Acupuncture for male fertility, A TCM-Informed Approach to Improving Sperm Quality

May 21
6 min read

When I see women going though fertility treatment we discuss their heath, but I aso ask about the quality of partner's sperm. In Western world the focus tends to fall on the woman, they are being tested, medicated, told to change their lifestyle. Yet male factor infertility accounts for around 40–50% of all cases — and in my clinical experience, it is consistently underaddressed. A semen analysis that comes back "Ok" is frequently accepted as the end of the conversation. The poor volume, morphology (shape), motility (movement) is not an obstacle for lots of IVF clinics, as they can do ICSI (Intracytoplasmic sperm injection), picking up the best sperm and injecting it into the center of the egg.

What if men could improve their sperm quality to increase the chances of a live birth, not just conception?

Why Sperm Quality Matters Beyond Getting Pregnant

Improving sperm parameters is not just about achieving conception — it has a direct bearing on whether that pregnancy continues to a healthy live birth. Research analysing over 22,000 assisted reproductive cycles found that sperm motility significantly predicted both pregnancy and live birth rates in IVF, while sperm morphology was a significant predictor of both pregnancy and live birth rates in ICSI cycles. The integrity of sperm DNA is equally important: a systematic review and meta-analysis found that live birth rates were significantly higher in couples where sperm DNA fragmentation was low, with an overall relative risk of 1.17 compared to those with high fragmentation. A further systematic review confirmed that miscarriage rates are positively correlated with sperm DNA damage levels — meaning poor sperm quality does not simply reduce the chance of conception, it increases the risk of losing a pregnancy once it has occurred. Total motile sperm count has also been shown to positively influence oocyte fertilisation rates and cumulative live birth rates, reinforcing that volume and concentration are not peripheral concerns. Taken together, the evidence is clear: optimising sperm quality across all parameters — motility, morphology, count, and DNA integrity — is one of the most impactful steps a couple can take to improve their overall reproductive outcome.

The Bigger Picture

Dr Shanna Swan, reproductive epidemiologist and author of the book Count Down, has spent decades documenting a crisis hiding in plain sight: sperm counts in Western men have declined by more than 50% over the past four decades. Her research points clearly to endocrine-disrupting chemicals in plastics, pesticides, and everyday personal care products as key drivers. Dr Swan believes that the rapidly decreasing fertility rate means that most men will be unable to produce viable sperm by 2045!!!!

I can highly recommend her Netflix documentary Plastic Detox . It is an excellent and eye-opening starting point — and a compelling argument for why doing nothing with "normal" results, is rarely the wisest strategy and how much difference we can do by introducing lifestyle changes.

Simple Positive Steps Men Can Take to Support Sperm Health

Sleep — go to bed before 11pm our energy restores during deep sleep, particularly in the early part of the night. Late nights are one of the fastest routes to constitutional depletion in TCM — and chronically poor sleep is directly associated with reduced testosterone, lower sperm count, and impaired motility. Protecting sleep is not optional. It is foundational reproductive medicine.
Food — Prioritise warm, cooked, nourishing meals over raw, cold, and processed foods, which TCM considers weakening to the digestive system and depleting to reproductive energy. Focus on bone broths, slow-cooked grains, oily fish rich in omega-3 for sperm membrane integrity and motility, walnuts, black sesame, pumpkin seeds, and eggs — all Kidney-supportive foods. Add plenty of colourful vegetables and fruit for antioxidant protection against sperm DNA damage, good fats from avocado and olive oil to support hormone production, and warming spices such as ginger and cinnamon. Warm water or herbal teas are always preferable to cold drinks, which TCM considers damaging to digestive Yang.
Reduce Damp-forming and depleting foods — protect the lower jiao Alcohol, excess sugar, dairy, processed foods, bananas, oranges, and peanut butter all contribute to Damp-Heat accumulation in the lower jiao — a TCM pattern consistently associated with poor sperm parameters and reduced reproductive function. Alcohol also directly impairs testosterone production and increases sperm DNA fragmentation. More than two cups of coffee daily has been associated with reduced sperm quality. Cigarettes and vaping introduce oxidative stress that damages sperm DNA and depletes Kidney Jing. During the preconception window, the honest advice is to reduce significantly or cut these out completely. Small daily habits compound over 74 days in both directions.
Hydration — support fluid metabolism and semen quality Adequate hydration supports semen volume, sperm motility, and the body's ability to clear heat and toxins from the lower jiao. Aim for 1.5–2 litres of filtered water daily, ideally at room temperature or warm — never ice cold.
Exercise — move Qi without depleting it Regular moderate exercise promotes the smooth flow of Liver Qi, supports circulation to the reproductive system, and helps regulate hormonal balance. Walking, swimming, and strength training in moderation are all well-suited. Excessive high-intensity training, however, can deplete Kidney Yang and raise core and scrotal temperature — both counterproductive. Consistency matters more than intensity.
Stress management — smooth Liver Qi, protect reproductive function Chronic stress causes Liver Qi stagnation, which over time restricts the flow of Qi and Blood to the reproductive organs and disrupts hormonal balance. Acupuncture is particularly effective here — it directly addresses stagnation and supports Kidney function simultaneously. Breathwork, walking in nature, and protective boundaries around work and screen time are all valuable daily practices. In TCM terms Liver opens into the eyes so spending too much time on the computer or the phone affects the energy of the Liver. This is not peripheral lifestyle advice. In TCM, unresolved stress is a direct clinical contributor to poor sperm quality.
Avoid localised heat — protect the lower jiao Scrotal temperature must remain slightly below core body temperature for healthy sperm production. Tight underwear, prolonged sitting, hot baths, saunas, and laptops on the lap all generate concentrated heat that impairs spermatogenesis. Switch to loose-fitting underwear, take regular movement breaks, and be mindful of heat exposure — particularly during the active preconception period.
Ejaculate regularly — every 3–4 days Both infrequent and excessive ejaculation compromise sperm quality. Ejaculating every 3–4 days maintains a healthy, fresh supply of motile sperm and reduces DNA fragmentation that accumulates in older sperm sitting in the reproductive tract. In TCM this reflects the principle of balance — neither hoarding Jing through excessive abstinence nor depleting it through excess.
Seek professional support — root cause matters If you have been trying to conceive for six months or more, or have received borderline semen analysis results, do not wait. A GP can arrange semen analysis and hormone testing. If you are with IVF clinic as for some more indepth testing or you can do online free assesment at testhim.com, which can be good start.

When to Seek a Full TCM Assessment

Home lifestyle changes are a meaningful starting point. But they work best when matched to the correct underlying pattern. If you have been trying to conceive for six months or more, have received borderline semen analysis results, or have a known health condition affecting reproductive function, a full TCM consultation may be the next efficient next step.

In clinic, I use pulse and tongue diagnosis alongside a detailed health history to identify the precise pattern driving the imbalance — and to build a treatment plan that addresses the root cause. This typically includes acupuncture and personalised dietary and lifestyle guidance alongside any botanical recommendations.

Three months of consistent, well-targeted support can produce real and measurable change. The biology allows for it. The question is whether you give it the conditions to happen.

References

Ombelet W, et al. (2014). Total motile sperm count and morphology as predictive variables for IUI success — systematic review. Human Reproduction Update. Cited in: Ensemble machine learning models for sperm quality evaluation concerning success rate of clinical pregnancy in assisted reproductive techniques. Scientific Reports, 2024. https://www.nature.com/articles/s41598-024-73326-7
Mangum C, et al. (2022). Are sperm parameters able to predict the success of assisted reproductive technology? A retrospective analysis of over 22,000 assisted reproductive technology cycles. PMC / Andrology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9298690/
Osman A, et al. (2015). The effect of sperm DNA fragmentation on live birth rate after IVF or ICSI: a systematic review and meta-analysis. PubMed / Human Reproduction. https://pubmed.ncbi.nlm.nih.gov/25530036/
Robinson L, et al. (2012). The effect of sperm DNA fragmentation on miscarriage rates: a systematic review and meta-analysis. PubMed / Human Reproduction. https://pubmed.ncbi.nlm.nih.gov/22791753/
Crafa A, et al. (2025). Does total motile sperm count predict embryo quality and ICSI success in young normal-weight women? A retrospective multicentre study. ScienceDirect / European Journal of Obstetrics & Gynecology. https://www.sciencedirect.com/science/article/pii/S147264832500416X