Aug 2011|Vol 8|Issue 8

   
 
Case
 

Homoeopathic Perspective in Male Infertility

 
 
 
 

Definition:
      Infertility is defined as diminished and Sterility as absence of ability to produce an offspring. This implies both in males as well as females.

Introduction:
      The male component of infertility is alarmingly on the raise. It constitutes nearly 50% cases of primary infertility. Various reasons have been attributed for this problem. Pesticides, environmental pollution, diet, occupation, mental stress, drugs, alcohol, smoking, various major illnesses such as Hypertension, Diabetes, Chronic Renal Failure, Chronic Liver problems, Endocrinological problems, Cancer, etc play a major role in infertility. Of all the above said problems few can be avoided or minimised.

      The primary objective of a homoeopath is to assess the level of problem in an infertile couple. It is always better if both the partners are screened for the problem and treated even if one partner is laboratorically normal. This enhances the chances of conception than treating a single person alone.

      When a couple approach the doctor regarding infertility always start off investigations with semen analysis. The test is easy, cost effective and non invasive. It is always advisable for the purpose of accuracy to collect the semen with approximately 3-5 days of abstinence. The sample should be freshly collected in the laboratory. Patient may also need to test for LH, FSH, Testosterone, Prolactin and various other battery of tests based on the outcome of the semen report.
For a good homoeopathic prescription it is imperative that we need a good case taking and lucky ones like Dr. Adolph Lippe can cure cases by the drop of their hat with medicines like Lac caninum. But in most of the cases we fail to get even a single symptom on which we can base our prescriptions.

      At this juncture the semen analysis, blood tests and ultrasound opens a Pandora’s Box for a homoeopath. A lot of things can be understood by these investigations.

Dynamis Homoeo Trust organized a National Seminar “Infertility Update 2011” at Hotel Le Jardin, Erode.

Dr.P.V.Venkatraman, speaker on the topic “Male Infertility and its Homoeopathic Perspective ” is given here.

He can be contacted at 9841153666.

Semen analysis:

      The physical properties of semen, it’s microscopic, macroscopic, microbiological and biochemical properties have important medical relevance and for a homoeopath, it is even more as it gives us lots of lateral thinking on the application of homoeopathic philosophy and Materia Medica.

Volume and Viscosity:

      The high and low volume of semen suggests the following medicines like Phosphoric acid, Selenium, Picric acid, Lyssin and Graphites. The appearance and viscosity of the semen will make you think of several medicines. The thin fluid and watery semen makes us think of medicines like Cannabis sativa, Natrum muriaticum, Natrum phosphoricum, Selenium and Sepia. While the thick semen indicates us the remedies like Alumina, Alumen and Medorrhinum. In the highly viscous semen (Arab gum like) where the liquefaction time is more than 30 minutes the same remedies can be used effectively. The thread like semen suggests medicines like Kalium bichromicum, Hydrastis canadensis and Medorrhinum.

Fructose:

      Fructose in Azoospermia: If Negative: This would mean obstruction of ductal system. Fructose Negative occurs in congenital absence of vas deferens and seminal vesicles. If vas is present, then obstruction is at the level of ejaculatory duct. In cases of obstruction we can always think of medicines like Thiosinaminum, Fel tauri, Graphitis, Calcarea fluorica, etc. In cases of Azoospermia with fructose positive we need to check the LH, FSH and Testosterone levels. For the above said three hormones are normal then we should suspect a Varicocele or Obstruction.

Varicocele:

      Varicocele can cause a wide range of problem from Azoospermia, to low count or low motility of sperms. We have hundreds of medicines for varicose veins. Medicines like Carduus marianus, Fluoric acid, Hamamelis virginica, Pulsatilla nigricans, Sulphur, etc., can instantly correct a mild one (mild varicocele can be ignored) and at a longer interval a little severe case. Remember surgery can also solve the problem immediately.

Low Count:

      In case of low counts always look for endocrine levels. If FSH is normal then suggest for testicular biopsy. If LH, FSH and Testosterone are normal then think of some medicines which will work on the gland like Calcarea carbonicum, Calcarea iodide, Conium, Iodum, Phytolacca, Tribulus terrestris, etc.

Testicular failure:

      Suggest the patient for testicular biopsy. In case of testicular failure with high LH and FSH levels do Karyotyping to rule out chromosomal abnormalities. If LH and FSH are low then the reason for testicular failure is at the level of Pituitary. In this case think of medicines working on the pituitary like Calcarea carbonicum, Lac caninum, Pituitarinum and other glandular remedies.

Abnormal forms:

      If more number of abnormal forms and dead sperms are present then think of medicines like Syphilinum and Carcinosin. If more number of dead sperm are present it may be due to infection or due to insult to the testes. Here Borax, Syphilinum, Zincum metallicum, etc., will prove the efficacy of homoeopathy once again. Any Liver problem or problem in cholesterol metabolism may affect the hormone synthesis. Protect the liver in this case and medicine which can correct the liver will also be useful.

Testosterone:

      Obesity and excess fat can cause disturbances in the Testosterone and SHBG. If the serum Oestrogen and thyroid levels are more then they can reduce the free testosterone levels. Proper diet, avoiding alcohol, weight reduction etc., can improve the availability of testosterone for the gonadal activity. Medicines which can reduce the fat levels in the body like Allium sativum, Ammonium bromatum, Calcarea carbonica, Fucus vesiculosus, Lycopodium, Phytolacca, Urtica urens and medicines which can remove the bad effects of alcohol such as Angelica archangelica, Calcarea arsenicosa, Nux vomica, Quercus glandium spiritus, Sterculia, Sulphuric acid, Syphilinum, etc., should be in our preferred list of medicines. Testosterone is one of the most important hormone in male life and is mostly produced by the Leydig cells. Alcohol converts testosterone into estrogen and this is one of the main reasons for male sexual dysfunction.

FSH:

      If FSH is double than the normal levels better don’t accept the patient. It is a complete testicular failure. If you obdurately want to try anything at the expense of the patient then try and I am not going to suggest you anything. But secretly I want to tell you that you can try to maintain normal levels of oestrogen and testosterone so that FSH levels may be corrected. In this situation think of all the menopausal drugs and also drugs which can be used for the treatment of benign prostatic hypertrophy.

Prolactin:

      High Prolactin levels in male can cause low libido and lower the levels of testosterone. High Prolactin levels may be due to simple excess production or may be due to micro adenoma in the Pituitary. Open the repertory and look for medicines which help to interfere with milk secretion. There is a sure cure in homoeopathy. Remember Lac caninum first. In allopathy Bromocriptin is given for high Prolactin and it almost cures the patient without side effects.(Bromocriptin is derived from Bromium and Secale cornutum – both are available in homoeopathy) High Prolactin may be co- existent with low LH and FSH. For low LH and FSH open repertory and look for Anosmia. It is mostly congenital and difficult to cure.

Capacitation:

      The sperm has to swim across the cervical mucosa hence mucosa needs to be in oestrogenic phase and without infection. Calcium is important for coagulation, liquefaction and capacitation and Zinc in the seminal fluid helps to prevent infection. Borax, Calcarea carbonicum, Natrum phosphoricum and Zincum metallicum can be given to the couples anxious to have a child.

Infection:

      Zinc is the primary factor in the seminal fluid having antibacterial activity. Low zinc levels are noted in azoospermic men. Serum and seminal zinc levels can be monitored if recurrent pus cells or dead sperms are noted in the semen. Borax, Ignatia amara, Medorrhinum, Pyrogenium, Selenium, Sulphur, Zincum metallicum, etc., are ready for you.

Gonadotoxic agents:

      Alcohol, Caffeine, Cimitidine, Marijuana, Nicotine, Nitrofurantin, Pesticides, Sulphasalazine, etc., have been implicated as Gonadotoxic agents. The same agents as homoeopathic preparation may neutralize and remove the bad effects. It may be tautopathy / isopathy. Something is better than nothing.

Mumps Orchitis:

      Infertility due to mumps is common only when mumps is acquired during puberty. There will be a chronic inflammation in the testicles due to mumps. Severe oligospermia or azoospermia may result. Now, are you ready with Parotidinum, Mercurius sol Hahn, Pulsatilla, Spongia tosta, etc? Can’t we undo the damage?

Exclusion:

       I am not dealing here with Diabetes, Hypertension, Adrenal and Thyroid problems, etc., or after effects due to Corticosteroidal treatment for ulcerative colitis, Rheumatoid arthritis, bronchial asthma etc., where all these can lead to infertility. I have also not included various causes of infertility such as work related hazards, impotency, stress and psychological problems. Above all I am ignoring the vast list of congenital disorders which being one of the main reasons for infertility and sterility.

I have also not included any cured case for want of space and I also solemnly believe that you know very well that miracles happen in homoeopathy every now and then.

Conclusion:

      Defying all the above parameters some are fertile and some are infertile about which I am still in dark.