Electroacupuncture and male infertility

Oligoasthenoteratozoospermia, also known as OAT, can be understood simply as having a lower sperm count and weaker sperm motility, often accompanied by problems in sperm shape, and it is a common cause of male infertility. For many men, the first time they see a semen analysis report, what troubles them most is not only the numbers, but the sudden realisation that everyday factors such as stress, sleep patterns, body weight, alcohol intake, and environmental exposures may be quietly affecting fertility. In recent years, under the combined influence of unhealthy lifestyles, psychological stress, and environmental pollution, OAT has become more prevalent, and this has pushed clinical care to look for interventions that are more consistent and better tolerated overall.

From the perspective of modern research, the mechanisms behind OAT are complex, but oxidative stress is widely regarded as a key shared pathway. The testes and sperm also produce some reactive oxygen species under normal conditions, and these are needed for physiological processes such as sperm capacitation and the acrosome reaction. The problem arises when reactive oxygen species become excessive and the body’s antioxidant systems cannot keep up, making sperm cell membranes and mitochondria more vulnerable to damage, reducing motility, increasing abnormal forms, and further worsening the environment for sperm production. Along this pathway, Nrf2 and HO1 are often seen as crucial protective systems, functioning like an internal antioxidant switch and a set of defensive tools, while antioxidant enzymes such as SOD and CAT reflect the capacity of tissues to clear free radicals, and MDA is commonly used to indicate the degree of lipid peroxidation and the level of damage. In other words, if excessive oxidative pressure can be reduced while these endogenous defences are strengthened, the environment for spermatogenesis is more likely to shift in a healthier direction.

In practice, pharmacological and supplement based approaches are still the more common routes in clinical settings. In Western medicine, hormones or nutritional supplements are frequently used, such as L-carnitine and vitamins C and E, yet the effects are not always consistent, and some options may bring adverse effects or tolerability issues for certain individuals. For this reason, acupuncture and electroacupuncture have attracted increasing attention in recent years both in China and internationally, and some guidelines and consensus statements include acupuncture among the recommended interventions for OAT. Electroacupuncture is also considered one of the optional treatment approaches.

What is particularly worth discussing with electroacupuncture is the choice of parameters, especially frequency. Different frequencies may activate different neuroendocrine regulatory pathways and central responses, yet in the field of male reproduction, clinical choices are often still driven by habit and personal experience, and mechanistic evidence remains relatively scattered.

In one study, researchers first used ornidazole to establish an OAT rat model, then from the first day of modelling they applied electroacupuncture at Guanyuan, Qihai, and bilaterally at Sanyinjiao and Zusanli, comparing 2 Hz continuous stimulation, 100 Hz continuous stimulation, and 2 Hz/100 Hz alternating stimulation. The model group showed typical signs of impaired spermatogenesis, including a reduced testicular index, lower sperm concentration and motility, and fewer offspring, alongside histological changes such as atrophy of seminiferous tubules and a lower score. Oxidative stress related markers were also worse, with higher reactive oxygen species expression and higher MDA, while SOD and CAT activity fell and the protein expression of Nrf2 and HO1 also decreased. All three electroacupuncture protocols could reverse these changes to varying degrees, improving sperm quality and reproductive outcomes, improving testicular tissue morphology, reducing oxidative stress, and increasing Nrf2 and HO1 expression. Most importantly, the 2 Hz/100 Hz alternating protocol performed more strongly across multiple indicators, suggesting that alternating frequencies may be more beneficial for improving spermatogenic function and antioxidant defence.

Reference

Chinese Association of Reproductive Medicine, Reproductive Andrology Group. (2021). Chinese expert consensus on the diagnosis and treatment of oligozoospermia. Chinese Journal of Reproduction and Contraception, 41(7).

Wang, W., Han, L., Liang, Y., et al. (2025). Effects of electroacupuncture at different frequencies on spermatogenic function and oxidative stress in rats with oligoasthenoteratozoospermia. Chinese Acupuncture & Moxibustion, 45(4), 495–504.