Male fertility is half of the equation — but it often gets half the attention.
When a couple is struggling to conceive, the focus frequently lands on the woman: her cycle, her hormones, her appointments.
The man goes for a semen analysis, gets a number, and often isn’t sure what to do with it. If results come back flagged, the path forward can feel unclear. If results come back normal, the conversation sometimes stops there — even when things could still be improved on the male’s end.
Barely being above what is normal is not optimal!
This article is for the men in the room. It covers what a semen analysis actually measures, how Traditional Chinese Medicine understands and treats male fertility concerns, what the research shows about acupuncture for sperm quality, and what you can do right now to give your fertility the best possible foundation.
You don’t have to navigate this alone — and you don’t have to wait for a diagnosis to start making a difference.
Male Factor — More Common Than You Think
Male factor infertility contributes to approximately 40% of all cases where a couple has difficulty conceiving. In roughly 30% of cases, male factor is the sole cause. Despite these numbers, men are often the last to be investigated and the least likely to seek support.
A basic semen analysis is one of the most informative and least invasive tests available in fertility medicine. If you haven’t had one, it’s worth discussing with your doctor — regardless of whether results are expected to be normal. Even if you have had a child in the past, getting a recent analysis done can save a lot of time and frustration.
Understanding Your Semen Analysis
A semen analysis measures several parameters that together paint a picture of your fertility potential. Here’s what each one means in plain language.
Volume The total amount of fluid in the ejaculate. The WHO 2021 reference value is ≥1.4 mL. Very low volume can indicate issues with the seminal vesicles or prostate.
Sperm Concentration The number of sperm per millilitre of semen. The WHO 2021 guidelines reference value is ≥16 million sperm per mL. Low concentration is called oligozoospermia.
Total Motility The percentage of sperm that are moving. According to WHO 2021 guidelines, ≥42% of sperm should be motile. Poor motility is called asthenozoospermia.
Progressive Motility The percentage of sperm moving forward purposefully in a straight line or large circles. WHO 2021 guidelines indicate that ≥30% of sperm should show progressive motility.
Morphology The shape and structure of the sperm — head, midpiece and tail. The WHO 2021 criteria state that a sample is considered normal if 4% or more of observed sperm have normal morphology. Abnormal morphology is called teratozoospermia. nih
An Important Note on Reference Values What is considered “normal” varies somewhat depending on where you are in the world and which edition of the WHO guidelines your clinic is using. The WHO has updated its reference criteria multiple times — in 1999, 2010, and most recently 2021 — and these updates have meaningfully changed how semen parameters are categorized. If your results are borderline, it’s worth understanding which reference values your clinic is applying. PubMed
A single semen analysis is also not the whole story. Sperm parameters can fluctuate based on recent illness, stress, heat exposure, and lifestyle factors. A second analysis is often recommended before drawing firm conclusions.
How Does TCM Understand Male Fertility?
Traditional Chinese Medicine views male fertility through the lens of the Kidney system — the root of reproductive energy in TCM — as well as the health of Blood and the free flow of Qi throughout the body. When these are functioning well, sperm production, quality and motility tend to be strong. When they are disrupted, sperm parameters often reflect that imbalance.
The three most commonly seen TCM patterns in male fertility concerns are:
Kidney Yang Deficiency The warming, activating energy of the Kidney is depleted. Common signs include low libido, fatigue, cold extremities, lower back weakness, frequent urination and a general sense of low vitality. Sperm motility is often the parameter most affected in this pattern.
Kidney Yin Deficiency The cooling, nourishing aspect of the Kidney is insufficient, often leading to signs of heat. Common symptoms include night sweats, a sensation of heat in the palms and soles, restless sleep, and a dry mouth. Sperm concentration and morphology may be more affected in this pattern.
Damp Heat An accumulation of heat and dampness in the lower body — often associated with lifestyle factors, diet, or a history of infection. May present as heaviness, discomfort in the groin or testes, strong-smelling urine, or a history of reproductive tract infections. This pattern can affect multiple sperm parameters simultaneously.
It is worth noting that many men present with combinations of patterns — and that the TCM diagnosis guides treatment selection rather than the semen analysis result alone. Two men with identical semen analyses may receive quite different treatment based on their overall TCM picture.
Treatment Options
Acupuncture Acupuncture for male fertility focuses on supporting Kidney function, improving circulation to the reproductive organs, reducing scrotal temperature, and regulating the hormonal pathways involved in sperm production. Not every man with a fertility concern needs acupuncture — but for those with a identified issue, research suggests it can make a meaningful difference to sperm parameters.
A meta-analysis of seven randomized clinical trials found that acupuncture as an adjuvant therapy improved sperm motility and sperm concentration in infertile men. A 2023 network meta-analysis found that acupuncture showed significant advantages in improving sperm forward motility, alongside other non-pharmaceutical interventions including CoQ10, omega-3 fatty acids, lycopene, zinc, selenium and carnitine. nih
Chinese Herbal Medicine Herbal medicine is a well-established component of TCM treatment for male infertility and is often used alongside acupuncture for greater effect. Formulas are selected based on your individual TCM pattern — not a generic male fertility protocol. Research on specific herbal formulas for male factor infertility has shown promising results, particularly for sperm motility and concentration. Drew will recommend herbs when he believes they are indicated for your situation.
Supplements The supplement research for male fertility is extensive and genuinely encouraging. A strong evidence base exists for several key nutrients that support sperm production and quality. As a starting foundation, the supplements most consistently supported by research for male fertility include:
- Coenzyme Q10 (CoQ10) — supports mitochondrial energy in sperm cells, particularly relevant for motility
- Zinc — essential for sperm production and testosterone metabolism
- Selenium — supports sperm morphology and motility
- Vitamin D — increasingly linked to sperm quality and testosterone levels
- Omega-3 fatty acids — support sperm membrane integrity and motility
- L-Carnitine — supports sperm energy metabolism and motility
These represent a reasonable starting point — but the right supplement stack for your specific situation depends on your individual diagnosis, your semen analysis results, and your overall health picture. Generic supplementation without guidance often misses the mark. Drew has completed extensive additional training in evidence-based supplementation for fertility and can provide specific product and dosage recommendations tailored to your situation.
Lifestyle Lifestyle factors have a profound and often underestimated impact on sperm quality. The most evidence-supported lifestyle considerations for male fertility include:
- Heat avoidance — scrotal temperature directly affects sperm production. Hot tubs, saunas, heated car seats and laptops on laps are all worth reconsidering
- Exercise — moderate regular exercise supports healthy testosterone levels and sperm parameters. Avoid extreme endurance training which can have the opposite effect
- Diet — an anti-inflammatory, nutrient-dense diet supports sperm production. Processed foods, excessive alcohol and high sugar intake are consistently associated with poorer sperm parameters
- Sleep — testosterone production is largely nocturnal. Chronic poor sleep measurably affects male hormone levels
- Stress — elevated cortisol suppresses testosterone and affects sperm quality. This is not a minor consideration — stress management is a legitimate fertility intervention
The 90-Day Window — Why Starting Now Matters
Sperm take approximately 90 days to mature from production to ejaculation. This means that what you do today — acupuncture, supplements, dietary changes, lifestyle adjustments — is influencing the sperm that will be relevant three months from now.
This is both a challenge and an opportunity. It means results from any intervention take time to appear. But it also means that a committed 90-day protocol of acupuncture, targeted supplementation and lifestyle optimization can produce measurably different sperm parameters by the time of a retrieval or timed cycle.
If you are currently waiting for a fertility clinic appointment or planning a retrieval in the next few months, the window before that appointment is genuinely valuable time. Don’t wait.
Working With Drew
Drew has worked with male fertility patients throughout his 25-year clinical career — both as primary patients and as the partners of fertility patients already under his care. He understands that the fertility process can feel isolating for men, and that the clinical environment doesn’t always make space for the male experience of this journey.
His approach to male fertility involves:
- Reviewing your semen analysis results to understand your specific picture — while leaving diagnosis and medical interpretation to your fertility specialist
- Building a TCM diagnosis based on your symptoms, pulse and tongue to guide treatment selection
- Providing targeted supplement recommendations with specific products and dosages based on your individual situation
- Developing a realistic 90-day treatment plan that works alongside whatever your medical team is doing
If your partner is also a patient of Drew’s, coordinating both treatment plans is a natural part of the process.
To book a male fertility consultation: 📧 Email Drew: drew@drewnesbitt.ca 🌐 Or click the Book With Drew button below.
Key Research References
- Network meta-analysis of non-pharmaceutical interventions for sperm quality, PubMed 2023: Read here
- Systematic review and meta-analysis, acupuncture for male infertility, 2024: Read here
- Electroacupuncture and sperm motility, SAGE Journals 2024: Read here
- WHO 6th Edition semen analysis manual updates, PMC 2024: Read here