Acupuncture may have significant positive effects on the percentage of motile sperm in infertile men who have severe oligoasthenozoospermia, reports research from Germany. According to two prospective randomized clinical studies (Dieterle et al., 2006; Westergaard et al., 2006) and a systematic
review with meta-analysis (Manheimer et al., 2008), acupuncture has a significant effect on clinical pregnancy and live birth rates when it is conducted at the time of embryo transfer in patients undergoing in vitro fertilization (IVF). The effect of acupuncture on semen parameters has only been evaluated in a small sample of patients, however (Yu Ng et al., 2009). Therefore, the purpose of this study by S. Dieterle and colleagues was to determine the effects of acupuncture on the semen parameters of infertile men with severe oligoasthenozoospermia. "A significantly higher percentage of motile sperm (WHO categories A - C), but no effect on sperm concentration, was found after acupuncture compared with placebo acupuncture," wrote Dieterle et al. ("A Prospective Randomized Placebo-Controlled Study of the Effect of Acupuncture in Infertile Patients with Severe Oligoasthenozoospermia," Fer & Ster, 2009;92(4):1340-1343). The study included 47 infertile men with severe
oligoasthenozoospermia who were randomized to receive either acupuncture (n = 28) or placebo acupuncture (n = 29) twice a week for six weeks. Acupoints were chosen for both groups based on an earlier acupuncture study on sperm morphology in male infertility (Pei et al., 2005). The acupuncture needles,
which were 0.30 x 30 mm, were inserted to a depth of 15 - 30 mm. They were rotated manually to evoke the Deqi sensation; 10 minutes later, they were manipulated again for the same sensation. Non-penetrating needles of the same dimensions were used for placebo acupuncture. Semen samples were
evaluated according to WHO (1999) standards at the following times: ≤ five months prior to intervention, < 3 months prior to intervention, < 2 months after intervention, and ≤ 3 months after intervention. Statistical analysis included Dixon and Mood sign test,

Mann-Whitney U-test, and Wilcoxon matched pairs test. Data are given as mean ± SD. In the group of patients that underwent acupuncture, a significant (P = 0.035) increase occurred in motility A - C after intervention (24.2% ± 17.0 before intervention vs. 33.8% ± 18.2 after intervention). No significant difference was seen in motility A - C after use of non-penetrating needles in the control group. Sperm concentration improved after intervention in the acupuncture group, but not to a significant extent; however, sperm concentration did improve significantly (P = 0.0180) in the control group from 0.016 ± 0.085 million/mL before use of non-penetrating needles to 0.468 ± 1.712 million/mL after placebo acupuncture. Semen volume decreased significantly (P = 0.041) after intervention in the acupuncture group, but no significant difference was noted after placebo acupuncture in the control group. "The decrease in semen volume after acupuncture has to be investigated. There was a significant increase in sperm concentration after placebo acupuncture, but not after acupuncture. These results might be due to the number of patients included in this study," concluded Dieterle et al. "The results of the present study support the significance of acupuncture in male patients with severe oligoasthenozoospermia." Address correspondence to Priv.-Doz Dr. Med. Stefan Dieterle, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Witten/Herdecke, Olpe 19, D-44135 Dortmund, Germany; e-mail: dieterle@ivf-dortmund.de.