44 yo male with >95% abnormal sperm morphology

Curious what you have done to treat this man for his condition? I have seen many men have healthy children with this morph %. Are you treating his wife? What is her medical/TCM presentations?

The patient reports that there are no Western issues with his wife.  I will approach him about treating his wife as well, as I know this is important.

I am treating him based on Peter Deadman's suggestions for Liver Damp-Heat and Kidney Yin/Essence Def, using front and back points alternate weeks- Ren 3,4; ST 30; Liv 8,5,2; Kid 8,10; Sp 6; UB 23, 25, 28, 32, 35.  I've also added a couple points like Du 20, LI 4 and the Hua tuo jia ji points at L5.

I saw this person this morning (3rd treatment) - after doing a back treatment last week, he reported almost a complete reduction in his low-back pain, and that he felt very relaxed.  His pulse was more slippery than tight this week.  The tongue was red with the yellow, greasy coat appearing to have retreated about 3-5 mm toward the back of his tongue, with a white border surrounding the front edge of the coat.  I decided to do another back treatment today - Du 20, LI 4, UB 23,25,28,32,35,52; Kid 10,8; Liv 8; Sp 6.

Herbal formula: I wavered between using a variation of Long Dan Xie Gan Tang and the following formula for this patient.  The first formula I decided on for him mainly clears Damp and Toxic Heat from the Liver, and moves Blood, among other things.  He did not mention feeling any side-effects to this formula (digestive upset, etc.)

Granular herb amounts in g

Hu zhang 虎杖    6
Pu gong ying 蒲公英    6
Zi cao 紫草    6
Huang qi 黃芪    6
Dan shen 丹參    6
Chi shao 赤芍    6
Dang gui 當歸    6
Hong hua 紅花    4
Shou wu 首烏    6
Nu zhen zi 女貞子    6
Sheng di 生地    6
Xian ling pi 仙靈脾    6
Du Zhong 杜仲    5
Bai Zhu 白术    3
Dang Shen 党参    4

I am switching him to a Long Dan Xie Gan Tang modified formula this week as I felt there should be more focus on clearing Damp-Heat, especially since his tongue changed only slightly since last week, and his pulse felt more slippery this week:

Formula 4-21-10

Granular amounts in g

Long dan cao    18
Huang qin    12
Zhi zi    12
Ze xie    12
Mu tong    9
Che qian zi    15
Pu gong ying    12
Dang gui wei    15
Sheng di    18
Gou ji    12
Du zhong    12
Chai hu    12
Gan cao    5

I would greatly appreciate your comments on this case, as it's my first time treating a patient with such an high abnormal morphology issue.

Stick with the Long Dan for a while, at least a couple months if the damp-heat is quite extensive (this is quite normal for male infertility patients). Clear the excess first before you start to nourish or enrich. As far as treatment protocol, try to get a commitment of 12 acu tx's with him (either 2/wk for 6 wks, or 1/wk for 12 wks), and ensure him that 3-6 months of herbals may be necessary. More colorful foods, less saturated fats, less greasy and spicy foods. Alcohol should be kept to a minimum as by definition it is 'fire water' (damp heat). Spermatogenesis is a 90-100 day process, and morphology is decided when stem cells in the testis switch on and become sperm, i.e. right from the get go it will either have 2 tails, or a big head etc.. So you may see improvement in morphology ranges at any time, but really, 3-6 months after treatment has been performed and compliance ensured will you see the results of your labor manifest in the sperm morphology.

Check out this recorded webinar archive: http://www.healthstream.tv/product/chinese-medicine-and-male...

Also check out my site for a few articles etc I have compiled on the topic: http://mens.health-info.org/male-infertility