I have a female patient that has been doing everything she can to ensure she is optimizing her fertility, supplements, exercising, dietary changes, regular acupuncture treatments, taking herbal medicine.  She has endometriosis & pcos.  She has now just finished 2 cycles with clomid, no luck so far.  Well, now what, of course, the fertility clinic says 'it is time for IVF'.  Well, I have another idea, and it corresponds with what everyone I know that works intimately with fertility thinks, let's treat the other major variable in this infertility scenario, THE MAN.  The husband of this woman has never been tested, has done nothing to his diet, does not exercise, is extremely overworked, does not take any supplements, and most certainly does not do acupuncture or herbal medicine.  Wouldn't it make sense, ESPECIALLY when the woman is displaying fertility issues, to optimize his sperm health, EVEN IF AN ANALYSIS SAYS IT IS OK?

 When treating male factor infertility, you often treat female fertility also, this makes sense.  Research and understandings of female infertility also help us better understand what to investigate when it comes to men.  An area of female infertility that is generally overlooked, misunderstood, and treated poorly is issues of the thyroid.  Since thyroid health is showing more and more importance in female infertility, it makes sense to start investigating its role in male factor as well.  First off, we now know the ranges of TSH on lab reports are not specific enough when it comes to a woman wanting to conceive.  Could this hold true for men also?  Does TSH need to be 'more' specific for optimal sperm production and health?  

Pharmacological studies on Yang and Yin tonifying herbs suggest that Yang tonifying herbs stimulate mitochondrial adenosine triphosphate (ATP) generation, presumably through the intermediacy of reactive oxidant species, leading to the enhancement of cellular/mitochondrial antioxidant status. Yin tonifying herbs, however, apart from possessing antioxidant properties, exert mainly immunomodulatory functions that may boost a weak immune system and may also suppress overreactive immune responses.

The results demonstrate a negative association between semen analysis parameters and sperm with fragmented DNA. Since extremely poor semen samples are the indication for intracytoplasmic sperm injection, there is a high likelihood that sperm with fragmented DNA may be selected by chance and used for oocyte injection, resulting in poor fertilization and/or cleavage rates. 

We have recently established that poor-quality semen samples have a greater percentage of spermatozoa with DNA fragmentation than normal fertile samples (Sun et al., 1997; Lopes et al., 1998). In addition, we demonstrated a negative correlation between the percentage of spermatozoa with fragmented DNA and fertilization rates in in-vitro fertilization (IVF) (Sun et al., 1997) and in intracytoplasmic sperm injection (ICSI) (Lopes et al., 1998). At present the aetiology of sperm DNA fragmentation in infertile men is unclear.We hypothesize that ROS may be involved in the DNA fragmentation seen in these germ cells since several studies have shown that ROS can cause DNA damage in somatic cells (Buttke et al., 1994; Ratan et al., 1994).