Several controlled acupuncture studies have shown a positive effect on sperm production in males with low sperm quality (10, 11). A controlled trial on men with idiopathic, normal gonadotropic oligospermia revealed that pregnancy rate or normalization of semen parameters increased significantly in 74% of patients receiving acupuncture plus clomiphene compared with 52% of those receiving clomiphene alone (12). Another controlled trial on infertile men showed a positive effect on the 279 cases of male infertility treated by the combination of acupuncture and Chinese herbal medicine (13). In our previous studies, the results showed that acupuncture could improve sperm quality, fertilization rate (14), and pregnancy rate (15) in assisted reproductive technology (ART).
Encouraging results prompted us to analyze the possible effect of acupuncture treatment on sperm structure. Standard semen analysis is a relatively blunt instrument for the diagnosis of male infertility, and sperm morphology at light microscopic level has been insufficiently evaluated. Thus, we considered transmission electron microscopy (TEM) to be the appropriate tool for estimating ultrastructural changes occurring in spermatozoa or in fine structure of organelles involved in fertilization after acupuncture treatment (16, 17, 18, 19).