Mechanism of Bushen Yijing Method in Treatment of Oligoasthenozoospermia Based on Intestinal Microbiota / 中国实验方剂学杂志

Oligoasthenozoospermia is the main cause of male infertility， with complex and diverse causes. Currently， there are still some unclear causes of oligoasthenozoospermia in clinical practice， known as idiopathic oligoasthenozoospermia. With the development of high-throughput sequencing technology， it has been found that intestinal microbiota disorder may be an important promoting factor for the onset of oligoasthenozoospermia. Traditional Chinese medicine believes that "deficiency of kidney essence" is the core pathogenesis of oligoasthenozoospermia. In clinical practice， the method of tonifying the kidney and strengthening the essence has a significant therapeutic effect on oligoasthenozoospermia， but its mechanism of action has not been fully elucidated. Based on the basic theories of traditional Chinese medicine and molecular biology research， it has been found that there is a similarity between "kidney essence" and intestinal microbiota. During the onset of oligoasthenozoospermia， the disorder of intestinal microbiota has similarities with the pathogenesis of "deficiency of kidney essence" in traditional Chinese medicine. Moreover， traditional Chinese medicine for tonifying the kidney and strengthening the essence can regulate the disorder of intestinal microbiota， which may be one of the effective mechanisms for the treatment of oligoasthenozoospermia with the Bushen Yijing method. Based on this， this article explored the mechanism of Bushen Yijing method of traditional Chinese medicine in treating oligoasthenozoospermia from the perspective of intestinal microbiota， so as to provide new ideas for the treatment of oligoasthenozoospermia with traditional Chinese medicine.

Ayurvedic Management of Oligoasthenozoospermia - A Case Report

Oligoasthenozoospermia is the condition where the two parameters, sperm count and sperm motility is altered. It depicts a decrease in the concentration and percentage of motile spermatozoa in a sperm sample and is determined by semen analysis. Researches show that nearly 50% of infertility in India is related to the male reproductive factors or diseases. Based on the study conducted by WHO from 1982 to 1985 in multicentres about 20% of infertility cases is due to male factors. Approximately 23% of Indian couples taking infertility treatment attributed the cause towards male factors. Oligoasthenozoospermia can be correlated to Sukra kshaya Lakshanas mentioned in Ashta sukra dushtis. A male patient aged 32 years with 2.5 years of married life revealed the semen volume as 2ml, Sperm concentration 1 million/ml, progressive motility 3%, Non progressive motility 2% and immotile sperms 95% with normal sperm morphology, increased viscosity and increased liquefaction time. After Ayurvedic management through Sodhana and Samana chikitsa for about 5 months revealed Normozoospermia with Sperm count 47 million/ml, progressive motility 25% and Non progressive motility15%. This shows the effectiveness of Ayurveda medicines in the case of Oligoasthenozoospermia and ensures that Ayurveda can provide spectacular outcome in the areas of Male infertility.

Ayurvedic Management of Oligoasthenozoospermia - A Single Case Study

Male infertility makes up half of all infertility globally, and numerous etiological factors play a significant role to it. Oligoasthenozospermia is a sperm disorder that involves two disorders at the same time, Oligozoospermia (low sperm count) and Asthenozoospermia (Abnormal sperm motility). The signs and symptoms of oligoasthenozoospermia can be co-related with Kshina Shukra in Ayurveda. In Ayurveda Asta-vidha Shukra dushti are mentioned. Kshina Shukra is one among the Asta-vidha Shukra dushti, in which qualitative as well quantitative vitiation of Shukra dhatu occur. While describing the Dushti associated with Shukra and Artava, Vagbhatacharya explained Kshina Shukra as a pathological condition caused by vitiated Vata and Pitta. The present case study explains the role of Shodana aushadi and Shamana aushadi in the management of oligoasthenozoospermia. The patient has report of low sperm count and abnormal morphology was subjected to Ayurvedic management protocol initially Shodana treatment and then Shamana aushadi, administration of Satavari Kshira paka for 30 days. This Ayurvedic treatment protocol including a combination of both Shodana and Shaman therapies were helpful in improving the seminal parameters like sperm count will increase from 10 million/ml to 90 million/ml, Actively motility increase from 0% to 30%, Moderately motility increase from 0% to 30%, Slightly motility increase from 10% to 20%, Non motile decrease from 90% to 20% and number of normal spermatozoa increase to 98%. Hence this approach can be considered in patients with low sperm count and motility.

Association of occupational exposure on semen density in male industrial workers undergoing infertility treatment at tertiary care hospital

Background: Working with particular substances or under certain working situations may cause some workers to experience abnormalities in their sexual or reproductive health. Occupational exposures can lead to infertility, but the workers may not be aware of such problems. The purpose of the study was to determine the association between male infertility and occupation of industrial workers in organized sector.Methods: Prospective case-controlled study that included 136 industrial workers working in organized sector and attending infertility clinic for treatment. This study included male partners aged between 21-46 years with primary or secondary infertility and undertaking same occupation for at least last three months. Complete infertility workup of all male partners attending infertility clinic was done that included detailed history and information related to occupation. Routine semen parameters were evaluated according to the 2010 World Health Organization (WHO) criteria.Results: In the present study, significant semen abnormalities were observed in male partners with age more than 31 years and undertaking arduous jobs for more than 5 years (p <0.05) in study group (n=136) as compared to control group (n=62). The abnormal semen count were observed in 114 (83.2%) workers in the study group that included 43 (31.6%) with total sperm concentration (TSC) less than 10 million/ml and azoospermia in 44 (32.3%). Reduced motility (asthenozoo-spermia) was observed in majority 125 (91.9%) of male partners. The findings were significant (p <0.05) as compared to control group.Conclusions: Preventive measures in the workplace need to be established to reduce the effect of occupational hazards and its influence in the semen parameters ultimately leading to infertility.

Mid-frequency transcutaneous electrical acupoint stimulation combined with tamoxifen for the treatment of oligoasthenozoospermia / 中华男科学杂志

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) or PMS (［15.87 ± 7.81］ vs ［16.76 ± 5.86］ %, P >0.05); TEAS markedly increased total sperm motility (［24.81 ± 8.27］ vs ［32.43 ± 4.97］ %, P 0.05) or sperm concentration (［11.27 ± 2.24］ vs ［14.12 ± 2.47］ ×10⁶/ml, P >0.05); TAM+TEAS, however, improved not only the total sperm count (［26.17 ± 5.05］ vs ［ 51.14 ± 3.69］×106, P <0.05) and sperm concentration (［12.78 ± 2.41］ vs ［27.28 ± 1.98］ ×10⁶/ml, P <0.05), but also total sperm motility (［23.89 ± 9.05］ vs ［37.12 ± 5.33］%, P <0.05) and PMS (［17.14 ± 8.04］ vs ［31.09 ± 7.12］%, 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.

Yam polysaccharide improves sperm viability and protects sperm DNA integrity in vitro / 中华男科学杂志

Objective@#To clarify the roles of yam polysaccharide (YPS) in improving sperm viability and protecting sperm DNA integrity in vitro and provide a new approach to the treatment of oligoasthenozoospermia.@*METHODS@#We collected samples by masturbation from 36 normal fertile males aged 27－39 years. Each sample was divided into six groups: blank control or treated with normal saline, vitamin C solution, and YPS solution at low (0.25 mg/ml), medium (1.0 mg/ml) or high concentration (5.0 mg/ml). Using eosin-Y staining, sperm hypotonic swelling (HOS) and sperm chromatin diffusion (SCD) test, we observed the effects of different concentrations of YPS on sperm viability, membrane integrity and nuclear DNA.@*RESULTS@#After 24 and 48 hours of treatment, sperm viability was markedly reduced in the vitamin C (［28.5 ± 3.1］ and ［6.5 ± 1.2］%), low-YPS (［31.3 ± 3.5］ and ［6.5 ± 2.2］%), medium-YPS (［37.1 ± 3.5］ and ［9.5 ± 2.8］%) and high-YPS groups (［38.3 ± 3.3］ and ［9.0 ± 3.2］%) as compared with the blank control (［17.3 ± 2.1］ and ［3.2 ± 1.3］%) (P 0.05).@*CONCLUSIONS@#Yam polysaccharide can improve sperm viability and protect sperm DNA integrity in vitro.

Protective effect of astaxanthin against epididymal oxidative damagein rats with ornidazole-induced oligoasthenozoospermia / 中华男科学杂志

Objective@#To investigate the improving effect of astaxanthin (AST) on the sperm quality of rats with ornidazole (ORN)-induced oligoasthenozoospermiaand its action mechanism.@*METHODS@#Forty adult male SD rats were equally randomized into groups A (solvent control), B (low-dose ORN ［400 mg/（kg·d）］), C (high-dose ORN ［800 mg/（kg·d）］), D (low-dose ORN ［400 mg/（kg·d）］ + AST ［20 mg/（kg·d）］), and E (high-dose ORN ［800 mg/（kg·d）］ + AST ［20 mg/（kg·d）］), all treated intragastrically for3 weeks.After treatment, the epididymal tails ononeside was taken for determination of sperm concentration and activity, and the epididymideson the other side harvested for measurement of the activities of GSH-Px, GR, CAT and SOD and the MDA contentin the homogenate.@*RESULTS@#Compared with group A, sperm motilityin the epididymal tail andGSH-Px and SOD activities in theepididymiswere markedly decreased while the MDAcontent significantlyincreased in group B (P<0.05), spermmotility and concentrationin the epididymal tail, testisindex, and the activities of GSH-Px, GR, CAT and SOD in the epididymis were remarkably reduced while theMDA contentsignificantly increased in group C(P<0.05). In comparison with group B, group D showed markedly increased sperm motility (［45.3±8.7］% vs ［66.3±8.9］%, P<0.05) in the epididymal tail and SOD activity in the epididymis (［116.7±25.3］ U/mg prot vs ［146.1±23.8］ U/mg prot, P<0.05), decreased MDA content(［1.68±0.45］ nmol/mg prot vs ［1.19±0.42］ nmol/mg prot, P<0.05).Compared with group C, group Eexhibited significant increases in the weight gained (［89.0±9.5］ vs ［99.9±4.1］ %, P<0.05) and sperm motility (［17.9±3.5］% vs ［27.3±5.3］ %, P<0.05) but a decrease in the content of MDA (［2.03±0.30］ nmol/mg prot vs ［1.52±0.41］ nmol/mg prot, P<0.05).@*CONCLUSIONS@#AST can improve spermquality in rats with ORN-inducedoligoasthenozoospermia, which may be associated with its enhancing effect on the antioxidant capacity of the epididymis.

Correlation between ubiquitin specific peptidase 7 expression and male infertility / 第二军医大学学报

Objective To investigate the expression of ubiquitin specific peptidase 7 (USP7) in the sperm of infertile man suffering asthenozoospermia or oligoasthenozoospermia, and to explore its role in the pathogenesis of male infertility. Methods The semen samples were obtained from 120 donors attending the Fertility Clinic, the Centre of Reproductive Medicine, the Second Affiliated Hospital, Chongqing Medical University. The sperm specimens were divided into normozoospermia group (n=57), asthenozoospermia group (n =37) or oligoasthenozoospermia group (n =26) after semen analysis according to 2010 WHO standards. The localization and expression of USP7 were examined using immunofluorescence and Western blotting analysis in the three groups. Then the correlation between USP7 expression and sperm parameterswas analyzed. Results USP7 mainly localized in the middle part and main part of thesperm tail; the USP expression was significantly lower in asthenozoospermia group(0. 86 ± 0. 53) and oligoasthenozoospermia group (0. 62 ± 0. 43) compared with normozoospermia group (1. 63 ± 0. 76, P<0. 01). And USP7 expression was found positively correlated with the ratio of sperm moving forward(r = 0. 431 2, P =0. 008 7), total motility rate(r=0. 443 8, P =0. 006 7), and sperm concentration(r = 0. 455 0, P =0. 005 3). Conclusion The lowered expression of USP7 is related to the reduction of human sperm motility and concentration, indicating that USP7 expressionmay serve as an indicator for sperm quality evaluation in infertile men.

Clinical Observation of Acupuncture for Idiopathic Oligoasthenozoospermia / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture in treating male idiopathic oligoasthenozoospermia. Method A hundred patients with oligoasthenozoospermia were recruited and randomized into a treatment group and a control group, 50 cases in each group. The treatment group was intervened by acupuncture, while the control group was by placebo acupuncture at non-meridian points. The clinical efficacies and changes of the relevant parameters of sperms after treatment were observed. Result The clinical efficacy of the treatment group was significantly better than that of the control group (P0.05); after intervention, the improvements of the relevant parameters of sperms in the treatment group were more significant than that in the control group (P<0.05). Conclusion Acupuncture can effectively improve the sperm density, sperm motility, and sperm viability, and enhance the recovery rate in treating infertility, and it’s easy-to-operate, without significant adverse reactions, safe, and reliable.

Efficacy research of BuShen QiangJingTang on oligoasthenozoospermia / 中国生化药物杂志

Objective To study the efficacy of BuShen QiangJingTang on oligoasthenozoospermia. Methods 100 patients with oligoasthenozoospermia were selected and divided into observation group (n=50) and control group (n=50) randomly, observation group were given BuShen QiangJingTang, while control group were given WuZi YanZong pills, then the efficacy was compared.Results Efficiency of observation group was 96%, which was obviously higher than control group (54%, P<0.05).Before treatment, semen parameters and symptom scores had no statistical significant differences; after treatment, semen volume, sperm survival rate, sperm density and sperm activity of observation group were significantly higher than control group, the scores of symptom (lumbar debility, fatigue weakness, nocturia) were significantly lower than control group(P<0.05).No adverse reactions were observed in two groups.Conclusion The efficacy of BuShen QiangJingTang applied to oligoasthenozoospermia is satisfying,and it can significantly improve sperm quality and activity.

Human sperm centrin levels & outcome of intracytoplasmic sperm injection (ICSI) - A pilot study.

Background & objectives: The objective of the present study was to compare the levels of sperm centrin a centrosomal protein that influences cell migration, in normal fertile donors and in oligoasthenozoospermic males (count 5 million/ml and motility <40%, grade c+d) undergoing intracytoplasmic sperm injection (ICSI) and to correlate with the outcome of ICSI. Methods: The prospective study carried out at Inkus IVF Centre, Mumbai, India, during (January-December 2003). It included 20 normal fertile donor males (group I) and 20 oligoasthnozoospermic (OA) males (group II). Group II was further divided in II a and II b according to the centrin levels. Centrin levels were measured by using enzyme linked immunosorbent assay (ELISA) in both groups. All participants underwent an ICSI procedure and the levels of centrin and outcome of ICSI were correlated. Results: Centrin levels were significantly lower (P<0.001) in group II (0.39) as compared with group I (1.34). With centrin levels <0.45 optical density (OD) (group II a) the pregnancy rate was further reduced, with only 2 pregnancies (out of 14) both of which, ended in abortion. Cases in group II showed levels of centrin much lower than in the fertile group. Further lowered centrin levels were associated with lowered pregnancy rates in OA males, but statistically was not significant. Interpretation & conclusions: The study revealed that lower centrin levels in OA males resulted in lower pregnancy percentage in this group after ICSI. Disturbances in centrosomal protein could be one of the possible causes of ICSI failure.