Ui Min Jerng et al Asian J Androl. 2014 Nov-Dec; 16(6): 884–891
Asian Journal of Andrology
This review looks at a selected number of RCTs that examined the effect of acupuncture on sperm motility and count, but not morphology. From the 4 trials they examined, they report that motility and sperm concentration were significantly increased in the acupuncture groups. However if trial designs are heterogeneous, and there is risk of bias, as was the case in this meta analysis, it makes it more difficult to draw conclusions that are applicable in clinic.
The aim of this review is to evaluate the effectiveness and safety of acupuncture for poor semen quality in infertile men. We searched for relevant trials registered up to May 2013 in 14 databases. We selected randomized controlled trials (RCTs) that compared acupuncture, with or without additional treatment, against placebo, sham, no treatment, or the same additional treatment. Two reviewers independently performed the study selection, data extraction, risk of bias and reporting quality appraisal. Risk of bias and reporting quality were appraised by the Cochrane risk of bias tool, the consolidated standards of reporting trials and Standards for Reporting Interventions in Clinical Trials of Acupuncture. The outcomes were sperm motility, sperm concentration, pregnancy rate, and adverse events. Pregnancy was defined as a positive pregnancy test.
Four RCTs met the eligibility criteria. Acupuncture increased the percentage of sperm with rapid progression (mean difference – 6.35, 95% confidence interval (CI): 4.38–8.32, P< 0.00001) and sperm concentration (mean difference – 6.42, 95% CI: 4.91–7.92, P< 0.00001), but these two outcomes were substantially heterogeneous among the studies (I2 = 72% and 58%, respectively).
No differences in pregnancy rate were found between acupuncture and control groups (odds ratio 1.60, 95% CI: 0.70–3.69, P= 0.27, I2 = 0%). No participants experienced adverse events. The current evidence showing that acupuncture might improve poor semen quality is insufficient because of the small number of studies, inadequacy of procedures and/or insufficient information for semen analysis, high levels of heterogeneity, high risk of bias, and poor quality of reporting. Further large, well-designed RCTs are required.
Keywords: acupuncture, asthenozoospermia, male infertility, oligozoospermia, sperm quality