Abstract
In this chapter, the main causes of male factor infertility, specifically endocrine abnormalities and effect of endocrine disrupters, will be outlined. For many patients, conventional therapy presents considerable financial strain and moral dilemma. In this context, many patients are preferring complementary medicine (CAM). Hence, the promises offered by herbal medicine including Ayurveda, Arab, and Chinese medicine will be explored in this chapter. Many naturopathic medicaments such as Withania somnifera, Asparagus racemosus, Curculigo orchioides, Zingiber officinale, etc. are being routinely used as part of traditional medicine practice in Ayurveda and Arab medicine and gaining wider acceptance in other countries. Common herbs, targeted infertility condition, and results thereafter shall be discussed. In the concluding part of the chapter, the potential deleterious contraindications of alternate medicine such as lead toxicity from Ayurvedic medications shall be briefly discussed.
TopBackground
Infertility is classically defined as the inability for a couple to conceive after 12 months of frequent vaginal intercourse without the use of contraception (Gnoth, 2005). The most common cause of male subfertility is primary testicular dysfunction and a defect in spermatogenesis that is generally due to irrever ible damage, and these men typically require treatment with Assisted Reproductive Technology (ART) (Jungwirth, 2012).
Infertility can occur when there is a low sperm count, or problems with the motility (movement) or morphology (appearance or shape) of the sperm. The World Health Organization (WHO) estimates that approximately 50-80 million people suffer from infertility. Causes of male infertility can be divided into three main categories:
- A)
Sperm production disorders affecting the quality and/or the quantity of sperm (Non Obstructive Azoospermia, NOA). NOA may be manifested as Sertoli cell-only pattern (SCO), maturation arrest (MA), or hypospermatogenesis.
- B)
Anatomical obstructions (Obstructive Azoospermia)
- C)
Other factors such immunological disorders.
Approximately a third of all cases of male infertility can be attributed to immune or endocrine problems, as well as to a failure of the testes to respond to the hormonal stimulation triggering sperm production. However, in a great number of cases of male infertility due to inadequate spermatogenesis (sperm production) or sperm defects, the origin of the problem still remains unexplained. The etiology of male infertility is either congenital or acquired due to environmental toxins or disease processes (Anawalt, 2013). In order to evaluate factors that may cause infertility, it is crucial to understand the process by which sperm are produced in male testis, namely Spermatogenesis and mechanisms of its regulation.
Key Terms in this Chapter
HPG Axis: The hypothalamus-pituitary-testis are often referred to as one single entity. Hypothalamus and Pituitary secrete hormones that control spermatogenesis in testis.
Spermatogenesis: The sequence of cytological events that occur within the testis, that result in the formation of the mature spermatozoa from precursor cells- spermatogoniais known as spermatogenesis.
Infertility: Infertility is the failure of conception after at least 12 months of unprotected intercourse.