Abnormal semen parameters in the male partner of the couple who are unable to conceive even after 1 year of unprotected intercourse should be called as male infertility (Dohle 2010).

The World Health Organization (W.H.O.) defines male factor infertility as the presence of one or more abnormalities in the semen , or the presence of inadequate sexual or ejaculatory function (Rowe 2004).
In 50% of childless couples, a males are found to be suffering from abnormal semen parameters (Dohle 2010).

Male fertility means :
1.Normal sperm production
2.Normal sperm transport
3.Adequate sexual performance.
These functions require normal levels of testosterone.

Male infertility can be due to a number of factors, including abnormal spermatogenesis; reproductive tract anomalies or obstruction; inadequate sexual and ejaculatory functions; and impaired sperm motility (Patki 2004; Isidori 2005; Dohle 2010).

In 30-40% of men, no cause for infertility is found (Dohle 2010).

However, in such men, semen analysis reveals :
a). A decreased number of spermatozoa (oligozoospermia)
b) Decreased sperm motility (asthenozoospermia)
c) Many abnormal forms of sperm (teratozoospermia) (Dohle 2010).

Factors that alter sperm production include endocrine disturbances such as low testosterone levels, exposure to medicines or environmental toxins, varicocele, increased scrotal heat, systemic diseases, smoking and alcohol, and testicular torsion and trauma (Cherry 2001; Kunzle 2003; Shefi 2006; Arap 2007).

Erectile and ejaculatory dysfunction may be associated with psychological factors, hypogonadism, spinal cord disease, and metabolic and vascular conditions such as diabetes (Dohle 2010).
Sperm motility can be reduced in immotile cilia syndrome or in the presence of antisperm antibodies (Arap 2007).

Treatment for male infertility should be targeted to the cause whenever possible, and includes hormonal treatment, hormonal modulators, corticosteroids, antioxidants, and surgery.
Assisted reproductive techniques ( IUI or IVF) are often the fastest and most effective method to achieve pregnancy regardless of the aetiology (Isidori 2005; Dohle)

How acupuncture can help
Some clinical trials suggest that acupuncture
1.Improves sperm motility (Dieterle 2009)
2.Increases sperm count (Siterman 2009, Siterman 2001)
3.Improves sperm quality (Pei 2005; Gurfinkel 2003)
4.Provides beneficial effect on psychogenic erectile dysfunction (Engelhardt 2003).

Acupuncture may help in the treatment of male infertility (Stener-Victorin 2010), by:

• lowering scrotal temperature (Siterman 2009);
• enhancing local microcirculation, by increasing the diameter and blood flow velocity of peripheral arterioles (Komori 2009);
• reducing inflammation, by promoting release of vascular and immunomodulatory factors  (Zijlstra 2003)
• by improving sperm maturation in the epididymis, increasing testosterone levels, and reducing liquid peroxidation of sperm  (Crimmel 2001)