New TCM formula fights male immune infertility

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May 17, 2007  
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CM NEWS – A Chinese medicinal formula, Huzhangdanshenyin (?????), derived by researchers in Xiamen, China has been proved more effective than corticosteroids in targetting male immune infertility – but without the side effects of steroids.

What is male immune infertility? Sperm are relatively protected from the immune system by a natural protective mechanism called the blood-testes barrier. Tight connections between the cells lining the male reproductive tract keep immune cells from gaining entry to the sperm within. If an injury breaches this barrier, then the immune system has access to sperm and antibodies are formed.

Antisperm antibodies have been reported in approximately 10% of infertile men, compared to less than 1% of fertile men. The prevalence of antibodies jumps dramatically in men who have had surgery on their reproductive tract: nearly 70% of men who have undergone a vasectomy reversal will have antibodies present on their sperm. Women have a much lower chance for developing antibodies to sperm: less than 5% of infertile women can be shown to have antisperm antibodies, and it is unclear who is at risk for their formation.

Who is at risk for antisperm antibodies?

Anything that disrupts the normal blood-testes barrier can result in the formation of antisperm antibodies. This may include any of the following conditions:

  • Vasectomy reversal
  • Varicocele (dilation of the veins surrounding the spermatic cord)
  • Testicular torsion (twisting of the testicle)
  • Congenital absence of the vas deferens
  • Testicular biopsy
  • Cryptorchidism (failure of testicular descent)
  • Testicular cancer
  • Infection (orchitis, prostatitis)
  • Inguinal hernia repair prior to puberty

The study done at the Department of Andrology, Xiamen TCM Hospital Affiliated to Fujian TCM College selected 90 men with immune infertility and randomly divided them into two groups: 60 in the treatment group, treated by Huzhangdanshenyin, and the other 30 in the control, treated by prednisone, both for 3 months.

What is prednisone? Prednisone is a synthetic corticosteroid drug which is usually taken orally but can be delivered by intramuscular injection and can be used for a large number of different conditions. It has a mainly glucocorticoid effect. Prednisone is a prodrug that is converted by the liver into prednisolone, which is the active drug and also a steroid.

Prednisone is particularly effective as an immunosuppressant and affects virtually all of the immune system. It can therefore be used in autoimmune diseases, inflammatory diseases (such as severe asthma, severe poison ivy dermatitis, ulcerative colitis, Rheumatoid Arthritis and Crohn’s disease), various kidney diseases including nephrotic syndrome, and to prevent and treat rejection in organ transplantation. This medicine may also reduce the sex drive.

Huzhangdanshenyin was derived these researchers. The formula includes:

Hu zhang (??) 15g

Pu gong ying (???; Herba Taraxaci Mongolici cum Radice, dandelion) 15g

Zi cao (??, radix arnebia, stoneweed) 15g

Huang qi (??, Radix astragali) 15g

Dan shen (??, Salvia miltiorrhiza, or Chinese sage) 15g

Chi shao (??, root of common peony) 15g

Dang gui (??, Radix Angelicae sinensis, roots of Chinese angelica) 15g

Hong hua (??, Flos Carthami Tinctorii) 10g

Shou wu (??, Radix Polygoni Multiflori, Chinese knotweed) 15g

Nu zhen zi (???, Fructus Ligustri Lucidi, privet fruit) 15g

Sheng di (??, Rehmannia Radix) 15g

Xian ling pi (???, Herba Epimedii, epimedium) 15g

The researchers then observed the subjects’ improvement of clinical symptoms, immunologic indexes (antisperm antibodies in serum and seminal plasma) and sperm indexes (semen liquefied duration, motility, viability, density and abnormal morphology rate).

How do antisperm antibodies cause infertility?

Antibodies that attach to the sperm may impair motility and make it harder for them to penetrate the cervical mucus and gain entrance to the egg; they may also cause the sperm to clump together, which is occasionally noted on a routine semen analysis. Antibodies may also interfere with the ability of the sperm to fertilize the egg.

What treatments are available for antisperm antibodies?

Suppressing the immune system with corticosteroids may decrease the production of antibodies but can result in serious side effects, including severe damage to the hipbone. Intrauterine insemination, with or without the use of fertility medications, has been used for the treatment of antisperm antibodies. It is believed to work by delivering the sperm directly into the uterus and fallopian tubes, thus bypassing the cervical mucus.

The total antisperm antibody reversing ratio of the treatment group was higher than that of the control (P < 0.01), especially the serum antisperm antibody reversing ratio. There were significant differences in the clinical cure rate and total validity rate between the treatment group and the control (P < 0.01).

After the treatment, the markers of the clinical symptoms were lower (P < 0.01), and the improvement of the clinical symptoms was better in the treatment group than in the control (P < 0.01), especially the symptoms of pain in the back and knees, distending and bearing-down sensation of the perineum and testis, hypersexuality and topoalgia.

Compared with pre-treatment, sperm motility and viability of the treatment group significantly improved (P < 0.01), and so did sperm density (P < 0.05). However, there were no significant differences in sperm density, semen liquefied duration, abnormal morphology rate and pH (P > 0.05) before and after the treatment.

In conclusion, the study says Huzhangdanshenyin works more effectively than prednisone in the treatment of male immune infertility. It could improve the antisperm antibody reversing ratio, clinical symptoms and signs and ameliorate sperm indexes with no obvious advierse effects.

[Zhonghua Nan Ke Xue. 2006 Aug;12(8):750-5; Chinese text here.]