The Integrated Approach

Science and Male Factor Infertility

The beauty of science is that there is always another step to take in moving toward a better way to deal with medical issues. It holds true in all avenues of medicine, including male infertility. A rather touchy subject at best, male infertility accounts for nearly half of the infertility issues facing couples who want to conceive. Methodologies range from surgical interventions to drug enhancements, IVF, ICSI, and other protocols.

Idiopathic oligoasthenozoospermia is a form of male factor infertility in which the man has a low sperm count and poor sperm motility (movement), but the cause for the disorder is unknown. Unexplained infertility is quite common and although sometimes the causes are discovered, often they aren't. Drug treatments for unexplained male infertility are not favored by many doctors, so the alternative is often ICSI.

A New Therapy That Works

In order to address this situation, a research team at the Cairo University Hospital in Egypt has created an integrated treatment that blends conventional medicine with alternative therapy. Specifically, the treatment combines clomiphene citrate (Clomid) and vitamin E. Sixty infertile men were involved in the study which saw them divided randomly into two groups, one receiving the integrated drug-vitamin treatment and the other group receiving a placebo. The time period of the treatment was six months.

At the end of the study the outcome was measured by pregnancy outcomes and changes observed in semen parameters. The men in the treatment group had greater increase in sperm concentration and sperm progression which seems to have lead to the increased pregnancy rate of the partner's at 37% in the therapy group as compared to 13% in the placebo group. Details of this study were published in the Fertility and Sterility journal.

A Little Bit About Clomid

Clomiphene citrate is the generic name for the prescription drug Clomid. Clomid is generally prescribed to women with fertility problems who are trying to conceive, usually prescribed after several months of unsuccessful attempts at conception. This drug has been very effective in situations where ovulation is irregular or problematic. It works by adjusting the amount of female hormones to create an environment conducive to conception. Clomid can also cause ovulation of more than one egg increasing the odds of at least one egg becoming fertilized - and the occasion of a multiples pregnancy.

Interestingly enough, Clomid is also used by bodybuilders to inhibit the flow of the hormone estrogen in their bodies. It also increases the amount of seminal fluid that is produced on ejaculation. Clomid increases the effect of the pituitary gland on male hormones and stimulates increased production of good sperm. A study by the World Health Organization (WHO) in the 1990s showed that there was an increase in sperm production of men taking Clomid, however, the study did not progress beyond that point. More research into how Clomid affects male fertility needs to be done. The current study in Cairo takes the Clomid connection into consideration and can be a move in that direction.

The Great Anti-Oxidant, Vitamin E

Vitamin E is a very well-known and very powerful antioxidant. Research has supported the fact that it plays a key role in inhibiting free radical damage to the unsaturated fatty acids of the sperm membrane. Low levels of vitamin E have been linked to male infertility. Conversely, adequate vitamin E has been shown to increase the ability of sperm to fertilize and egg (in test tubes). Vitamin E also helps to prevent the destruction of vitamin C, an important component for a healthy immune system. Additionally, vitamin E helps to keep the heart healthy and promotes healthy function of the sexual organs. If there is a lack of vitamin E, it is likely there could also be fertility issues.

"The results of this study will be encouraging to male factor patients and their doctors," Dr. R. Dale McClure, president of the American Society for Reproductive Medicine, commented in a news release. "However, more research is needed to determine how the components of the combination therapy affect the different semen parameters observed and the advantages of using these drugs singly or in combination with other drugs not used in this study."