A Common Case of Male Infertility

Featured Speaker: Lisa Lapwing, AP

A 31-year-old patient came to me with the chief complaint of male infertility. In his case, he had low sperm morphology and motility which was diagnosed in 2020. 

He and his wife intended to have children. They had a healthy sex life and after six months of trying with no success of conception, she had a complete medical workup herself to determine if she had any infertility issues. She did not, which therefore, led them to investigate his fertility health which further led to the findings of low sperm morphology and low sperm motility. He was prescribed Clomid (causes an increase in FSH and LH, this in turn increases testosterone) which didn’t improve his conditions over the course of another six months. He quit taking it because he “wanted to move forward with a more natural approach.” This is when he turned to me for care.

The patient’s history revealed that he was a former smoker of many years and was a recovering alcoholic. At the time of his first appointment with me, he had been smoke and alcohol free for two years. He also had a history of high cholesterol, hypertension, Bipolar disorder, Psoriasis and poor hearing. Otherwise, he was in good mental and physical health at the time of our initial meeting with a clear complexion and vibrant Shen in his eyes. He had sustained no injuries to his genital area, there was no history of abuse and he didn’t suffer any pain or dysfunction in this area either. He had normal bowel movements though he reported his stools were a bit loose and urination was normal. He currently had a moderately stressful job, slept 8-9 hours a night with no trouble falling or staying asleep. He drank 2 cups of coffee daily but otherwise drank water to maintain hydration and he ate a clean and healthy diet of lean proteins and a lot of vegetables with a few fruits and whole grains. He did, however, have a 40-hour-a-week job indoors at a desk and was also completely sedentary. He was taking Vitamin C, D, E, Zinc, Fish Oil, Cholest- Off and Ashwagandha.

The patient presented initially with a thin and wiry pulse; a pale, swollen tongue with a thick white coat and mapped spot on his right Liver area. This along with his symptoms, history and biomedical diagnosis led me to place a differential diagnosis on him of Spleen Qi Deficiency with Liver Yin Deficiency and Damp Retention in the Lower Jiao. The Liver Yin damage was born of the alcoholism, which in turn led to the inability to absorb proper nutrients which caused the Spleen Qi Deficiency, both of which led to Damp Accumulation (Retention by the time he made it to me) in the Lower Jiao. The key points I utilized to treat him at this first session are as follows: Lv 14, 3, 2; Sp 6, 9; St 40; and Gb 41. At this time he opted out of herbs to see if the acupuncture alone would suffice. I did, however, have him continue his vitamin and supplement regimen and asked him to start walking at least 30 minutes a day for at least 5 days a week. We also discussed the importance of him having sexual intercourse with his wife 2-3 times a week, especially, during her time of ovulation. If they felt like connecting through intercourse at other times, I let him know that’s perfectly fine and very healthy and that the rest of her cycle month could still carry potential for conception.

By his second treatment one week later, my observations were that his pulse was now only slightly wiry and his tongue was normal red, slightly swollen with a thin white coat. His only symptoms were “some fatigue and a few loose stools but not as many as before our initial treatment,” but he was otherwise feeling really well. My differential diagnosis at this treatment was Spleen Qi Deficiency as I saw no signs nor did he have any lingering symptoms of Liver Yin Deficiency or Damp Retention in the Lower Jiao. Therefore, I focused on that and did some general acupoints for male infertility: Sp 6, 3; St 36; left-side LingGu DaiBai in combination with right-side Lv 3; Tituo and Rn 4. I asked that he continue the same sex, supplement and exercise prescription from the prior treatment plan, which he had been following studiously.

Over the next few weekly treatments his tongue and pulse stayed the same although his stools had started to solidify and he no longer complained of fatigue. He also reported a new sense of calm and positivity towards his fertility health and their chances of conceiving. As with anything we treat and especially with fertility care, there is almost always an emotional/Shen component. Fertility can be stressful for both parties and carry some health concerns depending on the route taken to treat fertility, especially female fertility. So with this patient, as with nearly all, I was sure to add Shen calming points within each treatment. Some of the key points in these subsequent treatments included: the above mentioned points with the additions of Ki 3, Buddha’s Triangle, St 30, Lv 8, Du 20, 24, Yintang, and Shenmen.

After five treatments, the first two a week apart and the rest two weeks apart,the patient went for a semen analysis and to his delight and relief, the results showed improvement in his morphology and motility. A month after that, before his next appointment, he called to say that his wife was pregnant! At this time he chose not to continue treatment as he didn’t see a reason to. He was feeling overall extremely well and wanted to focus his attention going forward on his wife’s pregnancy.

This turned out to be a quick case of improvement! There are many pathways to male infertility, some easier to treat than others and gaining a clear and concise understanding of how to identify the causes from a biomedical and Traditional Chinese Medical perspective is paramount to successfully treating male infertility. My course aims to provide you with information so you can in turn, use the knowledge offered to start to treat this condition successfully within your own practice!

Lisa Lapwing headshotLisa Lapwing, AP has been specializing in Men’s Sexual Health/Andrology since 2012. Through her experience, studies, and continued dedication to treating conditions that fall under this subject, she found that there is little about men’s health and TCM being taught. It is touched on briefly in some acupuncture schools and there are a few continuing education courses for it.

Seeing the need to further educate fellow Acupuncturists and Oriental Medical

practitioners in this important and growing subject, her teaching career has begun to build over the last 5 years. She has taught at The Integrative School of Medicine at AOMA where she is an alumnus and for the Florida State Oriental Medical Association (FSOMA) wherein she is a proud member and volunteer for the Membership Committee. She has also spoken on dyspareunia and chronic pelvic pain for The Society of Urologic Nurses and Associates (SUNA) in October 2020. Currently, she is faculty at The Florida College of Integrative Medicine (FCIM) in Orlando, Florida, and is running her practice, Whole Health Acupuncture, in Windermere, Florida.

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