Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility


      To evaluate the ultramorphologic sperm features of idiopathic infertile men after acupuncture therapy.


      Prospective controlled study.


      Christian-Lauritzen-Institut, Ulm, IVF center Munich, Germany, and Department of General Biology, University of Siena, Siena, Italy.


      Forty men with idiopathic oligospermia, asthenospermia, or teratozoospermia.


      Twenty eight of the patients received acupuncture twice a week over a period of 5 weeks. The samples from the treatment group were randomized with semen samples from the 12 men in the untreated control group.

      Main Outcome Measure(s)

      Quantitative analysis by transmission electron microscopy (TEM) was used to evaluate the samples, using the mathematical formula based on submicroscopic characteristics.


      Statistical evaluation of the TEM data showed a statistically significant increase after acupuncture in the percentage and number of sperm without ultrastructural defects in the total ejaculates. A statistically significant improvement was detected in acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibers of sperm organelles. However, specific sperm pathologies in the form of apoptosis, immaturity, and necrosis showed no statistically significant changes between the control and treatment groups before and after treatment.


      The treatment of idiopathic male infertility could benefit from employing acupuncture. A general improvement of sperm quality, specifically in the ultrastructural integrity of spermatozoa, was seen after acupuncture, although we did not identify specific sperm pathologies that could be particularly sensitive to this therapy.

      Key Words

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        • Zollman C.
        • Vickers A.
        ABC of complementary medicine. Users and practitioners of complementary medicine.
        BMJ. 1999; 319: 836-838
        • Eisenberg D.M.
        • Davis R.B.
        • Ettner S.L.
        • Appel S.
        • Wilkey S.
        • Van Rompay M.
        • et al.
        Trends in alternative medicine use in the United States, 1990–1997. Results of a follow-up national survey.
        JAMA. 1998; 280: 1569-1575
        • Yu J.
        • Zheng H.M.
        • Ping S.M.
        Changes in serum FSH, LH and ovarian follicular growth during electroacupuncture for induction of ovulation.
        Zhong Xi Yi Jie He Za Zhi. 1989; 9 ([in Chinese]): 199-202
        • Chen B.Y.
        Acupuncture normalizes dysfunction of hypothalamic-pituitary-ovarian axis.
        Acupunct Electrother Res. 1997; 22: 97-108
        • Chang R.
        • Chung P.H.
        • Rosenwaks Z.
        Role of acupuncture in the treatment of female infertility.
        Fert Steril. 2002; 78: 1149-1153
        • Riegler R.
        • Fischl F.
        • Bunzel B.
        • Neumark J.
        Correlation of psychological changes and spermiogram improvements following acupuncture.
        Urologe A. 1984; 23: 329-333
        • Gerhard I.
        • Jung I.
        • Postneek F.
        Effects of acupuncture on semen parameters/hormone profile in infertile men.
        Mol Androl. 1992; 4: 9-24
        • Jiasheng Z.
        Male infertility treated with acupuncture and moxibustion.
        Chin Acupunct Moxibustion. 1987; 7 ([in Chinese]): 3-4
        • Xueying L.
        Treating azoospermia by acupuncture and indirect moxibustion.
        Am J Acupunct. 1984; 32: 184
        • Siterman S.
        • Eltes F.
        • Wolfson V.
        • Zabludovsky N.
        • Bartoov B.
        Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality.
        Arch Androl. 1997; 39: 155-161
        • Siterman S.
        • Eltes F.
        • Wolfson V.
        • Lederman H.
        • Bartoov B.
        Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study.
        Andrologia. 2000; 32: 31-39
        • Xinyun H.
        Acupuncture plus medication for male idiopathic oligospermatic sterility.
        Shanghai J Acupunct Moxibustion. 1998; 2 ([in Chinese]): 35-37
        • Zheng Z.C.
        Analysis on the therapeutic effect of combined use of acupuncture and medication in 297 cases of male sterility.
        J Tradit Chin Med. 1997; 17: 190-193
        • Zhang M.M.
        • Huang G.
        • Lu F.
        • Paulus W.E.
        • Sterzik K.
        Influence of acupuncture on idiopathic male infertility in assisted reproductive technology.
        J Tongji Med Univ. 2002; 22 ([in Chinese]): 228-230
        • Paulus W.E.
        • Zhang M.
        • Strehler E.
        • EI-Danasouri I.
        • Sterzik K.
        Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy.
        Fertil Steril. 2002; 79: 52-59
        • Baccetti B.
        • Strehler E.
        • Capitani S.
        • Collodel G.
        • De Santo M.
        • Moretti E.
        • et al.
        The effect of follicle stimulating hormone therapy on human sperm structure.
        Hum Reprod. 1997; 12 (Notulae seminologicae 11): 1955-1968
        • Strehler E.
        • Capitani S.
        • Collodel G.
        • De Santo M.
        • Moretti E.
        • Piomboni P.
        • et al.
        Submicroscopic mathematical evaluation of spermatozoa in assisted reproduction. 1 Intracytoplasmic sperm injection.
        J Submicrosc Cytol Pathol. 1995; 27 (Notulae seminologicae 6): 573-586
        • Piomboni P.
        • Strehler E.
        • Capitani S.
        • Collodel G.
        • De Santo M.
        • Gambera L.
        • et al.
        Submicroscopic mathematical evaluation of spermatozoa in assisted reproduction. 2 In vitro fertilization.
        J Assist Reprod Genet. 1996; 13 (Notulae seminologicae 7): 635-646
        • Strehler E.
        • Sterzik K.
        • De Santo M.
        • Baccetti B.
        • Capitani S.
        • Collodel G.
        • et al.
        Submicroscopic mathematical evaluation of spermatozoa in assisted reproduction. 3. Partial zona dissection (PZD).
        J Submicrosc Cytol Pathol. 1997; 29 (Notulae seminologicae 12): 387-391
        • World Health Organization
        Laboratory manual for the examination of human semen and sperm-cervical mucus interaction.
        4th ed. Cambridge University Press, New York1999
        • World Heath Organization
        Standard acupuncture nomenclature.
        WHO Regional Publications for the Western Pacific, Manila, Philippines1984
        • Hess R.
        Neurophysiological mechanisms of pain perception.
        Methods Find Exp Clin Pharmacol. 1982; 4: 463-467
        • Haker E.
        • Lundeberg T.
        Acupuncture treatment in epicondylalgia.
        Clin J Pain. 1990; 6: 221-226
        • Baccetti B.
        • Bernieri G.
        • Burrini A.G.
        • Collodel G.
        • Crisa N.
        • Mirolli M.
        • et al.
        Mathematical evaluation of interdependent submicroscopic sperm alterations (Notulae seminologicae 5).
        J Androl. 1995; 16: 356-371
        • Strehler E.
        • Sterzik K.
        • De Santo M.
        • Abt M.
        • Wiedemann R.
        • Bellati U.
        • et al.
        The effect of follicle-stimulating hormone therapy on sperm quality.
        J Androl. 1997; 8: 439-447
        • Bartoov B.
        • Eltes F.
        • Reichart M.
        • Langzam J.
        • Lederman H.
        • Zabludovsky N.
        Quantitative ultramorphological analysis of human sperm.
        Arch Androl. 1999; 43: 13-25
        • Zamboni L.
        Physiology and pathophysiology of the human spermatozoon.
        J Electron Microsc Tech. 1991; 17: 412-436