BackgroundThe increasing prevalence of male infertility has become a global concern. Traditional Chinese and Asian medicines have long been using herbal remedies to promote spermatogenesis. This study aimed to systematically explore the potential of herbal medicines and formulations to enhance the male reproductive function in humans. MethodsTwo prominent databases, MEDLINE and EMBASE, as well as scientific journals indexed in the Web of Science, were used for the literature search until October 2023. The studies included in the analysis focused on the impact of herbal medicines (Mucuna pruriens, Withania somnifera, Eurycoma longifolia, Panax ginseng, Lycopersicon esculentum, Crocus sativus, Vitis vinifera, Nigella sativa, Sesamum indicum, Curcuma longa, Lepidium peruvianum) and Chinese and Korean Polyherbal formulations (Shao-Fu-Zhu-Yu-Tang; 少腹逐瘀汤) on human serum reproductive hormone levels, semen parameters, and antioxidant enzymes. ResultsA total of 23 articles were deemed eligible for the review and meta-analysis, which included 1,194 men from seven countries (China, Korea, Iran, Peru, Japan, Malaysia, and India). Of these, 19 articles were analyzed for semen parameters. The use of herbal medicine increased seminal parameters, including semen volume during each ejaculation (standardized mean difference (SMD) = 0.89; 95 % CI: 0.52, 1.26), sperm concentration (SMD = 1.97; 95 % CI: 1.30, 2.64), total sperm count (SMD = 2.28; 95 % CI: 1.44, 3.11), sperm motility (SMD = 1.07; 95 % CI: 0.68, 1.46), and normal morphology (SMD = 1.47; 95 % CI: 0.62, 2.32). Additionally, 18 articles that analyzed sex hormone levels showed that treatment with herbal medicines favorably reduced serum prolactin (SMD = -0.70; 95 % CI: -1.13, -0.28) and FSH levels (SMD = -1.07; 95 % CI: -1.56, -0.56). Meanwhile, herbal medicines did not affect testosterone levels (SMD = 0.41; 95 % CI: -0.24, 1.06) and LH levels (SMD = 0.45; 95 % CI: -0.33, 1.23). Finally, six articles were analyzed for seminal biochemical and antioxidant profiles, and the results showed that herbal medicine increased the levels of ascorbic acid (SMD = 1.19; 95 % CI: 0.51, 1.86), corrected seminal fructose (SMD = 1.32; 95 % CI: 0.89, 1.76), superoxide dismutase activity (SOD) (SMD = 1.06; 95 % CI: 0.45, 1.68), and catalase activity (SMD = 0.91; 95 % CI: 0.69, 1.44) in seminal plasma. ConclusionHerbal remedies have been found to promote spermatogenesis by optimizing semen parameters, sex hormone levels, and antioxidant profiles. As a result, these treatments should be regarded as complementary approaches to male infertility.
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