperm DNA damage, excessive oxidative stress and decrease in motility may lead to low fertilisation or poor assisted reproductive techniques outcomes in asthenoteratozoospermic men. Selenium was considered as essential element for male reproductive functions. Selenium has important role in enzymatic process for elimination of excessive reactive oxygen species and helps to maintain membrane integrity. The aim of this study was to determine the effect of selenium supplementation on sperm quality, DNA fragmentation, mitochondrial membrane potential and membrane lipid peroxidation during sperm sampling in vitro at different times. In this experimental study, semen samples were collected from 50 asthenoteratozoospermic men. Samples were divided into two groups as control group and test group (incubated with 2 µg/ml selenium at 37°C for 2, 4 and 6 hr). Motility and viability were assessed based on WHO 2010 criteria. Mitochondrial membrane potential, sperm DNA fragmentation and malondialdehyde levels were evaluated in each group. Results revealed that motility, viability and mitochondrial membrane potential were significantly higher in the test group (p < .05). Also malondialdehyde levels were significantly lower in the test group (p < .03). DNA fragmentation significantly decreased in the test group after 6 hr of incubation (p < .02). In conclusion, in vitro selenium supplementation may protect spermatozoa from maltreatment effect of reactive oxygen species (ROS) during sperm sampling via keeping enzymatic and antioxidant process in optimum condition.

[Experimental Study for the Treatment of Asthenozoospermia by Electroacupuncture in Rats].

OBJECTIVE: To investigate the effects of different electroacupuncture (EA) parameters for the treatment of asthenozoospermia in rats. METHODS: One hundred and five male Sprague-Dawley rats were randomly divided into 2 Hz-EA treatment daily in 3 d group (n=9), sham-EA group (n=10), model group (n=10); 2 Hz-EA treatment every other day in 5 d group, sham-EA group, model group (8 rats in each group); 2 Hz-EA treatment every other day in 9 d group, sham-EA group, model group (10 rats in each group); 100 Hz-EA treatment every other day in 9 d group (n=7), sham-EA group (n=8), model group (n=7). Asthenozoospermia model was established by intragastric administration of ornidazole (ORN,400 mg·kg-1·d-1) once daily till the end of treatment. EA treatments (2 Hz or 100 Hz) were applied to "Shenshu" (BL 23,bilateral), "Zusanli" (ST 36, bilateral) for 30 min, intensity of 1-2-3 mA (increasing 1 mA per 10 min), once a day or once every other day for 3 times or 5 times. Sham-EA groups were treated with similar procedure except that the output leads of the stimulator were disconnected. The sperm density, viability, motility, the number of grade A sperm, and grade A+B sperm were examined by computer-assisted sperm analysis. RESULTS: (1) 2 Hz-EA treatment daily in 3 d:compared with the model group and the sham-EA group, 2 Hz-EA treatment once daily had no significant effect on all of the sperm motility indexes in the asthenozoospermic rats (P>0.05). (2) 2 Hz-EA treatment every other day in 5 d:compared with the model group, EA treatment could increase the sperm motility (P<0.05), the number of grade A sperm (P<0.05), and the number of grade A+B sperm (P<0.05) in the asthenozoospermic rats. However, compared with the sham-EA group, EA treatment could only improve the number of grade A+B sperm (P<0.05). (3) 2 Hz-EA treatment every other day in 9 d:compared with both the model group and the sham-EA group, EA treatment could markedly improve the sperm viability (P<0.001), the sperm motility (P<0.001), the number of grade A sperm (P<0.001), and the number of grade A+B sperm (P<0.001) in the asthenozoospermic rats. (4) 100 Hz-EA treatment every other day in 9 days:compared with both the model group and the sham-EA group, all of the sperm indexes in the asthenozoospermic rats including the sperm viability (P<0.001 vs. the model group, P<0.05 vs. the sham-EA group), the sperm motility (P<0.001 vs. the model group, P<0.01 vs. the sham-EA group), the number of grade A sperm (P<0.01) and the number of grade A+B sperm (P<0.01) also could be improved after EA treatment. Unexpectedly,none of the EA treatment had significant influence on the sperm density in the asthenozoospermic rats. CONCLUSIONS: Both 2 Hz-EA and 100 Hz-EA treatment once every other day for 5 times in 9 d had a therapeutic effect on asthenozoospermia by improving the sperm viability and the sperm motility in the rats.

Use of electroacupuncture and transcutaneous electrical acupoint stimulation in reproductive medicine: a group consensus.

With the rapid development of assisted reproductive technology, various reproductive disorders have been effectively addressed. Acupuncture-like therapies, including electroacupuncture (EA) and transcutaneous electrical acupoint stimulation (TEAS), become more popular world-wide. Increasing evidence has demonstrated that EA and TEAS are effective in treating gynecological disorders, especially infertility. This present paper describes how to select acupoints for the treatment of infertility from the view of theories of traditional Chinese medicine and how to determine critical parameters of electric pulses of EA/TEAS based on results from animal and clinical studies. It summarizes the principles of clinical application of EA/TEAS in treating various kinds of reproductive disorders, such as polycystic ovary syndrome (PCOS), pain induced by oocyte retrieval, diminished ovarian reserve, embryo transfer, and oligospermia/ asthenospermia. The possible underlying mechanisms mediating the therapeutic effects of EA/TEAS in reproductive medicine are also examined.

[Transcutaneous electrical acupoint stimulation for asthenozoospermia].

OBJECTIVE: To study the effect of transcutaneous electrical acupoint stimulation (TEAS) in the treatment of asthenozoospermia. METHODS: We randomly divided 72 asthenozoospermia patients into a 2 Hz TEAS (n = 29), a 100 Hz TEAS (n = 20), and a blank control group (n = 23), those in the former two groups treated by 30 minutes of TEAS at 2 Hz and 100 Hz respectively, applied to the acupoints of bilateral Shenshu, left Zusanli, and Guanyuan, once a day for 60 days, while those in the blank control group left untreated. Using computer-assisted sperm analysis (CASA), we examined sperm concentration and motility as well as the percentages of grade a and grade a+b sperm in different groups of the patients. RESULTS: Compared with the baseline, 2 Hz TEAS significantly increased sperm motility (ï¼»12.76 ± 1.39ï¼½ vs ï¼»18.89 ± 2.46ï¼½%, P<0.05) and the percentage of grade a+b sperm ( ï¼»10.68 ± 1.22ï¼½ vs ï¼»16.32 ± 2.10ï¼½%, P<0.05) in the asthenozoospermic patients, while 100 Hz TEAS improved not only sperm motility (ï¼»12.32 ± 2.21ï¼½ vs ï¼»23.81 ± 3.42ï¼½%, P<0.01) and the percentage of grade a+b sperm (ï¼»10.45 ± 1.98ï¼½ vs ï¼»20.25 ± 2.82 ï¼½%, P<0.01), but also the percentage of grade a sperm (ï¼»6.44 ± 1.16ï¼½ vs ï¼»13.31 ± 2.30ï¼½%, P<0.05). Moreover, in comparison with the blank control group, 2 Hz TEAS also remarkably increased sperm motility (ï¼»9.57 ± 1.60ï¼½ vs ï¼»18.89 ± 2.46ï¼½%, P<0.05) and the percentage of grade a+b sperm (ï¼»7.81 ± 1.31ï¼½ vs ï¼»16.32 ± 2.10ï¼½%, P<0.05) in the asthenozoosperma patients, while 100 Hz TEAS improved not only sperm motility (ï¼»9.57 ± 1.60ï¼½ vs ï¼»23.81 ± 3.42ï¼½%, P<0.01) and the percentage of grade a+b sperm (ï¼»7.81 ± 1.31ï¼½ vs ï¼»20.25 ± 2.82ï¼½%, P<0.01) but also the percentage of grade a sperm (ï¼»4.87 ± 1.01ï¼½ vs ï¼»13.31 ± 2.30ï¼½%, P<0.01). Meanwhile, the rate of clinical effectiveness was significantly higher in the 100 Hz TEASthan in the blank control group either in intention-to-treat (ITT) analysis (100% vs 18.18%) orper-protocol (PP) analysis (90% vs 0%), and so was it than in the 2 Hz TEAS group based on the data of ITT (100% vs 33.33%). CONCLUSIONS: Both 2 Hz and 100 Hz TEAS are effective for the treatment of asthenozoospermia by improving sperm motility and vitality.

[Mid-frequency transcutaneous electrical acupoint stimulation combined with tamoxifen for the treatment of oligoasthenozoospermia].

OBJECTIVE: To explore the feasibility, safety and clinical effect of mid-frequency transcutaneous electrical acupoint stimulation (TEAS) combined with oral tamoxifen (TAM) in the treatment of oligoasthenozoospermia. METHODS: We randomly and equally assigned 120 patients with idiopathic oligoasthenozoospermia to receive oral TAM, mid-frequency TEAS, or TAM+TEAS, all for 8 weeks. Before and after treatment, we recorded the semen volume, total sperm count, sperm concentration, sperm motility, percentage of progressively motile sperm (PMS), and the levels of follicle-stimulating hormone (FSH), luteotrophic hormone (LH) and testosterone (T) in the peripheral serum and compared these parameters among the three groups of patients. RESULTS: Compared with the baseline, none of the patients showed significant improvement in the semen volume (P >0.05) but all exhibited remarkably elevated levels of serum FSH, LH and T after treatment (P <0.05); TAM significantly improved the total sperm count (ï¼»25.16 ± 2.05ï¼½ vs ï¼»42.65 ± 5.78ï¼½ ×106, P <0.05) and sperm concentration (ï¼»12.15 ± 2.51ï¼½ vs ï¼»24.31 ± 2.59ï¼½ ×106/ml, P <0.05), but not total sperm motility (ï¼»21.78 ± 8.81ï¼½ vs ï¼»22.61 ± 5.75ï¼½ %, P >0.05) or PMS (ï¼»15.87 ± 7.81ï¼½ vs ï¼»16.76 ± 5.86ï¼½ %, P >0.05); TEAS markedly increased total sperm motility (ï¼»24.81 ± 8.27ï¼½ vs ï¼»32.43 ± 4.97ï¼½ %, P <0.05) and PMS (ï¼»19.71 ± 9.15ï¼½ vs ï¼»27.17 ± 5.09ï¼½%, P <0.05), but not the total sperm count (ï¼»23.23 ± 3.14ï¼½ vs ï¼»25.87 ± 4.96ï¼½ ×106, P >0.05) or sperm concentration (ï¼»11.27 ± 2.24ï¼½ vs ï¼»14.12 ± 2.47ï¼½ ×106/ml, P >0.05); TAM+TEAS, however, improved not only the total sperm count (ï¼»26.17 ± 5.05ï¼½ vs ï¼» 51.14 ± 3.69ï¼½×106, P <0.05) and sperm concentration (ï¼»12.78 ± 2.41ï¼½ vs ï¼»27.28 ± 1.98ï¼½ ×106/ml, P <0.05), but also total sperm motility (ï¼»23.89 ± 9.05ï¼½ vs ï¼»37.12 ± 5.33ï¼½%, P <0.05) and PMS (ï¼»17.14 ± 8.04ï¼½ vs ï¼»31.09 ± 7.12ï¼½%, P <0.05). The total effectiveness rate was significantly higher in the TAM+TEAS group than in the TAM and TEAS groups (97.5% vs 72.5% and 75.0%, P <0.05). CONCLUSIONS: Mid-frequency TEAS combined with tamoxifen can significantly improve semen quality and increase sex hormone levels in patients with idiopathic oligoasthenozoospermia.