Acupuncture and Male Factor Infertility: 4 Lifestyle Habits to Dramatically Improve Your Sperm Quality

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This article is chock-full of research-supported tips and tricks that will help you make quality, healthy sperm AKA World Champion Sperm! 

You have a lot more control over your fertility than you think, and I’m going to lay out some basic concepts that you can use to your advantage, whether your goal is simply to boost your sperm count or to take your sperm to the next level, from being merely acceptable to being totally awesome. Along the way, watch out for an Oopma-Loompa, the coolest thing to wear in your boxers, and my favorite high that doesn’t involve drugs.

You may have already heard of some of the great sperm killers, like hot tubs and long bicycle rides, but if you’re under the impression that you can avoid those few things and call it good, you’ll want to keep reading. There are SO many lifestyle tweaks that you can make that will have an immense impact on the quality of your swimmers, so if you are determined to improve your fertility, this article is for you.

This article is also for you even if:

  1. You already know you have awesome sperm counts, morphology, and motility based on a recent semen analysis.  In fact, semen analysis doesn’t tell the whole story, as I will explain in a bit.
  2. You believe that you are unlikely to have fertility issues because male infertility is much less common than female infertility. Don’t be fooled by this common misconception.  In fact, the male factor matches the female factor as a cause for infertility. Each accounts for a little over 30% of cases, while the remaining 30% of cases are attributed to either a mix of male and female factors or simply chalked up to “unexplained infertility.”

Before we get to the good stuff, here’s a quick overview of some basic sperm-related terminology you’ll need to be familiar with as you read: (You can jump over this box if you’re already a semen analysis pro!)

    • Semen Volume: The volume of liquid present in one ejaculation. (Normal: 1.5 to 5 milliliters (mL) of semen)
    • Sperm Count/Concentration: The number of sperm in millions per milliliter (M/mL) of semen. (Optimal: 55 to 300 M/mL, Moderate: 15 and 55 M/mL, Poor: below 15 M/mL)
    • Total Count: The total number of sperm present in one ejaculation.
    • Sperm Motility: The ability of sperm to swim forward, rated on a scale of 0-4. (Optimal: 3-4, Moderate: 1-2, No movement: 0)
    • Sperm Morphology: The percentage of sperm with normal shape, size, and appearance.  Sperm with abnormal morphology may be immature or have defective heads or tails. (Optimal: more than 14%, Moderate: 4%-14%, Poor: less than 4%, according to the Kruger (strict) guidelines)

Do Those Semen Analysis Numbers Tell the Whole Story?

While most male fertility research sticks to monitoring changes in sperm parameters to evaluate fertile potential, modern epigenetic research reveals that a deeper layer of sperm quality can be assessed at the level of DNA. As one male fertility expert puts it, “The idea that fertility can be defined by threshold values of semen parameters is a concept that is fundamentally flawed.” [1]

Epigenetic evaluations of sperm cell DNA methylation—involving compounds that attach to DNA strands and dictate which genes are turned “on” or “off” in terms of gene expression—indicates that even healthy-looking sperm may not be carrying the best genetic package inside.

Age and poor lifestyle habits cause significant aberrations in those methylation patterns, which is problematic because the methylation patterns (and, therefore, changes in gene expression) are inheritable across cell divisions and generations. This means that having large numbers of normal looking sperm is more of a basic requirement than a gold standard for measuring rockstar sperm.

The good news is that researchers have also found that positive changes in lifestyle habits can positively impact sperm DNA methylation very quickly, with large changes apparent in as little as one week after a lifestyle change. [2] Given that spermatogenesis takes anywhere from 60-75 days, the fact that lifestyle changes can affect sperm cell DNA so late in the maturation process is both rather surprising and great news!

So what do I need to do to make healthy, quality sperm?

1) Eat 8 Servings of Vegetables Per Day (DON’T SKIP!)

I am so not kidding about this one, gentlemen! And, no, the number 8 was not a typo. If you are the type of person who thinks that adding a salad and a baked potato to your dinner every night counts as “eating your vegetables,” this one’s for you.

The thing about vegetables is that they are packed with a jaw-dropping array of health-promoting vitamins, minerals, antioxidants, phytochemical, and bioactive compounds that our bodies need to carry out all of the intricate physiological processes of the human body—including the production of sperm. One meta-analysis concluded that antioxidant supplementation, for example, improved the number, motility, morphology, and DNA integrity of sperm. [3]

Here is a short list of some of the known requirements for building rockstar sperm: selenium, zinc, L-carnitine, CoQ10, omega-3 fatty acids, lycopene, and Vitamins A, B, C, and E.  

While a few of those (selenium, zinc, and omega-3s) are more concentrated in beans, nuts, and meats, you’re going to need to veggies for the rest, and variety is key. In other words, you can’t just eat 8 carrots a day and call it good. (Plus, you might actually turn orange and the Oompa Loompa look isn’t really in style these days.)

So: how on earth are you going to get in 8 servings a day? I’ll give you a hint: it will be a lot easier if you sneak some into your breakfast. How about something like this: 2 veggies with breakfast (example: scrambled eggs with grated zucchini and a big handful of spinach), 3 with lunch (soup with a side of sautéed green beans and a kale salad with cherry tomatoes) and 3 with dinner (entrée with sides of steamed chard and roasted beets and carrots).

If you’re not a vegetable person, the key for you will be to dress them up with delicious flavors. Try a garlic-ginger-tamari sauce on your green beans or sprinkle ground coriander, lemon juice, and a pinch of salt on your beets (so delicious). And if you’re new to this kind of thing, I advise against over-cooking: there’s nothing less appetizing than a bowl of broccoli that’s had all the life steamed right out of it.

Next up:

2) Chill Out (Your Scrotum)

We all know that scrotal temperature should be a few degrees under body temperature, but just how important is the correct temperature in maintaining great quality sperm?

Very important.

Genital heat stress is a sperm obliterator. One study demonstrated a mean rise of 491% in participants’ motile sperm count after cessation of heat exposure in the form of hot tubs and hot baths. [4] Another study demonstrated that sperm count nearly tripled in men diagnosed with oligoasthenoteratozoospermia (translation: low sperm count, motility, & morphology) after 12 weeks of testicular cooling via cool airflow during sleep. [5]

What are some examples of activities that heat up your scrotum? Hanging out in hot water (hot springs, hot tubs, saunas, hot showers), sitting for extended periods of time (at work, watching TV, surfing the web on your phone), cycling, typing with a laptop on your lap, and wearing tight-fitting clothing.  If any of these describe your daily habits, it’s time to turn the tables and make some habits that won’t heat you up. Switch to cold showers, use a standing desk, trade in your daily 50-mile ride for a 10-mile run, and trade in your skinny jeans for something a little looser like slacks. Or a kilt. (Those Scottish men knew what they were doing!)

For some men, the cause of genital heat stress is structural. One common culprit is a varicocele. Varicoceles are enlarged, twisted veins in the scrotum that raise the temperature of the tissue because of the increased blood flow they allow.  You’ll want to get checked for possible varicoceles if you have a dull, heavy sensation in your scrotum, a testicular lump, or your tissue resembles a “bag of worms.” The corrective surgery for varicoceles is simple, and that may be all it takes for you to correct your thermal imbalance.

Some men go so far as to make a habit of testicular cooling, which means reducing the testicular temperature by at least 5 degrees Fahrenheit for an extended period of time.  This tactic may sound odd, but it’s effective. How is this done? There’s always the ol’ bag-of-frozen-peas-down-the-pants method for do-it-yourselfers, or you can get a little fancier and order yourself a pair of Snowballs to drop into your drawers.

Once you’ve got that piece sorted out, you can move on to the next step:

3) Chill Out (Your Mind)

Stress doesn’t just ruin your mood; it ruins your sperm production.

Evidence suggests that high levels of cortisol, the “stress hormone,” negatively impact testosterone levels, which in turn decreases sperm production. A study on the semen parameters of medical students demonstrated a drop in mean sperm concentration from 55 million/mL at the start of the semester to 39 million/mL during a stressful period of exams. [6] Evolutionarily speaking, it makes sense: a time of high stress is not the optimal time to make a baby, and the female reproductive tract isn’t immune to stress either: periods of high stress can disrupt female hormones leading to delayed ovulation.

If you are chronically stressed out, over-worked, and under-slept, it is essential that you rein it in.  When you are operating on overdrive you may feel like you are conquering the world, but the strain will inevitably catch up with you, taking a toll on your health as well as your reproductive system.

Here are a few action items to get you on the right track to wrangling your stress levels into submission:

Set a Bedtime Alarm

Drop the attitude of “I’ll sleep when I’m dead.” Sleep hygiene is all the rage right now because consistent deep and restful sleep has the power to drastically improve quality of life. It will make you more productive at work, more calm in the face of adversity, and, most importantly, it will help ensure that your sperm will look and swim like champs.

Researchers in Denmark demonstrated that lack of sleep has a deleterious effect on numbers semen parameters, including sperm concentration, total sperm count, motility, and morphology. For example, sperm concentration in men with a high level of sleep disturbance was 29% lower than men with better sleep. [7]

Not only that, but their testes size was reduced!

One reason for this phenomenon is that hormone production is tied into your circadian rhythms and sleep patterns. To optimize your biological hormone clock, make sure you are asleep by 10:30pm. If you’re the type who forgets to go to bed because you’re a workaholic or because you get swallowed up the delightful internet fairyland of Facebook or fail videos or Netflix, you’ll want to set a bedtime alarm on your phone.

And because blue light from screens scrambles your circadian rhythms, I suggest setting your bedtime alarm an hour in advance at 9:30pm and committing to turning off all screens at that time. (If possible, shutting down screens 2 or 3 hours in advance is even better.) If you absolutely MUST look at a screen in the hour leading up to your bedtime, you’ll want to snag a pair of blue light blocking glasses.

Set Out Your Workout Clothes Before You Go To Bed

Regular exercise is a one-stop-shop for enhancing your circulation, keeping your heart healthy, blowing off steam, and building awesome sperm. And it makes you feel like a superhero!

One study on the effects of exercise on male fertility found that men with the highest activity level (who engaged in weightlifting and outdoor activities) had 42% higher sperm concentrations than men with the lowest activity level. [8]  One reason for their stellar sperm count could be that exercising large muscle groups can raise testosterone levels.  Just remember, cycling in any significant amount is out. The same study discovered that men who cycled just 1.5 hours or more per week had 34% lower sperm concentrations than men who didn’t cycle.

According to sleep hygiene guidelines, the best time to exercise is first thing in the morning, and experts on follow-through suggest setting out your workout clothes at bedtime. Why? Because seeing your running shorts first thing in the morning greatly increases your chances of actually putting them on and hitting the pavement as you intended.

And, by the way, discontinue any anabolic steroid use immediately. Steroids decrease your sperm count and shrink your testicle size. (Yikes!)

Put Your Fork Down Between Bites

This one is all about squeezing a little mindfulness into your day.

You’ve probably heard that meditation is the ultimate stress-reducer. If you haven’t tried it, there’s no time like the present. And you are lying to yourself if you think you don’t have time to meditate, because mediation can be as simple as breathing and eating.

A simple breathing meditation is nothing more than paying attention to the feeling of your lungs expanding and contracting. It can be done while driving, brushing your teeth, waiting in line, sitting at your desk, mowing the lawn, watching your favorite team win (or lose) the championship game…You get the point. Basically anywhere and everywhere.

My other favorite meditation-on-the-go is eating meditation. Most of us eat too fast or on the run, which tends to increase the stress level in our bodies. Try putting your fork down between bites, resting your hand in your lap, and chewing and tasting your food until it becomes fully liquefied in your mouth. I’ll bet you a hundred dollars that you’ll chew 2 or 3 times as much as usual and that you will digest your food better too. You’ll also probably be less inclined to overeat, because your brain is a bit slow in registering nutritional intake, and leisurely dining gives it a chance to send out a signal of satiety in time to prevent you from taking a third helping of sautéed green beans. (Because you’re eating those for lunch, right?)

Once you get your stress under control, you can move on to a cleanse of sorts:

4) Ditch the Sperm Sabotaging Substances

We’ll discuss the recreational substances soon, but let’s start with a substance that you are probably less worried about.


What you may not know about sugar is that it causes a hormonal domino effect in your body that results in lowered testosterone levels.  Studies show that sugar consumption reduces semen volume, sperm count, and sperm concentration. [9]

It works like this: you eat a doughnut and your blood sugar spikes. Blood sugar is physically damaging to blood vessel walls, so your body releases a flood of insulin ASAP which opens the gates for cells to take in that glucose. Unfortunately, the insulin released also upregulates aromatase, an enzyme that converts testosterone into estrogen, thereby increasing your estrogen levels and decreasing your testosterone levels.

Not a pretty picture.

By the way, this insulin-aromatase-testosterone link is believed to be the reason why diabetes is associated with estrogen-related problems in males, such as increased breast size (a.k.a. gynecomastia), swelling of the prostate (benign prostatic hypertrophy), and prostate cancer.

Don’t go down that road, my friend. Sugar may give you the warm-and-fuzzies, but it is not an innocent little bunny.

Recreational Substances

If you are serious about becoming a father, you will need to take a serious look at your substance use, because there is strong scientific evidence that it can wreak havoc on your sperm.

Cigarette smoking, for example, is associated with significant reductions in semen parameters. In one study of over 1700 smokers and non-smokers, smoking was associated with a 15% reduction in sperm concentration, a 17% reduction in sperm count, and a 17% reduction in total motility. [10]

Habitual drinking is similarly problematic. While a couple of drinks a week may not have a huge impact, you should know that ethanol alters testicular function, disrupts testosterone levels, and is toxic to sperm. [11] One study of men demonstrated adverse effects at only five drinks per week. [12] Furthermore, a study on mice demonstrated that ethanol consumption not only resulted in reduced sperm count but that it disrupted DNA integrity and lead to increased sperm cell death. [13] (Not to mention that alcohol can lead to erectile dysfunction!)

Finally, marijuana dramatically reduces sperm production. In one study of 1,215 young men, regular marijuana use (more than once a week) was associated with a 28% decrease in sperm concentration and a 29% reduction in total sperm count. [14] And to make matters worse, cannabinoids may disrupt the process of egg fertilization. [15]

If this information is seriously bumming you out, maybe it’s time to find a natural high… Ever think about trying acupuncture? The bliss is real. We joke that patients are “acu-stoned” when they walk out of an appointment, and it’s because acupuncture so deeply resets the nervous system. But more on that later.

Plastics & Other Toxins

It is also important to note that there are a number of toxins out there that can seriously squash your mojo, not to mention cause you other health problems.

Chances are that some of them are lurking innocently in your home.

Bisphenol A (BPA), found in plastics, is a prime example. BPA is a widely studied endocrine disruptor present in plastic food containers, water bottles, and food cans. It leaches into our leftovers, bottled drinks, and canned beans and tomatoes, and it is wicked. In one study, workplace exposure to BPA was associated with more than quadrupled risk of low sperm count and double the risk of low motility. [16]

The weed-killer Roundup is another common offender, as are most herbicides and pesticides. Roundup contains glyphosate, which is highly disruptive to hormone signaling and toxic to the nervous system. DO NOT USE IT. Pick the weeds in your garden by hand, or hire someone else to pick them. And for heavens sake, choose vegetables and fruits that are organic or that haven’t been sprayed with chemicals!

Both BPA and glyphosate are categorized as endocrine disrupting chemicals. The really bad news is that endocrine disruptors can have significant impacts on your hormone levels, even at infinitesimally small exposure levels (we’re talking parts per million and parts per billion).  Pharmaceutical hormones like birth control pills and bovine growth hormone are also considered endocrine disruptors when they enter the environment, and these drugs end up in our water supply at the aforementioned concentration levels. So, if you get really serious about cleansing your life of endocrine disruptors, you’ll want to get a carbon filtration device for your drinking water.

And we haven’t even touched on the workplace hazards linked with male infertility and reduced sperm count, which include chemicals like organic solvents (especially glycol ethers), benzene, toluene (in paint thinner), agricultural pesticides, and heavy metals like cadmium and lead.  If you know that you are in contact with any of these toxins at work, you may have a bit of soul searching to do.

In any case, the bottom line is this: do whatever it takes to strictly limit your exposure.

5. In a Hurry? Fast Track Your Efforts with Acupuncture Treatments

If you want to supercharge your efforts to boosting sperm quality, you’ll want to see an acupuncturist. Acupuncture is a safe and natural medicine that will give your sperm a boost while also relieving stress, improving your digestion, and increasing the quality of your sleep.

If the idea of acupuncture for male fertility is making you nervous, let’s clear one thing up right away: no, the acupuncturist is NOT going to put a needle THERE.

He or she will primarily use points on your lower arms, lower legs, back, and abdomen. The beauty of the energy pathways in the body is that treatment on one part of the body can produce an effect in a different area of the body. Not only that, but Chinese Medicine aims to resolve symptoms (e.g. poor sperm count, erectile dysfunction, etc.) by correcting larger imbalances in the body ecosystem as a whole.

How many visits will it take?

This “ecosystem rebalancing” is best accomplished through a combination of acupuncture and Chinese herbal medicine, and it requires a series of treatments—usually once or twice a week for 2-3 months. This may seem like a lot of treatments, but it is absolutely required if you want to reap true benefits.

Think of it this way: Chinese Medicine works by retraining your nervous system, coaxing it back to a state of health and balance.  This process can involve promoting circulation, enhancing organ function, facilitating hormone metabolism, and supporting proper hormone signaling. If you had a goal of doubling your lifting capacity at the gym, you wouldn’t expect to achieve your desired results after only a few trips to the gym. You would lift regularly, strengthening your capacity over time. Similarly, retraining your body through Chinese Medicine cannot be achieved overnight, but instead requires the repeated messaging of daily herbal medicine and weekly acupuncture over a period of several months.

What does the research say?

A number of studies have demonstrated the benefits of acupuncture on sperm quality:

  • When a group of infertile men received twice weekly acupuncture for 5 weeks, there was a general improvement in the sperm’s structural integrity and a statistically significant increase in the percentage and number of sperm with no structural defects. [17]
  • Another group of infertile men was divided randomly into an acupuncture group and a control group. The acupuncture group received 10 treatments over 5 weeks and demonstrated improved motility and morphology as compared to the control group. [18]
  • A study of acupuncture on infertile men—in fact, men with such extremely low sperm counts (or no sperm) that testicular biopsy would have been required to collect sperm for ICSI (intercytoplasmic sperm injection, sometimes used in IVF)—demonstrated  the efficacy of acupuncture in boosting sperm counts. After 10 treatments, the men who initially produced no sperm were able to produce sufficient sperm to no longer require testicular biopsy. [19]
  • A before and after study looked at the change in fertilization rates for IVF/ICSI procedures involving men with semen abnormalities and at least two previous poor outcomes with IVF/ICSI. After 8 treatments of acupuncture, fertilization rates increased from 40.2% to 66.2%. [20]
  • A randomized trial of 57 patients with very low semen parameters found that those who received twice weekly acupuncture for 6 weeks had significantly improved sperm motility as compared to the sham acupuncture group. [21]
  • A study on testicular blood flow demonstrated that 5 minutes of electro-acupuncture applied to a point on the lower abdomen about 1 inch above the pubic bone resulted in increased arterial blood flow in the testes. [22]
  • A prospective, controlled and blind study of infertile men married for between 3 and 11 years studied the effect of acupuncture and moxa treatment on semen parameters and found a significant improvement in morphology as compared to the control group. [23]

What to Expect At Your First Acupuncture Treatment

When you arrive for your first treatment, your acupuncturist will most likely perform a thorough intake and ask detailed questions about your energy, exercise, sleep, mood, diet, elimination, and, of course, your reproductive health. He or she will feel your pulse at each wrist and take a look at your tongue.  After needle placement, you will rest for 20-40 minutes and very well may fall asleep.  As I mentioned before, many people are so deeply relaxed after the acupuncture treatments that they practically float out the door when they leave.  Call it what you will—a state of acu-bliss or being acu-stoned—it will transform your life, one treatment at a time.

Your practitioner will also likely send you home with a custom herbal formula, specifically matched to your constitution and symptom picture.  They may also suggest a list of supplements to take.  Common male fertility supplements that we recommend at my clinic include:

  • Ubiquinol (supports energy production in reproductive cells)
  • Pycnogenol (benefits sperm morphology and improves erectile function)
  • L-Arginine (benefits sperm formation and motility)
  • Acetyl-L-Carnitine (benefits sperm formation and motility)
  • Omega 3s (reduces inflammation & supports health cell growth)
  • Vitamin C (supports healthy cell growth)
  • Vitamin E (improves sperm motility and overall quality)
  • Selenium (lost in semen and deficiency is linked to poor sperm count, motility, & morphology)
  • Zinc (supports sperm production and testosterone metabolism)
  • Vitamin B12 (promotes healthy cell replication)

Go forth and knock it out of the park!

If you take the process of boosting your sperm quality seriously and follow the guidelines outlined in this post, you will generate huge benefits for not only your sperm, but also yourself and your future child.

And, should you live in the Denver/Boulder area and wish to engage the support of Chinese Medicine, please don’t hesitate to reach out. Though our clinic is called Well Woman Acupuncture, we commonly treat our female patients’ male partners, and we would be delighted to help you reach your fertility goals.

Wishing you all the best!

Julie Johnson is a licensed acupuncturist who practices at Well Woman Acupuncture in Boulder, Colorado. She is passionate about helping couples achieve optimal health and maximize their fertility so that they can create the families they desire.  


[1] Horsager, A. (2017, March). The Interplay Between Epigenetics, Environment, and Behavior in Male Fertility. Paper presented at the Integrative Fertility Symposium.

[2] Obesity and Bariatric Surgery Drive Epigenetic Variation of Spermatozoa in Humans Donkin I et al.  Cell Metab. 23(2):369-378, Cell Metabolism

[3] Antioxidant supplements and semen parameters: An evidence based review. Ahmadi S et al. Int J Reprod Biomed. 14(12): 729–736, International Journal of Reproductive BioMedicine

[4] Wet heat exposure: a potentially reversible cause of low semen quality in infertile men. Shefi S et al. Int Braz J Urol. 33(1):50-6, International Brazilian Journal of Urology

[5] Improvement of semen quality by nocturnal scrotal cooling and moderate behavioural change to reduce genital heat stress in men with oligoasthenoteratozoospermia. Jung A et al. Reprod. (2001) 121:595-603, Reproduction

[6] Variation of semen parameters in healthy medical students due to exam stress Malawi Med J. 21(4):166-7. Malawi Medical Journal

[7] Association of sleep disturbances with reduced semen quality: a cross-sectional study among 953 healthy young Danish men. Jensen T et al. Am J Epidemiol. 177(10):1027-37, American Journal of Epidemiology

[8] Paternal physical and sedentary activities in relation to semen quality and reproductive outcomes among couples from a fertility center. Gaskins A et al. Hum Reprod. 29(11):2575-8, Human Reproduction

[9] Aromatase up-regulation, insulin and raised intracellular oestrogens in men, induce adiposity, metabolic syndrome and prostate disease, via aberrant ER-α and GPER signalling. Williams G. Mol Cell Endocrinol. 351(2):269-78, Molecular and Cellular Endocrinology

[10] The Effects of Cigarette Smoking on Male Fertility. Kovac JR et al. Postgrad Med J. 137(3):338-41.

[11] Does alcohol have any effect on male reproductive function? A review of literature. La Vignera S et al. Asian J Androl. 15(2): 221–225, Postgrad Medical Journal

[12] Habitual alcohol consumption associated with reduced semen quality and changes in reproductive hormones; a cross-sectional study among 1221 young Danish men. Jensen T et al. BMJ Open. 4(9): e005462, BMJ Open

[13] Effects of different doses of ethanol on sperm parameters, chromatin structure and apoptosis in adult mice. Rahimipour M et al. Eur J Obstet Gynecol Reprod Biol. 170(2):423-8, European Journal of Obstetrics and Gynecology and Reproductive Biology

[14] Association Between Use of Marijuana and Male Reproductive Hormones and Semen Quality: A Study Among 1,215 Healthy Young Men. Gundersen TD et al. Am J Epidemiol. 182(6):473-81, American Journal of Epidemiology

[15] Leutwyler, K. (2000, December 12). Marijuana Firmly Linked to Infertility. Scientific American. Retrieved from

[16] Harmon, K. (2010, October 28). Everyday BPA Exposure Decreases Human Semen Quality.  Scientific American. Retrieved from

[17] Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Pei J et al Fertil Steril. 2005 Jul;84(1):141-7, Fertility and Sterility

[18] Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality. Siterman S et al Arch Androl. 1997 Sep-Oct;39(2):155-61, Archives of Andrology

[19] Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study. Siterman S et al Andrologia. 2000 Jan;32(1):31-9., Andrologia

[20] Influence of acupuncture on idiopathic male infertility in assisted reproductive technology. Zhang M et al J Huazhong Univ Sci Tech Med Sci. 2002;22(3):228-30

[21] A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia. Dieterle et al Fertil Steril 2009 Oct; 92 (4): 1340–3, Fertility and Sterility

[22]  Point- and frequency-specific response of the testicular artery to abdominal electroacupuncture in humans. Cakmak Y et al, Fertil Steril 2008;90:1732–8, Fertility and Sterility

[23] Effects of acupuncture and moxa treatment in patients with semen abnormalities. Gurfinkel E et al Asian J Androl. 2003 Dec;5(4):345-8., Asian Journal of Andrology