Oligospermia is a condition in which abnormally low number of sperm in the ejaculate of the male. The normal range of sperm count is between 20 million/ml and 200 million/ml. That sperm count is below 20 million/ml indicates oligospermia.

Etiology and Pathogenesis

Constitutional weakness or irregular sexual life depletes kidney essence. Chronic illness or weakness or malnourishment of the body results heart spleen deficiency, qi blood deficiency, qi not controlling blood, blood not generating essence. Spleen yang deficiency  results in kidney yang deficiency and true yang deficiency. All these could lead to cold sperm, scanty sperm and low sperm count.

Pattern Differentiation and Treatment

Three patterns for oligospermia are differentiated in Chinese medicine:

1. Kidney Yang Deficiency

Clinical Manifestations: Infertility, low sperm count, weak knees and back, aversion to cold, impotence, premature ejaculation, scanty-clear urination, frequent urination in the night, dizziness, ear ringing, pale and puffy tongue body, deep and thin or deep and slow pulse.

Treatment Principle: Warm the kidneys and strengthen yang.

Prescription: Sheng Jing Zhong Zi Tang

Shu Di Huang 9g
Xian Ling Pi 15g
Xu Duan 10g
Tu Si Zi 15g
Ba Ji Tian 15g
Fu Zi 6g
Rou Gui 8g
Xiao Hui Xiang 10g
Yuan Zhi 10g
Shi Chang Pu 9g
Gou Qi Zi 10g

2. Kidney Essence Deficiency

Clinical Manifestations: Low sperm count, slow liquefaction of semen, dead sperms, weak knees and back, hot feeling in the palms and soles, seminal emission, night sweating, dry throat, anxiety, insomnia, red tongue, less tongue coating, thin and rapid pulse.

Treatment Principle: Nourish kidneys and supplement essence.

Prescription: Ye Hua Sheng Jing Tang with modifications

Sheng Di Huang 15g
Mu Dan Pi 10g
Di Gu Pi 10g
Bai Shao 10g
Mai Men Dong 10g
Yuan Shen 10g
He Shou Wu 15g
Sang Shen 10g
Gou Qi Zi 15g
Shan Zhu Yu 10g
Xian Ling Pi 15g
Fu Ling 10g
Zhu Ye 10g

3. Qi Blood Deficiency

Clinical manifestations: Low sperm count, dull-pale complexion, lassitude, pale finger nails, palpitations, shortness of breath, insomnia, poor memory, loose stool, premature ejaculation, pale-puffy-tender tongue, thin and weak pulse.

Treatment Principle: Tonify qi, nourish blood, tonify kidneys and supplement essence.

Prescription: He Che Zhong Zi Wan with modifications

Zi He Che 15g
Dang Gui 9g
Shan Zhu Yu 9g
Bu Gu Zhi 9g
Du Zhong 9g
Rou Gui 9g
Tian Men Dong 9g
Mai Men Dong 9g
Sheng Di Huang 12g
Shu Di Huang 12g
Dang Shen 9g
Gou Qi Zi 15g
Tu Si Zi 9g
Fu Pan Zi 9g
Wu Wei Zi 9g
Shan Yao 15g
Ba Ji Tian 9g
Niu Xi 12g
Huang Bai 9g
Fu Ling 9g
Suo Yang 9g
Bai Zhu 9g