Male infertility - Wokingham, Berkshire

Overview of male infertility
Semen analysis parameters
Types of male infertility
Causes of male infertility
Male infertility in traditional Chinese medicine
Acupuncture for male infertility
Chinese herbal medicine for male infertility
Diet for male fertility
Self-care tips for male fertility
Commonly asked questions
References

1. Overview of male infertility

Male infertility is far more common than is widely appreciated. It is estimated that male factor issues contribute to approximately 40–50% of all infertility cases, either as the sole cause or as a contributing factor alongside female fertility problems. Despite this, male fertility is frequently overlooked, underinvestigated and undertreated — with fertility investigations often focusing predominantly on the female partner while male assessment is limited to a single standard semen analysis.

Sperm quality has been declining globally for several decades. Large-scale meta-analyses have documented a significant reduction in sperm count and quality in men across western countries over the past 70 years, driven largely by increasing exposure to endocrine-disrupting chemicals, heat, electromagnetic radiation, sedentary lifestyles and chronic stress. This decline is not inevitable — it is largely driven by modifiable lifestyle and environmental factors, and both acupuncture and Chinese herbal medicine have been shown in multiple clinical trials to significantly improve sperm parameters.

Male fertility has one important advantage over female fertility from a treatment perspective: sperm regenerate on a continuous cycle of approximately 74 days. This means that improvements in health, lifestyle, diet and treatment will be reflected in semen analysis results within three months — a relatively short timeframe in which meaningful change can be achieved. I recommend that the male partner be assessed and treated as early as possible, and ideally in parallel with the female partner rather than as an afterthought.

I treat male infertility at my clinics in Wokingham, Berkshire, and also offer online herbal consultations for patients who cannot attend in person. Where possible, I prefer to treat both partners simultaneously, as addressing male and female fertility factors together consistently produces the best outcomes for the couple.

2. Semen analysis parameters

The standard assessment of male fertility is the semen analysis, which measures several parameters of sperm quality. The reference ranges used are set by the World Health Organization (WHO) and were updated in their fifth edition guidelines. These are the minimum thresholds at which sperm is considered within the normal range — not the optimal levels for fertility:

Semen volume — more than 1.5ml per ejaculate
Total sperm count — more than 39 million sperm per ejaculate
Sperm concentration — more than 15 million sperm per millilitre
Sperm motility (movement) — more than 32% of sperm showing progressive forward movement
Sperm morphology (shape) — more than 4% of sperm of normal shape (using Kruger strict criteria)
Sperm vitality (live sperm) — more than 58% of sperm alive
White blood cells — fewer than 1 million per millilitre (higher levels suggest infection or inflammation)
Anti-sperm antibodies — should be negative (antibodies can impair sperm motility and fertilisation)

It is important to note that the standard semen analysis does not measure sperm DNA fragmentation — the degree of damage to the genetic material within the sperm. DNA fragmentation can be high even when all standard semen parameters are within the normal range, and it significantly impairs fertilisation rates, embryo quality and the risk of miscarriage. A sperm DNA fragmentation test is strongly recommended for men who have had normal semen analyses but whose partner has experienced repeated implantation failure or recurrent miscarriage.

3. Types of male infertility

Male infertility is classified by the specific parameters of semen quality that are affected:

Oligozoospermia — a low sperm count (below 15 million/ml). Severe oligozoospermia is defined as fewer than 5 million/ml; azoospermia is the complete absence of sperm in the ejaculate.
Asthenozoospermia — poor sperm motility, where fewer than 32% of sperm show progressive forward movement. This is the most common cause of male infertility and has the greatest impact on the ability to fertilise an egg naturally.
Teratozoospermia — poor sperm morphology, where fewer than 4% of sperm have a normal shape. Abnormally shaped sperm are less likely to penetrate and fertilise an egg.
Oligoasthenoteratozoospermia (OAT) — a combination of all three problems simultaneously, which is common and represents a more significant fertility challenge.
High DNA fragmentation — damage to the genetic material within the sperm, which may coexist with normal conventional parameters but significantly impairs embryo development and increases miscarriage risk.
Azoospermia — complete absence of sperm in the ejaculate, which may be obstructive (a blockage preventing sperm from reaching the ejaculate) or non-obstructive (failure of sperm production in the testes).
Erectile dysfunction and ejaculatory problems — functional difficulties that prevent normal sexual intercourse and the delivery of sperm. Acupuncture is an effective treatment for erectile dysfunction, addressing both the physical and psychological components of the condition.

4. Causes of male infertility

Male infertility has many potential causes, and in a significant proportion of cases multiple factors are present simultaneously:

Lifestyle and environmental factors

These are among the most important and most modifiable causes of male infertility:

Scrotal heat — the testes are located outside the body specifically to maintain sperm production at a temperature a few degrees below core body temperature. Anything that raises scrotal temperature — tight underwear, laptop use on the lap, prolonged sitting, hot baths, saunas or fever — impairs sperm production and motility. Even a modest increase in scrotal temperature can significantly reduce sperm quality.
Smoking — nicotine and other compounds in cigarette smoke cause oxidative damage to sperm DNA, reduce sperm count and motility, and impair sperm morphology. The damage is dose-dependent and is seen in both smokers and men regularly exposed to passive smoke.
Alcohol — chronic alcohol consumption reduces testosterone levels, impairs sperm production and maturation, and damages sperm morphology. Even moderate regular alcohol consumption has been shown to affect sperm quality.
Recreational drugs — cannabis, cocaine and anabolic steroids are particularly harmful to sperm quality. Anabolic steroids suppress the HPO axis and can cause prolonged or permanent damage to sperm production.
Chemical exposure — endocrine-disrupting chemicals including polyfluoroalkyl substances (PFCs), bisphenol A (BPA), phthalates, pesticides and heavy metals interfere with testosterone production and sperm development. These chemicals are found widely in food packaging, non-stick cookware, cosmetics and agricultural produce.
Electromagnetic radiation — mobile phone radiation and electromagnetic fields from devices such as laptops have been shown in research to reduce sperm motility and increase DNA fragmentation. Carrying a mobile phone in a trouser pocket or using a laptop on the lap is inadvisable for men concerned about fertility.
Overwork and sleep deprivation — testosterone production peaks during sleep, particularly during the early morning hours. Chronic sleep deprivation and overwork significantly impair testosterone levels and sperm quality.
Excessive exercise — while moderate exercise is beneficial, very high-intensity training and endurance sports can suppress testosterone production and impair sperm quality through elevated cortisol, overheating and oxidative stress.

Medical causes

Varicocele — an enlargement of the veins draining the testicle, similar to a varicose vein, which raises scrotal temperature and impairs sperm production. It is present in approximately 15% of the general male population and in up to 40% of men presenting with infertility.
Hormonal deficiencies — low levels of FSH, LH and testosterone reduce sperm production. Hormonal causes may be primary (originating in the testes) or secondary (originating in the pituitary or hypothalamus).
Infections — sexually transmitted infections including chlamydia and gonorrhoea can cause scarring of the vas deferens or epididymis, leading to obstructive azoospermia. Prostatitis and orchitis can also impair sperm quality.
Genetic causes — chromosomal abnormalities such as Klinefelter syndrome (47,XXY) and Y-chromosome microdeletions are found in a proportion of men with severe oligozoospermia or azoospermia.
Oxidative stress — excessive production of reactive oxygen species (ROS) damages sperm DNA, membranes and mitochondria, impairing all sperm parameters. It is one of the most common pathological mechanisms in male infertility and is exacerbated by smoking, poor diet, chemical exposure and infection.

5. Male infertility in traditional Chinese medicine

In traditional Chinese medicine (TCM), male fertility is governed primarily by the Kidney — the organ system that stores the body's fundamental essence (jing) and provides the constitutional vitality that determines sperm quality, quantity and vigour. The Kidney jing is the material basis of reproductive capacity in both men and women, and its strength or weakness is the first thing I assess in a male fertility patient.

The most common TCM patterns underlying male infertility are:

Kidney yang deficiency

Kidney yang — the warming, activating aspect of Kidney energy — provides the driving force for sperm production and motility. When Kidney yang is deficient, sperm are produced in insufficient quantities and lack the energy and forward drive to reach and penetrate the egg. This pattern is associated with low sperm count, poor motility, fatigue, a general tendency to feel cold (particularly in the lower back, knees and feet), frequent clear urination and low libido. It is one of the most common patterns in men with oligozoospermia and asthenozoospermia.

Kidney yin deficiency

Kidney yin — the nourishing, cooling, moistening aspect — provides the substance and form from which sperm are built. When Kidney yin is deficient, sperm quality suffers in terms of morphology and DNA integrity, as there is insufficient nourishing substance for the sperm to develop their correct structure. This pattern is often associated with poor morphology, high DNA fragmentation, a tendency to feel heat (particularly in the afternoon and evening), night sweats, dry mouth and difficulty sleeping.

Damp-heat in the lower jiao

Damp-heat — an accumulation of pathological heat and fluid in the pelvic region — is associated with elevated scrotal temperature, inflammation, oxidative stress and infection. In western terms, this pattern corresponds closely to the pathological process of oxidative stress and inflammatory damage to sperm. It is particularly relevant for men with varicocele, prostatitis or a history of sexually transmitted infection, and for those with poor sperm morphology and high DNA fragmentation driven by an inflammatory process.

Qi and blood stagnation

Stagnation of qi and blood in the lower jiao — often driven by chronic stress, sedentary lifestyle or a history of injury — can impair testicular blood flow and create the local circulatory conditions associated with varicocele, poor oxygen delivery to the testes and impaired sperm production. This pattern often coexists with other patterns and benefits from treatment that moves qi and blood alongside addressing the underlying deficiency.

6. Acupuncture for male infertility

A substantial body of clinical research supports the use of acupuncture for male infertility. Multiple randomised controlled trials and systematic reviews have demonstrated significant improvements in sperm count, motility, morphology and DNA fragmentation following acupuncture treatment. It is effective both as a standalone treatment and in combination with Chinese herbal medicine.

Improving sperm parameters

Research has shown that acupuncture produces significant improvements in sperm count, motility and morphology in men with oligozoospermia, asthenozoospermia and teratozoospermia. A study by Pei et al. (2005) found that acupuncture treatment significantly improved the ultrastructural integrity of sperm in infertile men, with improvements in multiple parameters of sperm quality not captured by standard semen analysis.

Improving sperm DNA integrity

A key benefit of acupuncture for male fertility is its ability to reduce DNA fragmentation in sperm — a parameter that standard semen analysis does not assess but that has a profound impact on fertilisation rates and embryo quality. Research has shown that acupuncture reduces oxidative stress in the reproductive system, protecting sperm DNA from the damage that leads to high fragmentation rates and reducing the risk of miscarriage associated with high-fragmentation sperm.

Increasing testicular blood flow

A study by Cakmak et al. (2008) demonstrated that abdominal electroacupuncture significantly increased blood flow in the testicular artery, improving oxygen and nutrient delivery to the testes and enhancing the local environment for sperm production. This is particularly relevant for men with varicocele or poor testicular circulation.

Regulating hormones

Acupuncture influences the hypothalamic-pituitary-testicular axis, the hormonal cascade that governs sperm production. Research by Ren et al. (2016) demonstrated that acupuncture and moxibustion can regulate reproductive endocrine function in men with partial androgen deficiency, improving testosterone levels and supporting normal sperm production. This hormonal regulatory effect is particularly important for men with low testosterone and low gonadotropin levels.

Treating erectile dysfunction

Acupuncture is an effective treatment for erectile dysfunction, addressing both the physical components (improved genital blood flow, hormonal regulation) and the psychological components (anxiety, stress, performance pressure) that commonly contribute to the condition.

Reducing scrotal temperature

A study by Siterman et al. (2009) found that the success of acupuncture treatment in men with initially low sperm output was associated with a measurable decrease in scrotal skin temperature. By improving the circulatory environment and reducing the heat accumulation associated with poor testicular blood flow, acupuncture can create more optimal conditions for sperm production.

7. Chinese herbal medicine for male infertility

Chinese herbal medicine is a powerful complement to acupuncture for male infertility, working at a deeper constitutional level to nourish Kidney jing and yin, strengthen Kidney yang, clear damp-heat and reduce the oxidative stress that damages sperm quality. It is particularly effective for men with Kidney deficiency patterns, where direct nourishment of the reproductive system is needed over a sustained period.

The combination of acupuncture and Chinese herbal medicine consistently produces better results for male infertility than either therapy used in isolation. While acupuncture works by regulating energy flow, improving circulation and modulating the neuroendocrine axis, herbs directly replenish the constitutional substances — Kidney yang, yin and jing — that provide the material basis for healthy sperm production.

Research has demonstrated the effectiveness of specific Chinese herbal formulas for male infertility. The formula Yi Jing Tang has been shown to improve sperm quality in men with oligozoospermia. Other formulas targeting Kidney yang deficiency have been shown to increase sperm count, improve motility and reduce DNA fragmentation rates. The herb Shan Zhu Yu (Cornus officinalis) has been shown in research to increase sperm motility when used as part of a formula. The formula Bu Zhong Yi Qi Tang has been shown in Japanese research to reduce sperm motility problems by over 50%.

Each herbal prescription I write is bespoke — tailored specifically to the individual patient's TCM pattern and the specific sperm parameters that need to be improved. The herbs I prescribe come from Sun Ten in Taiwan — pharmaceutical-grade herbal granules tested to the highest international quality and safety standards.

Because sperm take approximately 74 days to develop, a minimum course of three months of herbal treatment is recommended before repeating semen analysis to assess the impact of treatment. Many men see significant improvements within this timeframe; those with more complex or long-standing problems may benefit from a longer course.

8. Diet for male fertility

Diet plays a significant role in male fertility, primarily through its impact on oxidative stress, testosterone levels and the quality of the nutritional environment in which sperm develop. The following dietary recommendations are supported by both the clinical evidence base and the principles of Chinese food therapy.

Increase antioxidant-rich foods

Oxidative stress is one of the most important drivers of poor sperm quality and high DNA fragmentation. Antioxidant-rich foods neutralise the reactive oxygen species (ROS) that damage sperm DNA and membranes. Key antioxidant foods for male fertility include berries (blueberries, strawberries, raspberries), dark leafy greens, walnuts, Brazil nuts (an excellent source of selenium, which is essential for sperm motility), pomegranate, tomatoes (lycopene), citrus fruits (vitamin C) and eggs (vitamin E and zinc).

Eat plenty of oily fish

Omega-3 fatty acids are a major structural component of sperm membranes and are essential for normal sperm morphology and motility. Men with poor morphology and motility often have low omega-3 levels. Oily fish (salmon, mackerel, sardines, anchovies) are the richest dietary source and should be eaten several times per week. Walnuts are a plant-based alternative for men who do not eat fish.

Reduce alcohol consumption

Alcohol reduces testosterone levels, impairs sperm maturation and damages sperm DNA. Reducing alcohol intake to a maximum of one to two units per week, or eliminating it entirely during the period of fertility treatment, can produce measurable improvements in sperm parameters within three months.

Reduce red meat

High red meat consumption is associated with elevated insulin-like growth factor (IGF)-I and increased oxidative stress, both of which can impair sperm quality. Replacing some red meat with oily fish, poultry and plant-based protein sources is beneficial. Organic meat is preferable to conventionally farmed meat to reduce exposure to hormones and pesticides.

Avoid excessive heat-producing foods

In TCM, excessive consumption of spicy foods, alcohol and very fatty or fried foods generates damp-heat in the body — a pattern associated with elevated scrotal temperature, inflammation and oxidative stress in the reproductive system. Reducing these foods, particularly chilli and very spicy foods, can reduce the internal heat that impairs sperm quality.

Avoid caffeine in excess

High caffeine intake has been associated with reduced sperm motility and increased DNA fragmentation in some research. Moderate coffee consumption (one to two cups per day) is unlikely to be significantly harmful, but it is sensible to avoid very high caffeine intake during the period of fertility treatment.

9. Self-care tips for male fertility

In addition to diet, the following lifestyle measures have been shown in research to significantly improve sperm quality:

Stop smoking — smoking is one of the most damaging things a man can do to his sperm quality. Stopping smoking is one of the single most impactful changes that can be made, and improvements in sperm parameters are measurable within three months of cessation.
Avoid scrotal heat — avoid tight-fitting underwear (boxer shorts are preferable), avoid prolonged sitting (particularly on heated seats), do not use a laptop directly on the lap, avoid saunas, hot tubs and very hot baths during the period of fertility treatment, and avoid excessive cycling if the saddle exerts pressure on the perineal area.
Keep your phone out of your trouser pocket — research suggests that mobile phone radiation reduces sperm motility and increases DNA fragmentation. Carrying a phone in a trouser or shirt pocket rather than a trouser pocket, and using speaker mode or a headset rather than holding the phone to the ear, reduces exposure.
Get adequate sleep — testosterone production peaks during sleep, particularly in the early morning hours. Aim for seven to eight hours of good quality sleep per night at consistent times. Men who regularly work night shifts or sleep very late have measurably lower testosterone levels and poorer sperm quality.
Reduce overwork and manage stress — chronic overwork and stress elevate cortisol, which suppresses testosterone production and impairs sperm development. Regular acupuncture treatment is an effective way to reduce stress and cortisol while simultaneously improving sperm quality.
Exercise moderately — regular moderate exercise improves testosterone levels and sperm quality. However, very high-intensity training, endurance sports and excessive gym work can have the opposite effect through elevated cortisol, overheating and oxidative stress. Aim for 30–45 minutes of moderate exercise four to five days per week.
Reduce chemical exposure — choose organic food where possible to reduce pesticide exposure; avoid heating food in plastic containers; choose BPA-free food storage; use natural personal care products; and, if your occupation involves regular exposure to industrial chemicals, solvents or pesticides, discuss protective measures with your employer and GP.

10. Commonly asked questions about acupuncture for male infertility

How long does acupuncture take to improve sperm quality?

Because sperm take approximately 74 days to complete their development from stem cell to mature spermatozoon, the effects of any treatment — including acupuncture and herbal medicine — will be reflected in a semen analysis approximately three months after starting. Most men who complete a three-month course of weekly acupuncture, combined with Chinese herbal medicine and lifestyle changes, see significant improvements in their sperm parameters. I recommend repeating the semen analysis after three months of treatment to assess the impact and decide on next steps.

Is there a semen analysis test that measures DNA fragmentation?

Yes — sperm DNA fragmentation testing is a separate test from standard semen analysis and is not routinely included in NHS fertility investigations. It can be requested privately. A sperm DNA fragmentation index (DFI) above 15–25% (depending on the test method used) is considered elevated and is associated with reduced fertilisation rates, poor embryo quality and increased miscarriage risk. I can advise on where to access this test. Acupuncture and Chinese herbal medicine have been shown to reduce DNA fragmentation rates, making this an important target of treatment for men where this is identified as a problem.

Can acupuncture help with azoospermia?

Acupuncture is most effective for oligozoospermia (low count), asthenozoospermia (poor motility) and teratozoospermia (poor morphology) — the three most common forms of male infertility. For non-obstructive azoospermia (complete absence of sperm due to failure of production), acupuncture and Chinese herbs may in some cases stimulate residual sperm production, and a study by Siterman et al. (2000) found that acupuncture treatment led to the appearance of sperm in the ejaculate of men with very low or absent sperm output. However, results are less predictable than for other forms of male infertility, and surgical sperm retrieval (TESE/MESA) may be needed for IVF/ICSI.

Does the male partner need to attend appointments?

Yes — the male partner should attend for an initial consultation and regular treatment sessions. A full TCM consultation includes detailed questioning, tongue examination and pulse-taking to identify the individual pattern of imbalance and formulate an appropriate treatment plan. I do not prescribe herbs without seeing the patient. If attending in person is difficult, I offer online herbal consultations.

Should both partners be treated simultaneously?

Yes — this is strongly recommended. Treating both partners together addresses the fertility challenge from both sides simultaneously, maximising the overall chance of conception. In couples where both male and female factor issues are present, treating only one partner while neglecting the other significantly reduces the effectiveness of treatment. I routinely treat both partners at the same clinic, often scheduling their appointments on the same day for convenience.

How much does treatment cost?

Full pricing information is available on the treatment prices page. An initial acupuncture consultation at my Wokingham clinic is £70; follow-up sessions are £60. Chinese herbal medicine consultations are available from £50, with bespoke herbal prescriptions at £35 per week.