Abstract
Pomegranate fruit (Punica granatum) and galangal (Alpinia galanga) have separately been shown to stimulate spermatogenesis and to increase sperm counts and motility in rodents. Within traditional medicine, pomegranate fruit has long been used to increase fertility, however studies on the effect on spermatogenesis in humans have never been published. With this study we investigated whether oral intake of tablets containing standardised amounts of extract of pomegranate fruit and powder of greater galangal rhizome (Punalpin) would increase the total number of motile spermatozoa. The study was designed as a prospective, randomized, controlled, double-blinded trial. Enrolment was based on the mean total number of motile spermatozoa of two ejaculates. The participants delivered an ejaculate after 4–8 days of tablet intake and two ejaculates just before they stopped taking the tablets. Seventy adult men with a semen quality not meeting the standards for commercial application at Nordic Cryobank, but without azoospermia, were included in the study. Participants were randomized to take tablets containing extract of pomegranate fruit (standardised with respect to punicalagin A+B, punicalin and ellagic acid) and freeze-dried rhizome of greater galangal (standardised with respect to 1′S-1′-acetoxychavicol acetate) or placebo on a daily basis for three months. Sixty-six participants completed the intervention (active treatment: n = 34; placebo: n = 32). After the intervention the total number of motile spermatozoa was increased in participants treated with plant extracts compared with the placebo group (p = 0.026). After three months of active treatment, the average total number of motile sperm increased by 62% (from 23.4 to 37.8 millions), while for the placebo group, the number of motile sperm increased by 20%. Sperm morphology was not affected by the treatment. Our findings may help subfertile men to gain an improved amount of motile ejaculated sperm by taking tablets containing preparations of pomegranate fruit extract and rhizome of greater galangal.Trial Registration ClinicalTrials.gov NCT01357044
Highlights
In the Western world, a decline in sperm quality during the last 40 years has been suggested [1,2], the decrease may have been stabilized during the last decade [3]
This study revealed that the combination of P. granatum fruit extract and A. galanga rhizome powder (Punalpin) significantly increased the total number of motile sperm in men with a semen quality, which is reduced or low within the normal range, after three months of daily treatment
Since no difference in the number of motile sperm was seen after the first week of intake of standardised extract of P. granatum and A. galanga powder, we propose that the combination exerts its positive effect during spermatogenesis rather than on the epididymal environment
Summary
In the Western world, a decline in sperm quality during the last 40 years has been suggested [1,2], the decrease may have been stabilized during the last decade [3]. Intracytoplasmic sperm injection is often the only alternative offered to couples, where the male suffers from poor semen quality. The pomegranate fruit consists of a leathery pericarp containing numerous seeds, each covered by a juicy, translucent aril. Both pericarp and aril juice contains hydrolysable tannins, with the pericarp being the far most concentrated source [8]. Juice from P. granatum fruit has been shown to stimulate spermatogenesis, to increase sperm motility, and to decrease the percentage of abnormal sperm in rats after seven weeks of gavage [4]. An increase in sperm motility and concentration together with a decrease in abnormal sperm rate was observed after 6 weeks of oral administration of pomegranate juice extract to rats [5].
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