Abstract

Oligoasthenozoospermia is a crucial factor in male infertility. Wuzi Yanzong (WZYZ) pill is a popular traditional Chinese medicine (TCM) formula which has been used for male infertility treatment for years. However, its effects on semen quality remain controversial. We conducted a preregistered meta-analysis to assess the effect of WZYZ pill for the therapeutic effects on oligoasthenozoospermia. Five randomized controlled trials including 960 participants were selected from databases of domains in North-East Asian regions, PubMed, Embase, and Cochrane Library. WZYZ pill group yielded a greater mean increment on sperm concentration (5 trials: MD 5.99, 95% CI 2.12–9.85, P = 0.002), sperm motility (5 trials: MD 4.57, 95% CI 0.47–8.68, P = 0.03), sperm morphology (2 trials: MD −1.93, 95% CI −4.87–1.01, P = 0.20), activity of acrosomal enzyme (2 trials: MD 28.27, 95% CI 12.41–44.14, P < 0.01), volume of semen (2 trials: MD 0.56, 95% CI 0.21–0.91, P = 0.002), and a decrement of sperm DNA fragmentation index (2 trials: MD −3.82, 95% CI −6.45–−1.19, P = 0.004). However, qualities of selected studies were generally unsatisfactory, and there was inherent heterogeneity among some of the outcomes. Despite these limitations, the WZYZ pill improved sperm quality by improving several semen parameters and decreasing DNA damage in oligoasthenozoospermia patients.

Highlights

  • It is reported that 15% of couples suffer from fertility problems and nearly half of them are caused by male factors [1, 2]

  • Vitamins C and E are commonly used as control interventions for sperm quality studies [12, 13]; randomized controlled trials (RCT) [14,15,16] have confirmed these vitamin controls are the equivalent of placebos

  • It should be mentioned that most of the chosen studies lacked the sperm parameters before Wuzi Yanzong (WZYZ) pill treatment, so this meta-analysis delineated the outcomes after treatment

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Summary

Introduction

It is reported that 15% of couples suffer from fertility problems and nearly half of them are caused by male factors [1, 2]. As one of the male infertility factors, Oligoasthenozoospermia is defined as the total number or concentration of spermatozoa and percentage of progressively motile spermatozoa, below the lower reference limits (total number < 33 × 106 per ejaculate; concentration < 12 × 106 per ml; progressively motile < 31%) [3]. More than 40% of infertile men are diagnosed with oligoasthenozoospermia, and their poor sperm quality is considered as one of the major causes of infertility [4]. Improving the sperm quality in these patients is one of the main targets of male infertility therapy. Effective pharmaceutical treatments for oligoasthenozoospermia are lacking [5]. Attentions have been drawn to the use of alternative complementary medicine including traditional Chinese medicine

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