---
title: "Male infertility"
url: "https://acuiq.com/wiki/evidence/male-infertility"
updated: 2026-10-22
last_verified: 2026-10-22
license: CC-BY-4.0
license_url: "https://creativecommons.org/licenses/by/4.0/"
section: "evidence"
basis: "Modern research"
audience: "Anyone"
published: "2026-10-22"
reading_minutes: 11
sources: 21
---

# Male infertility

_What systematic reviews, umbrella reviews, sham-controlled trials and the European, WHO, American and NICE guidelines report on acupuncture for semen quality and male factor infertility._

A [2021 meta-analysis](https://doi.org/10.1097/MD.0000000000027816) by Jia and colleagues in Wuhan pooled seven randomised trials with 527 men with a low sperm count or poorly moving sperm, and found that acupuncture alone had no clear advantage over placebo acupuncture for sperm motility, sperm concentration or semen volume. Reviews that also count trials against no treatment, or acupuncture added to drugs or herbs, report better semen results, and most of their authors rate the trials as small and at high risk of bias. Cochrane has not reviewed acupuncture for male subfertility. The European urology guidelines and the World Health Organization’s 2025 infertility guideline make no recommendation on it. This page reports what each source found and what it compared acupuncture with; [IVF](/wiki/evidence/ivf) covers acupuncture given to women during assisted reproduction.

## What the trials measure

A semen analysis counts sperm per millilitre (concentration), the share that swim and how well (motility, graded in older manuals as rapid progressive, slow progressive and non-progressive), and the share with a normal shape (morphology). Oligozoospermia is a low concentration, asthenozoospermia low motility and teratozoospermia few normal forms; trials often enrol men with two or all three. Most trials below report semen parameters within weeks of the last session, and few report pregnancy.

## Systematic reviews

| Review | Trials and comparison | Finding | Authors’ caution |
| --- | --- | --- | --- |
| [Jerng and colleagues 2014](https://doi.org/10.4103/1008-682X.129130) | 4 trials, 500 men: one against a non-penetrating placebo needle, three adding acupuncture to an herbal mixture against the mixture alone | More rapidly progressive sperm (mean difference 6.35 percentage points, 95% CI 4.38 to 8.32) and higher concentration; no difference in pregnancy (odds ratio 1.60, 95% CI 0.70 to 3.69) | Heterogeneity of I² 72% and 58%, high risk of bias, poor reporting; evidence insufficient |
| [You and colleagues 2020](https://doi.org/10.1111/and.13415) | 12 trials, 1,088 men with oligoasthenozoospermia, acupuncture alone or with another treatment | No meta-analysis, because the trials differed too much; the trials reported better semen quality | Low methodological quality; inadequate to draw a solid conclusion |
| [Jia and colleagues 2021](https://doi.org/10.1097/MD.0000000000027816) | 7 trials, 527 men: three against placebo acupuncture, four against drugs such as clomiphene, tamoxifen, vitamins or L-carnitine | No clear difference from placebo (motility, standardised mean difference 1.13, 95% CI −0.64 to 2.89) or from drugs; acupuncture added to drugs improved motility and concentration | Heterogeneity too high for robust conclusions; the authors did not recommend acupuncture for these conditions |
| [Gong and colleagues 2021](https://pubmed.ncbi.nlm.nih.gov/34914271/) | 4 trials, 321 men with idiopathic oligoasthenozoospermia, transcutaneous electrical acupoint stimulation (TEAS) at 2 Hz or 100 Hz | No effect on concentration at either frequency; more grade a (rapidly progressive) sperm with 100 Hz | No trial reported live birth and one reported pregnancy; effect on pregnancy unclear |
| [Wang and colleagues 2023](https://doi.org/10.1186/s40001-022-00968-6) | Network meta-analysis of 38 trials, 3,080 men with oligoasthenozoospermia, eight non-drug therapies against sham, no treatment and each other | Warming acupuncture ranked first for concentration and electroacupuncture first for motility | Limited quality of the included trials; findings need validation |
| [Chen and colleagues 2023](https://doi.org/10.18632/aging.204727) | Network meta-analysis of non-drug interventions for sperm quality, among them supplements, exercise and acupuncture | Against placebo, higher total motility (mean difference 17.81, 95% CI 10.32 to 25.29) and concentration (5.40, 95% CI 2.32 to 8.49) | The abstract states no limitation |

A standardised mean difference expresses a result in standard deviations so that trials using different scales can be pooled; a confidence interval that crosses zero means no clear difference. Heterogeneity, measured as I², is the share of the variation between trial results that chance does not explain. A network meta-analysis ranks treatments partly from indirect comparisons, through trials that share a comparator, so a ranking is not a head-to-head result.

Two umbrella reviews, which appraise the reviews themselves, were published in 2024. [Fasanghari and colleagues](https://doi.org/10.1002/hsr2.2118) in Iran assessed 11 systematic reviews of complementary and alternative medicine for male infertility and rated every one low or critically low in methodological quality on AMSTAR 2, a standard checklist for reviews, mainly for not examining publication bias or discussing the trials’ risk of bias. [Ye and colleagues](https://doi.org/10.4103/aja202428) at Sichuan University took 18 meta-analyses covering 28 treatments for male infertility. For acupuncture they used two of the placebo-controlled trials in the Jia review, with 134 men, and found no clear effect on concentration (summary effect 0.09, 95% CI −0.08 to 0.26) or motility (0.11, 95% CI −0.06 to 0.28), rating that evidence moderate in certainty on GRADE, the standard scale of how far evidence can be trusted. Varicocele repair and several drugs and supplements did improve semen parameters in the same review.

## Sham-controlled trials

A [2009 trial in Fertility and Sterility](https://doi.org/10.1016/j.fertnstert.2009.02.041) by Dieterle and colleagues in Dortmund, Germany, randomised 57 infertile men with severe oligoasthenozoospermia to acupuncture following traditional Chinese medicine (28 men) or placebo acupuncture (29), with patients and assessors blinded. The Jia review lists its points as [`ST36`](/points/st36) (Zusanli), [`SP06`](/points/sp06) (Sanyinjiao), [`KD03`](/points/kd03) (Taixi), [`LV03`](/points/lv03) (Taichong), [`BL23`](/points/bl23) (Shenshu), [`BL32`](/points/bl32) (Ciliao), [`ST29`](/points/st29) (Guilai), [`SP10`](/points/sp10) (Xuehai), [`CV04`](/points/cv04) (Guanyuan) and [`GV20`](/points/gv20) (Baihui). After acupuncture a higher share of sperm were motile than after placebo, with no effect on concentration. The Jerng review rated it the only one of its four trials with adequate randomisation and allocation concealment.

A [2003 trial](https://pubmed.ncbi.nlm.nih.gov/14695986/) by Gurfinkel and colleagues at the Federal University of São Paulo randomised 19 men with unexplained semen abnormalities to ten weeks of acupuncture and moxibustion at treatment points or at what the authors called indifferent points. The treated group had a higher percentage of normally shaped sperm afterwards.

A [2019 trial in Acupuncture in Medicine](https://doi.org/10.1136/acupmed-2017-011365) by Yu and colleagues in Jinan, China, used TEAS, electrical stimulation through pads on the skin over the points, rather than needles. It randomised 121 men with oligozoospermia, asthenozoospermia or both to two months of stimulation at 2 Hz (31 men), at 100 Hz (31), mock stimulation (29) or lifestyle advice only (30), at `BL23`, `ST36`, [`CV01`](/points/cv01) (Huiyin) and `CV04`. Total sperm count and motility rose more with 2 Hz than with mock stimulation or advice; the abstract reports these differences for 2 Hz only.

A [2021 Iranian trial](https://doi.org/10.34172/jlms.2021.84) by Allameh and colleagues at Shahid Beheshti University gave 35 men with oligospermia laser acupuncture twice a week for five weeks and a control group sham laser, double-blind. Concentration and motility differed significantly between the groups; volume and morphology did not. One man in the laser group reported dizziness and three in the sham group mild weakness or itching.

## Trials against other treatments

A [2016 trial in Andrologia](https://doi.org/10.1111/and.12541) by Küçük and colleagues in Istanbul randomised 30 men with a varicocele, a swelling of the veins draining the testis, and abnormal semen to microsurgical varicocelectomy or to acupuncture twice a week for two months. Concentration and motility improved in both groups at six months, concentration more after acupuncture, and the pregnancy rate over an average 42 months of follow-up was 33% in each.

A [2024 Indonesian trial](https://doi.org/10.1177/22799036241272394) by Budihastuti and colleagues randomised 30 men to coenzyme Q10 with or without electroacupuncture; motility and total motile sperm count rose in the combined group and fell in the coenzyme Q10 group.

Two earlier studies compared acupuncture with no treatment. A [2005 study](https://doi.org/10.1016/j.fertnstert.2004.12.056) by Pei and colleagues compared 28 men given acupuncture twice a week for five weeks with 12 untreated men, and found by electron microscopy more sperm without structural defects after treatment. A [2000 pilot study](https://pubmed.ncbi.nlm.nih.gov/10702864/) by Siterman and colleagues in Tel Aviv reported sperm in the ejaculate after acupuncture in 10 of 15 men with a history of azoospermia, no sperm at all, against no change in 20 untreated men; it was a pilot study.

## What guidelines say

The European Association of Urology’s [guidelines on sexual and reproductive health](https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Sexual-and-Reproductive-Health-2026.pdf), in a limited update of March 2026, cover lifestyle change, antioxidants, probiotics, selective oestrogen receptor modulators and aromatase inhibitors as empirical treatments for male infertility. They advise men to improve their lifestyle (a strong recommendation) and not to be treated routinely with the other four for idiopathic infertility (weak). The male infertility chapter does not mention acupuncture; the guidelines name it only among treatments for premature ejaculation that need more evidence, which [Premature ejaculation](/wiki/evidence/premature-ejaculation) covers. A [summary of the 2025 male infertility chapter](https://doi.org/10.1016/j.eururo.2025.02.026) in European Urology lists probiotics and exome sequencing as its new sections.

The World Health Organization’s [Guideline for the prevention, diagnosis and treatment of infertility](https://iris.who.int/handle/10665/383755), published in November 2025, covers two male-factor treatments: it made no recommendation for or against antioxidant supplements, and suggests surgical or radiological treatment of a clinical varicocele over waiting (conditional, low certainty). It makes none on acupuncture, whose name appears only in the title of one trial in its reference list. The American Urological Association and the American Society for Reproductive Medicine published a joint guideline on infertility in men in 2020 and [amended it in 2024](https://doi.org/10.1097/JU.0000000000004180); the amendment’s abstract covers genetic testing, pelvic MRI and the use of testicular sperm, and does not mention acupuncture. The full guideline is open only to registered readers, and this page has not checked it. In England, NICE’s [fertility guideline (NG257)](https://www.nice.org.uk/guidance/ng257/chapter/Advice-about-factors-that-can-affect-fertility) of March 2026 keeps a 2004 recommendation to tell anyone concerned about their fertility that complementary therapies have not been properly evaluated. [Clinical guidelines](/wiki/evidence/clinical-guidelines) sets these positions beside other bodies’ positions on acupuncture.

## What the reviews could not settle

The placebo comparison rests on a few small trials: the Dieterle and Gurfinkel trials together enrolled 76 men, and the acupuncture estimate in the umbrella review by Ye and colleagues rests on 134. Against no treatment, or added to herbs or drugs, the reviews report better semen results for acupuncture, and as in [IVF](/wiki/evidence/ivf) the reviews cannot say how much of that the comparison explains. [Sham acupuncture](/wiki/research/sham-acupuncture) sets out why no sham is inert. The trials used different points, numbers of sessions and forms of stimulation, from manual needling to warming needles, electroacupuncture, skin electrodes and laser, and measured motility on different grades. Most measured semen within weeks of the last session, so whether a change in semen parameters leads to more pregnancies is untested: the Jerng review found no difference in pregnancy, from small numbers, and Gong and colleagues found no trial that reported live birth.

AcuiQ’s [infertility](/symptoms/infertility) and [oligospermia](/symptoms/oligospermia) pages list the protocols individual studies prescribed, each with its citation. [Erectile dysfunction](/wiki/evidence/erectile-dysfunction) and [Chronic prostatitis and chronic pelvic pain syndrome](/wiki/evidence/chronic-prostatitis) cover other conditions in men.

### Sources

1. Jia W, Wang C, Yin Y, Acupuncture for oligospermia and asthenozoospermia: a systematic review and meta-analysis, Medicine 2021 — https://doi.org/10.1097/MD.0000000000027816
2. Jerng UM, Jo JY, Lee S, Lee JM, Kwon O, The effectiveness and safety of acupuncture for poor semen quality in infertile males: a systematic review and meta-analysis, Asian Journal of Andrology 2014 — https://doi.org/10.4103/1008-682X.129130
3. You F, Ruan L, Zeng L, Zhang Y, Efficacy and safety of acupuncture for the treatment of oligoasthenozoospermia: a systematic review, Andrologia 2020 — https://doi.org/10.1111/and.13415
4. Gong Y, Li J, Wu XK, Transcutaneous electrical acupoint stimulation for the treatment of idiopathic oligoasthenospermia: a meta-analysis, Zhonghua Nan Ke Xue 2021 — https://pubmed.ncbi.nlm.nih.gov/34914271/
5. Wang Z, Zhou Z, Zhang L, et al., Efficacy and safety of nonpharmacological strategies for the treatment of oligoasthenospermia: a systematic review and Bayesian network meta-analysis, European Journal of Medical Research 2023 — https://doi.org/10.1186/s40001-022-00968-6
6. Chen Z, Hong Z, Wang S, et al., Effectiveness of non-pharmaceutical intervention on sperm quality: a systematic review and network meta-analysis, Aging 2023 — https://doi.org/10.18632/aging.204727
7. Fasanghari M, Keramat A, Tansaz M, Moini A, Chaman R, Effect of alternative and complementary medicine on male infertility: an umbrella review, Health Science Reports 2024 — https://doi.org/10.1002/hsr2.2118
8. Ye JJ, Chen ZY, Wang QH, et al., Current treatment for male infertility: an umbrella review of systematic reviews and meta-analyses, Asian Journal of Andrology 2024 — https://doi.org/10.4103/aja202428
9. Dieterle S, Li C, Greb R, Bartzsch F, Hatzmann W, Huang D, A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia, Fertility and Sterility 2009 — https://doi.org/10.1016/j.fertnstert.2009.02.041
10. Gurfinkel E, Cedenho AP, Yamamura Y, Srougi M, Effects of acupuncture and moxa treatment in patients with semen abnormalities, Asian Journal of Andrology 2003 — https://pubmed.ncbi.nlm.nih.gov/14695986/
11. Yu Y, Sha SB, Zhang B, et al., Effects and mechanism of action of transcutaneous electrical acupuncture point stimulation in patients with abnormal semen parameters, Acupuncture in Medicine 2019 — https://doi.org/10.1136/acupmed-2017-011365
12. Allameh F, Razzaghi M, Hosseini S, et al., The effect of laser acupuncture on semen parameters in infertile men with oligospermia: a randomized clinical trial, Journal of Lasers in Medical Sciences 2021 — https://doi.org/10.34172/jlms.2021.84
13. Küçük EV, Bindayi A, Boylu U, Onol FF, Gumus E, Randomised clinical trial of comparing effects of acupuncture and varicocelectomy on sperm parameters in infertile varicocele patients, Andrologia 2016 — https://doi.org/10.1111/and.12541
14. Budihastuti UR, Murti B, Prakosa T, et al., Effect of electroacupuncture on total motile sperm count and sperm motility, Journal of Public Health Research 2024 — https://doi.org/10.1177/22799036241272394
15. Pei J, Strehler E, Noss U, et al., Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility, Fertility and Sterility 2005 — https://doi.org/10.1016/j.fertnstert.2004.12.056
16. Siterman S, Eltes F, Wolfson V, Lederman H, Bartoov B, Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study, Andrologia 2000 — https://pubmed.ncbi.nlm.nih.gov/10702864/
17. Salonia A, Minhas S, et al., EAU Guidelines on Sexual and Reproductive Health, European Association of Urology, limited update March 2026 — https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Sexual-and-Reproductive-Health-2026.pdf
18. Minhas S, Boeri L, Capogrosso P, et al., European Association of Urology guidelines on male sexual and reproductive health: 2025 update on male infertility, European Urology 2025 — https://doi.org/10.1016/j.eururo.2025.02.026
19. World Health Organization, Guideline for the prevention, diagnosis and treatment of infertility, November 2025 — https://iris.who.int/handle/10665/383755
20. Brannigan RE, Hermanson L, Kaczmarek J, Kim SK, Kirkby E, Tanrikut C, Updates to male infertility: AUA/ASRM guideline (2024), Journal of Urology 2024 — https://doi.org/10.1097/JU.0000000000004180
21. National Institute for Health and Care Excellence, Fertility problems: assessment and treatment (NG257), advice about factors that can affect fertility, March 2026 — https://www.nice.org.uk/guidance/ng257/chapter/Advice-about-factors-that-can-affect-fertility