Role of various Homoeopathic Medicine in Male Infertility

ABSTRACT: Male infertility is considered as a taboo in our society because according to normal norms of society a male can never infertile, only a female can be infertile. But as much as a female can be infertile so can a male be. In the recent time due to increasing modern lifestyle the prevalence of male infertility is increasing.  Male infertility is defined as the inability of male to make a fertile female pregnant, also for a minimum of at least one year of unprotected intercourse. 

• Keywords: male, infertility, Testes, spermcount, spermmotolity, ejaculation, psychology, Homoeopathy, Homoeopathic medicine
• Introduction: Infertility is usually defined as a failure to conceive within one or more year of regular unprotected coitus. Conception depends on the fertility potential of both the male and female. The male is directly responsible in about 30-40 percent.[1] It is estimated that infertility affects 8-12% of couples globally, with a male factor being a primary or contributing cause in approximately 50% couples. Causes of male sub-infertility vary highly, but can be related to congenital, acquired, or idiopathic factors that impair spermatogenesis. Many health conditions can affect male fertility, which underscores the need for a thorough evaluation of patients to identify treatable or reversible life style factors or medical conditions. Although semen analysis remains the cornerstone for evaluating male infertility.[4]
• Fault in male [1][2]: defective spermatogenesis(50%), Obstruction of the efferent duct system(30%), Failure of deposition sperm high in vagina, Error in seminal fluid, Disorder of sperm motility(15%), Sexual dysfunction.
• Causes of male infertility[1][2][3]
• The important causes of male infertility area:-

• Hypothalamic-pituitary disorder (1-2%),
• Primary gonadal disorder (30-40%), 
• Disorder of sperm transport(10-20%),
• Idiopathic(40-50%)

• Congenital: Undescended testes, Kartagener syndrome, Hypospadias, Prader-Willi Syndrom
• Thermal Factor: The scrotal temperature is raises in condition such as varicocele. Varicose probably interferes with the cooling mechanism or increase catecholamine concentration.
• Infection: Mumps  orchitis permanently damage spermatogenesis, Bacteria or viral infection of seminal vesicle or prostate depresses the sperm count, T. mycoplasma or Chlamydia trachomatis infection is also implicated.
• General Factor: Chronic debilating diseases, malnutrition, heavy smoking reduce spermatogenesis. Alcohol inhibitis spermatogesis either by suppressing Leyding cell synthesis of testosterone or possibly by suppressing gonadotropin levels.
• Endocrine: Testicular failure due to gonadotropin deficiency is rare. FSH level is raised in idiopathic testicular failure with germ cell hypoplasia. Hyperprolactinemia is associated with impotence. Hypothalamic disorder, Hyperprolactinaemia, Hypothyroidism.
• Psychological and environmental factor: like smoking, alcohol consumption, tobacco chewing, Radiation, cytotoxic drugs, nitrofurantoin, cimetidine, antihypertensive, anticonvulsant, antidepressant drug are likely to hinder spermatogenesis.
• Sexual dysfunctions: Low frequency coitus, premature ejaculation, retrograde ejaculation.
• Immunological Factor: Antibodies against spermatozoal surface antigen may be the cause of infertility. This results in clumping of the spermatozoa after ejaculation.
• Obstruction of the efferent ducts: Obstructed by infection like tubercular, gonococal or by surgical truma (herniorrhaphy) following vasectomy. In Young’s syndrome, there is epididymal obstruction and bronchiectasis.
• Coital problem: Erectile dysfunction, Ejaculatory defect-premature, retrograde or absence of ejaculation.
• Sperm  and vesicular abnormality: Loss of sperm motility (asthenozoospermia), abnormal sperm morphology(rounded sperm, teratozoospermia) are the important factors. Sperm acrosome defect, Zona pellucida binding defect, Zona penetration defect.
• Error in the seminal fluid : High or low volume of ejaculate, Low fructose content, High prostaglandin content, Undue viscosity.
• Investigation[1][2]

General Examination

Local Examination

Semen Analysis

Sims’s or Huhner’s test

Sperm penetration test

Semen-cervical mucus contact test

Testicular biopsy

FSH level

Chromosomal study

Sperm morphology

Ultrasound

Vasogram

Immunological test

• How  Homoeopathic  medicines act in case of male Infertility:                                                                                                                            
• Homeopathic medicine increases the sperm count, It prevent the early ejaculation and also improves the erectile dysfunction.  It help in deposition of sperm  high into vagina and  improve the defective spermatogenesis,
• Role of various Homoeopathic medicine in case of male Infertility[5][6][7][8][9]

• Lycopodium clavatum: The erections are absent or imperfect and the genital organs are cold and shriveled. ‘’The old man’s balm.’’ No erectile power, Impotence, Premature emission. Enlarged prostate. Condylomata, Sexual exhaustion, impotence, erections feeble, falls asleep during coition. Yellow tumor corona glandis. Impotency from tobacco smoking. 
• Agnus castus: These so called ‘’old sinners’’ are just as excitable in their sexual passions. It is useful in paralytic impotence. It is used when a man’s desire and physical ability are reduced,The genital’s stay relaxed, cold, and flaccid. No erections, Impotence, desire gone, Scanty emission without ejaculation, Woebegone young man, heartbroken over his early life, now finds himself newly married, and impotent.
• Nux Vomica:It is useful in those overdrugged by tea, coffee, wine. Desire easily excited. Penis becomes relaxed during an embrace. Bad effect of onanism; sexual excess. Premature ejaculation. Increase of smegma.
• Caladium Seguinum : It is used when infertility or impotency because of mental depression. Here after masturbation, the penis is as flabby as a rag, the prepuce when  withdrawn behind the glans does not have sufficient  contractility to replace it.The genitals stay relaxed and weak , Impotency relaxation of penis during excitement. No emission and no orgasm during embrace. Erection when half-sleep. skin of scrotum thick.
• Selenium metallicum: Seminal emissions, voluntary or involuntary, make the patient worse. The patient is so relax that the semen dribbles involuntary. It is used for erectile dysfunction and weak erections. Involuntary semen discharge may also be indicated as a symptom.  Irritability after coitus. Loss of sexual power, with lascivious fancies. Increase desire, decrease ability. Sexual neurasthenia. On attemping coition, penis relaxes. Hydrocele.   
• Aurum metallicum: It is suited to a person who has disgust of life, and thoughts of suicide. Pain and swelling of testes. Chronic induration of testes. Violent erection. Atrophy of testes in boys. Hydrocele. Sarcocele. Epididymitis.
• Argentum nitricum: Impotence. Erection fails when coition is attempted. Cancer like ulcers. Desire wanting. Genital shrivel. Coition painful.
• Phosphorus: It has impotence preceded by over excitation of the genital organs. It also has discharge of prostatic juice during a hard stool.
• Moschus: Violent desire, involuntary emission. Impotence, associated with diabetes. Premature senility. Nausea and vomiting after coition. Erection, with desire to urinate.
• X-Ray: Lewd dreams. Sexual desire lost. Reestablishes suppressed gonorrhea. Infertility in male with low sperm count. Sperm count gets increased, enhancing both the quality and quantity of sperm.
• Conium: Emission on the slightest provocation. It is produce a perfect picture of hypochondriasis; patient is melancholic, naturally excitable, but has gone over to this weakness. It used for treating Infertility in men, which occur due to orchitis, The testicles get swollen, enlarged and hardened. Conium also help in patient with a history of suppressed sexual desire.
• Calcarea carb:This Homeopathic medicine is helpful for men with a high libido but premature ejaculation. Frequent emissions. Increase desire. Semen emitted too soon. Coition followed by weakness and irritability. Impotence, from sexual abuse or indulgence. Seminal discharge premature.
• Onosmodium virginianum: Constant sexual excitement. Psychical impotence. Loss of desire. Speedy emissions. Deficient erection.
• Sabal serrulata: Wasting of testes and loss of sexual power. Coitus painful at the time of emission. Sexual neurotics. Organs feel cold. Epididymitis. Impotency. Semen thick, causes hot feeling along the cord. Genitals cold.
• Phosphoric acid: Emission profuse, followed by great exhaustion, without sensual dreams. Priapism; satyriasis. Hard erections, with pain in testicles and up cord. Prostatic hypertrophy, especially in case not too far advanced.
• Eryngium aquaticum: General debility, seminal emissions without erections.
• Damiana: Sexual neurasthenia, Impotency. Sexual debility from nervous prostration. Incontinence of old people. Chronic prostatic discharge.
• Barayta carbonica: Diminished desire and premature impotence. Enlarged prostate. Testicles indurated. Erection when riding. Falling asleep during coition. Genital feels numb
• Conclusion: In homeopathy, we take the whole picture of patient, his complains in detail, his emotional, physical & mental sphere with the help of which we come to his constitutional remedy. Thus, homeopathy has ample of scope in cases of male infertility especially  when associated with environmental factor, lifestyle and stress.

• Referances:

1. Dutta’s. DC,Textbook of  Gynecology including[Edited by: Hiralal konar] New Delhi: Jaypee Brothers medical           publishers(p) LTD
2. Howkins and Bourne Shaw’s Textbook of Gynaecology, [Edited by : VG Padubidri, Shirish N Daftary] Elsevier 2008, 14^th Edition.
3. N. Hephzibah Kirubamani, A.P. Nalini Alexander, R.Premalatha Undergraduate Manual of Clinical Cases in Obstetrics & Gnecology With Embedded Videos, Elsevier.
4. Agarwal A, Baskaran S, Parekh N, Cho CL, Henkel R, Vij S, Arafa M, Panner SelvamMK, Shah R. Male infertility. Lancet. 2021 jan 23;397910271):319-333.doi:10.1016/S0140-6736(20)32667-2. Epub 2020 Dec 10. PMID: 33308486
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8. Dewey, W.A. Practical Homoeopathic Therapeutics, Third edition revised and  enlarged. New Delhi, India: B. Jain.
9. Phatak. S.R. Materia Medica of Homoeopathic medicines, Second edition Revised & enlarged. New Delhi, India;B.Jain;2005