Alternative and complementary medicinal treatments are those that fall outside of mainstream healthcare; these include practices such as massage, acupuncture, tai chi, drinking green tea, and many other traditional treatments. Current evidence regarding whether acupuncture in infertile men improves sperm motility, sperm concentration, and the pregnancy rate of couples is insufficient. The poor quality of the evidence is attributable to the small number of studies, inadequate procedures and/or insufficient information for semen analysis, high risk of bias, methodological heterogeneity, and poor reporting quality. Large-scale randomized controlled trials with elaborate designs are needed to rigorously test the effectiveness and safety of acupuncture on semen quality.
There is good evidence showing that stress can affect the reproductive system, with psychological stress leading to lower serum total testosterone levels with secondary rises in serum luteinizing hormone and follicle-stimulating hormone levels altering seminal quality in men. There are a number of studies that show that massage appears to decrease psychological stress, including studies showing moderate pressure massage reduces stress hormones such as cortisol and catecholamine; however, other studies show that massage does not reduce cortisol levels.
Traditional Chinese medicine includes approaches and substances that are based on a solid scientific premise; the effectiveness of traditional Chinese medicine for male infertility has been confirmed by numerous studies. At present, however, the evidence in favor of traditional Chinese medicine is still not compelling. The studies of such traditional medicine for infertility are almost all domestic (i.e., done in China) and contain small sample sizes. They are also not blinded randomized controlled trials, and do not contain detailed descriptions of the methods; therefore, the overall quality score for methodology is low. In addition, most studies lack reports of adverse effects and mainly target infertile men with oligoasthenozoospermia, neglecting patients with azoospermia and teratozoospermia.
