Male Immune Infertility

Cohort description:

Altogether, there were 264 men enrolled in this two-wing comparison study. These 264 subjects were randomly divided into two groups of 132 patients each – a treatment group and a comparison group. All 264 men were AsAb blood serum and/or seminal fluid positive sufferers of immune infertility. The age in the treatment group ranged from 24-52 years, with an average age of 28.9 years. These patients had been married without conception for1-9 years, with an average duration of marriage of 2.15 years. Forty-two cases were AsAb serum positive, 34 cases were AsAb seminal fluid positive, and 56 cases were positive in both. There were 82 men who presented a Chinese medical pattern of liver depression and blood stasis in the treatment group and 50 men who presented a pattern of liver depression, blood stasis, and damp heat pouring downward. In the comparison group, the men’s ages ranged from 25-51 years, with an average age of 33.7 years. These men had been married with conception for 2-11 years, with an average duration of marriage of 2.52 years. Forty-five of these cases were serum AsAb positive, 36 were seminal fluid AsAb positive, and 51 cases were positive in both. Eight-four men in this group presented a liver depression and blood stasis pattern, and 42 presented a liver depression, blood stasis, and damp heat pouring downward pattern. Therefore, in terms of age, length of being married, AsAb, and Chinese pattern discrimination, these two group were considered statistically comparable.

As for the criteria of liver depression and blood stasis,, there were three main criteria: 1) chest oppression and discomfort with a tendency to great sighing, 2) chest and rib-side distention and pain, and 3) testicular hardness, distention, and pain. There were also seven secondary criteria: 1) vexation, agitation, and easy anger, 2) seminal vesicle varicosity, 3) testicular or testicular adnexal nodulations, 4) yang wilting, i.e., impotence, or nonejaculation, 5) an excessively high dead sperm count, 6) a dark tongue substance, and 7) a deep, bowstring, possibly choppy pulse. Patients had to have all three of the main symptoms or one at least one of the main symptoms and at least two of the secondary symptoms to qualify for this pattern.

Treatment method:

All members of the treatment group were administered Ju He Wan with added flavors:

stir-fried Ju He (Semen Citri Reticulatae)
stir-fried Hai Zao (Sargassum)
stir-fried Kun Bu (Thallus Algae)
stir-fried Hai Dai (Thallus Eckloniae)
stir-fired Chuan Lian Zi (Fructus Toosendan)
stir-fried Tao Ren (Semen Persicae), 30g each
ginger juice stir-fried Hou Po (Cortex Magnoliae)
stir-fried Mu Tong (Caulis Akebiae)
stir-fried Zhi Shi (Fructus Immaturus Aurantii)
stir-fried Yan Hu Suo (Rhizoma Corydalis)
stir-fried Rou Gui (Cortex Cinnamomi)
stir-fried Mu Xiang (Radix Auklandiae), 15g each

One packet of these medicinals was decocted in water and administered per day in two divided doses, morning and evening. One and a half months equalled one course of treatment. If, after one course of treatment, AsAb was still positive, another course of treatment was given up to a total of three courses.

All members of the comparison group were orally administered 15 milligram of prednisone one time per day in the morning. The course of treatment was the same for the treatment group above. If there was a reproductive tract infection, antibiotics were also administered.

Study outcomes:

Cure was defined as the patient’s wife conceiving after1-2 courses of treatment. Marked effect meant that, although the wife had not yet conceived after 1-2 courses of treatment, eight criteria of the seminal fluid and sperm returned to normal. These included pH, liquefaction time, sperm motility, morphology, and mortality, white blood cells counts, etc. Some effect meant that the sperm function was not yet normal but the seminal fluid had improved. No effect meant that, after 1-2 courses of treatment, there was no change from before to after treatment. Based on these criteria, the following table shows the outcomes in the two groups.

Thus there was a very marked difference in the total effectiveness rates between these two groups. Further, AsAb turned negative in 120 patients (90.91%) in the treatment group compared to only 59 patients (44.70%) in the comparison group. Note that these percentages were the same as the total effectiveness rates. Six months after treatment, 74 families (56.06%) had given birth (with two pairs of twins) as compared to only 26 cases (19.70%) in the comparison group. In addition, there were no adverse reactions reported in the treatment group. However, in the comparison group, 107 cases reported such side effects as acne, hirsutism, insomnia, upper abdominal discomfort, and decreased libido.

Discussion:

According to the Chinese authors, the basic disease mechanisms of male immune infertility are damp heat, stasis, and stagnation, yin vacuity with fire effulgence, and a mixture of vacuity and repletion. Mostly they see this condition in men with prostatitis, epididymitis, orchitis, varicocele, nongonorrheal urinary tract inflammation, etc. or those who have a history of surgical damage to their reproductive organs. These conditions result in liver qi depression and binding, inhibition of the movement of essence, and essence stasis leading to essence pathway blockage and obstruction. Or they may lead to liver-kidney yin debility, yin vacuity and fire effulgence, or damp heat pouring downward, internally harassing the essence chamber. Further, these condition may also result in spleen-kidney yang vacuity with essence cold leading to congelation and stagnation and stasis obstruction of the essence pathway. In all these cases, either vacuity of the righteous is unable to overcome evils or there is recurrent contraction of damp heat.

Within Ju He Wan, Ju He moves the qi and treats child welling abscesses. These latter are probably welling abscesses on the genitalia. It is the sovereign ingredient in this formula. Mu Xiang and Chuan Lian Zi move the qi and stop pain. Tao Ren and Yan Hu Suo quicken the blood and scatter binding. Together, these are the ministerial medicinals. Rou Gui warms the liver and kidneys in order to scatter cold evils. Zhi Shi and Hou Po break the qi and divide accumulation and stagnation. Hai Zao, Kun Bu, and Hai Dai saltily soften the hard and scatter binding. Mu Tong frees the flow and disinhibits lower burner damp evils. Together, these are the adjuvant medicinals. When used together, these medicinals can straighten and spread the jue yin liver channel, clear and dry dampness, soften the hard and scatter binding, move the qi and transform stasis. Thus they treat the root and tips or branches of this condition simultaneously.

abstracted & translated by

Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

On pages 39-40 of issue #7, 2007 of Xin Zhong Yi (New Chinese Medicine), Cheng Ke-jia et al. published an article titled “Observations on the Therapeutic Effects of Treating 132 Cases of Male Immune Infertility with Ju He Wan (Citrus Seed Pills). A summary of this article is presented below.

Copyright © Blue Poppy Press, 2007. All rights reserved.