Male infertility is often associated with a low sperm count or weakened sperm motility.  Average normal sperm counts range from 80 million to100 million sperm per ml.  Male infertility is usually quantified at a count of 20 million sperm per ml or less.  Male fertility in certain parts of the world has been falling in recent years at an alarming rate (Comhaire et al., 1999).  Under investigation is the possibility that pesticides and other forms of pollution are responsible, because many chemicals have been shown to impair fertility and/or lead to impaired prenatal and perinatal development in experimental studies (Petrelli et al., 1999).  Such problems require a global improvement in environmental conditions to reverse.  At the local level, your nutritional, vocational and living environment choices can hopefully minimize risk.

There are numerous tonic and aphrodisiac herbs that can affect general sex drive and desire, and improve sperm counts.  Since sex drive is part of one's general health, almost any general tonic herb can offer some help in this area.  It is important to keep in mind that aphrodisiac herbs are usually only one part of a treatment program for infertility, and there are some differences to keep in mind.  Some of these herbs are very warming and stimulating, while others are more nourishing and strengthening.  A qualified herbalist or physician can prescribe from the below lists based upon signs and symptoms. 

• Warming, stimulating, aphrodisiac herbs include epimedium herb, cistanche (rou cong rong or C.  deserticola), deer antler, ginseng root, garlic bulb, morinda root (ba ji tian root or M.  officinalis), and guduchi stem.  These herbs can sometimes be over-stimulating, and should not be used if there are signs of heat or inflammation. Eucommia bark (du zhong / E. ulmoides) is more neutral (tonifies both Yin and Yang) and is a good choice.

• Nourishing aphrodisiac herbs include wild asparagus root, ashwaghanda root, muira puama tincture, saw palmetto berry, shilajatu, dang gui root, milky oat seed tincture, amla fruit, purified gunga seed (Abrus precatorius), cuscuta seed (tu si zi seed or C.  chinensis), and purified cowhage seed (Mucuna prurita).  TCM doctors note that seeds in general tend to nourish hormonal energy, which explains why there are several types of seeds in this group. 

• Lesser-known Ayurvedic herbs for increased semen production include the condensed extract of kadamba bark (Anthocephalus), ikshubalika seed (Hydrophila spinosa), and hastanjali tuber (Orchid incarnata). These are rare and difficult to obtain.

Increased temperature in the genital region can sometimes cause a drop in sperm count.  I saw a particularly interesting case of a diabetic patient who had a low sperm count.  Physical examination revealed a fungal skin infection near the testicles, causing increased temperature.  After we cleared up the infection with teatree oil, genital temperature declined and his sperm count returned to normal. 

In a separate case, this time with low sperm motility, we made a formula using the herbs mentioned above, also adding some astragalus root because the young man showed the signs and symptoms of Qi deficiency.  Within two weeks, a surprisingly short time, his sperm count returned to normal, offering support for earlier published in vitro experiments in which astragalus root increased sperm motility (Hong et al 1992).

Research Highlight

• In one study, 28 men with low sperm counts received 7.5 grams daily of the standard TCM formula rehmannia eight for 2 to 6 months.  According to examinations of semen, subjects experienced, on average, a 78% increase in number, and moderate increases in sperm motility (53%) and sperm volume (56%).  They also showed improvement in blood hormone (estradiol-17 beta) levels (Usuki, 1986).  Three of the ingredients in this rehmannia eight formula are rehmannia root, astragalus root and schisandra berries.