Medicinal plants as potential male anti-infertility agents: a review

Dose-Dependent Protective Effect of Hygrophila auriculata Seeds on Cyproterone Acetate-Induced Testicular Dysfunction

Infertility affects 15% of global population. This study was designed to search out the most effective dose of chloroform fraction of hydro-ethanolic extract of Hygrophila auriculata seed to ameliorate cyproterone acetate (CPA)-treated male subfertility. The rats were made subfertile by CPA at the dose of 2.5 mg/100gm body weight for 45 days. The male subfertility represented by low sperm concentration, less motile, less viable, and less hypo osmotic tail swelled spermatozoa in CPA-treated group. Serum LH, FSH, and testosterone levels were significantly decreased in CPA-treated group in respect to control. Androgenic key enzyme Δ5,3β-HSD, 17β-HSD activities and gene expression pattern were also decreased significantly in respect to control. These antispermatogenic and antiandrogenic activities of CPA were significantly recovered after the treatment of Hygrophila auriculata at the dose of 2.5 mg, 5mg, and 10 mg/100gm body weight. CPA also generate oxidative free radical that indicated by altered catalase, superoxide dismutase, and peroxidase activities and protein expression pattern along with conjugated diene and thiobarbituric acid reactive substance levels in testis. Expression pattern of Bax and Bcl2 genes were deviated from control after CPA treatment. Significant diminution of body weight, organo-somatic indices, and SGOT, SGPT activities were observed in CPA-treated group. All these biomarkers significantly recovered towards control after the treatment of Hygrophila auriculata at different doses. More significant recovery was observed in 5 mg and 10 mg of chloroform fraction-treated group and 5 mg dose, i.e., the minimum therapeutic dose to recover the CPA-induced subfertility.

Chamomile and Urtica dioica extracts improve immunological and histological alterations associated with polycystic ovarian syndrome in DHEA -induced mice

BACKGROUND

One of the novel mechanisms in the pathogenesis of Polycystic ovary syndrome (PCOS) is low-grade chronic inflammation. Chamomile (Matricaria recutita L.) and Nettle (Urtica dioica), with phytoestrogenic and antioxidant properties, are traditionally used to treat gynecological diseases. This study investigated the immune-modulating effects of these two plants.

METHODS

Following the induction of PCOS by subcutaneous injection (SC) of Dehydroepiandrosterone (DHEA) in BALB / C mice. Mice were treated in five groups: Sham, PCOS, PCOS + Chamomile, PCOS + Nettle, and PCOS + Chamomile and Nettle for 21 days. Ovarian morphology, blood antioxidant capacity, the abundance of Treg cells, and expression of matrix metalloproteinase-9 (MMP-9), transforming growth factor-ß (TGF-ß), cyclooxygenase-2 genes (COX-2), and tumor necrosis factor-alpha (TNF-α) were measured.

RESULTS

Folliculogenesis, Cystic follicles, and corpus luteum improved in the treatment groups (P < 0. 05). Treg cells in the DHEA group were significantly reduced compared to the Sham group (P < 0. 01). However, this decrease was not corrected in treatment groups (P > 0. 05). Total serum antioxidant capacity was significantly increased in the treatment group of Nettle and Chamomile + Nettle (P < 0. 05). The expression of MMP9 and TGFβ genes in the PCOS group was significantly higher than the Sham group (P < 0. 05), which the expression of MMP9 was corrected by treatment with Chamomile + Nettle extract (P < 0. 05).

CONCLUSION

Chamomile and Nettle extract may be an effective supplement in improving the histological and immunological changes of PCOS. However, more research is needed to confirm its effectiveness in humans.

Knowledge on ethnogynaecology of Indian Tribes- a comprehensive review

ETHNOPHARMACOLOGICAL RELEVANCE

Ethnogynaecology is an emerging branch of science dealing with the treatment of gynaecological ailments by tribals, local healers, and traditional practitioners. The ethnogynaecological importance of medicinal plants in India is a fertile area to conduct more scientific studies to evaluate their potentialities, to isolate bioactive compounds, and thereby to develop drugs for the common gynaecological health-related issues faced by women everywhere.

OBJECTIVES

The Indigenous medical knowledge systems of India have not been properly documented with special reference to ethnogynaecology. This review aims to document the knowledge of ethnogynaecology among tribals, villagers, and local people inhabiting different parts of India and the bioactive compounds responsible for the action. This review provides a vast record of medicinal plants and their parts used, types of formulations, dosage, and ethno-gynaecological usage.

MATERIALS AND METHODS

The detailed investigation of ethnobotanical and ethnogynaecological-related literature published between 1985 and 2021 by different scientific tools such as journals, books, and current electronic databases like Springer Link, SciFinder, Google Scholar, Web of Science, Wiley, ACS, Science Direct and Pubmed have been considered for the present study. The study included 300 articles published between 1985 and 2021 by scientific search using various standard databases. The tribals, vaidyas, traditional practitioners, indigenous medical healers, and local people of different regions in India have recognized the importance of ethnogynaecological uses of plants. The study on ethnogynaecology is limited to a few common but significant gynaecological issues including abortion, contraception, infertility, menstruation, leucorrhoea, and obstetrics. The phytocompound compounds isolated from various parts of the plants and responsibility for the gynaecological action were documented.

RESULTS

The major ethnogynaecological disorders recorded by various studies are leucorrhoea, abortion, contraceptives, infertility and related issues, and obstetrics including the irregular physiological process of menstruation. The ethnogynaecological and ethnobotanical information has been recorded from almost all the states of India; the highest number of records on ethnogynaecology was reported from the state of Madhya Pradesh. The most explored tribal populations to record ethnogynaecological knowledge belong to the following tribes: Bhil, Munda, Irula, Kani, Malayali, Meena, Paliyar, Muthuvar, Oraon, Narikuravar, Mannan, Malayarayan, and Malapandaram. Moreover, limited or no study has been attempted to prove the knowledge of ethnogynaecology of these tribes and the efficiency of their crude drugs against pharmacological actions. The paste prepared from various parts of the plants has been used widely as primary health care materials for abortion, obstetrics, menstruation, female infertility and male infertility. Phenols, glucoside, steroids and fatty acids reported with cytotoxic activities are connected to several gynaecological disorders whereas flavonoid, coumarin, sitosterol disrupt pregnancy. The phenolic compounds induced spontaneous abortion due to the major composition aristolochic acid, ceryl alcohol, β-sitosterol. Coreopsin, butin, isobutrin, monospermoside, palastrin, butrin. Mucunine, lecithin, prurieninine, gluthione and luteolin, Indicine, kaempferol, apigenin and quercetin effected therapeutic activity against leucorrhoea. Lignin, friedelin and beta-sitosterol are reported with abortifacient properties and therapeutic ability for leucorrhoea and menorrhagia. Tannins, mimusopsic acids, taraxerol and spinaserol effected fertility problems in women and tannins, saponins, flavonoids, steroids, terpenoids and alkaloids which effected infertility.

CONCLUSION

This review reported comprehensive data on ethnogynaecological knowledge published from available literature and evident that the indigenous medical system of Indian tribes has also contributed considerably to the healthcare system and drug development of India. The fresh plant parts were identified as effective materials against various gynaecological illnesses including infertility. The root is considered an excellent plant part against obstetrics followed by abortion, menstruation, and leucorrhoea. These studies need experimental proof as well as standardization to confirm their efficiency. Promoting the sustainable use and the equitable sharing of benefits to the knowledge provider is a pathway for harnessing the conservation of this knowledge.

Comparative evaluation of solvent extracts of Azanza garckeana fruit pulp on hormonal profiles, spermiogram and antioxidant activities in rabbit bucks

The study investigated the comparative influence of different extraction solvents on spermiogram, hormonal profiles and antioxidant activities in rabbit bucks. Adult New Zealand White rabbit bucks (n=18), with average live weight of 1.2±0.03 kg and aged 10-18 mo were fed ad libitum on a commercial diet. They were administered five different Azanza garckeana (AG) fruit pulp extracts at 500 mg/kg via oral gavage, comprising control group (Con), crude (AG Cr), methanol (AG M), n-hexane (AG H), ethyl acetate (AG E)and aqueous (AG AQ) for four weeks. The extracts improved the spermiogram in rabbit bucks administered methanol (AG M) and the reaction time was significantly (P<0.05) lower in AG E group when compared to other groups. The ejaculate volume, sperm motility, pH and sperm concentration were significantly (P<0.05) higher in the AG M group when compared to the other groups. There was a significant (P<0.05) increase in concentrations of blood testosterone, follicle-stimulating hormone and luteinising hormone in methanol extract group (AG M). While the glutathione and malondialdehyde concentrations were (P<0.05) lower, catalase and superoxide dismutase activities were significantly (P<0.05) higher in the groups administered methanol extract (AG M). It was concluded that AG M extracts of AG pulp elicited the best response in spermiogram, hormonal concentrations and antioxidant activities in New Zealand White rabbit bucks. Its use as the extraction solvent is recommended.

Effect of Flavonoid-Rich Extract From Dalbergiella welwitschii Leaf on Redox, Cholinergic, Monoaminergic, and Purinergic Dysfunction in Oxidative Testicular Injury: Ex Vivo and In Silico Studies

The antioxidant, cholinergic, monoaminergic, and purinergic activities of flavonoid-rich extract from Dalbergiella welwitschii leaf (FEDW) were investigated on oxidative testicular injury (ex vivo) due to the local report on the use of this plant as anti-testicular injury. Flavonoid extract was obtained from FEDW using a standard procedure. Five male albino rats were used, testes harvested and incubated with FeSO₄ for accessing the cholinergic, monoaminergic, and purinergic activities of the FEDW (ex vivo). Testicular tissues incubated with FeSO₄ demonstrated a significant decrease in antioxidant biomarkers, arginase, ATPase, ENTPDase, 5'-nucleotidase, and PDE-5 activities, as well as Zn and sialic acid levels with an upsurge in malondialdehyde (MDA), and NO levels, myeloperoxidase, cholinesterases, monoamine oxidase (MAO), and angiotensin-converting enzyme (ACE) activities. Treatment of testicular tissues incubated with FeSO₄ via different concentrations of FEDW significantly increased the activities of antioxidant, arginase, ATPase, E-NTPDase, 5'-nucleotidase, phosphodiesterase-5 (PDE-5), as well as Zn and sialic acid levels with a significant decrease in MDA, nitric oxide (NO), myeloperoxidase, cholinesterases, MAO, and ACE levels. Molecular docking revealed the molecular interactions of cyclooxygenase-2 (COX-2) with ellagic acid, piperine, and caffeine with piperine and caffeine obeyed the druggability and pharmacokinetic. These findings point to FEDW as a possible potential for the treatment of oxidative testicular injury.

Use of Tribulus terrestris and Lepidium meyenii extract in rats: reproductive, biochemical and body parameters

The oral administration of Tribulus terrestris and Lepidium meyenii extracts on reproductive, biochemical and body parameters was evaluated in rats. Thirty-six male Wistar rats weighting 210 ± 18 g were divided into six experimental groups (n = 6). Each group received, daily for 28 days, different solutions: T. terrestris (100 mg/kg), L. meyenii (1 g/kg) and T. terrestris at doses of 75, 50 and 25 mg/kg combined with L. meyenii at doses of 0.25, 0.5 and 0.75 g/kg, respectively, and distilled water (control). T. terrestris increased (p < 0.05) the serum testosterone, regardless of dose. Combined use of the extracts increased (p < 0.05) the diameter of the epididymal duct and epididymis lumen. The combinations of T. terrestris (75 and 50 mg/kg) with L. meyenii increased (p < 0.05) the sperm concentration. There were no differences (p > 0.05) in the other semen characteristics; relative weight of organs; and serum levels of urea, creatinine, alanine and aspartate transaminase, gamma glutamyl transferase, cholesterol, triglycerides, glucose, follicle-stimulating hormone and luteinizing hormone. No histopathological changes were observed (p > 0.05). It is concluded that the association of T. terrestris and L. meyenii has positive effects on serum testosterone, sperm concentration and epididymal morphology, with no evidence of effects in the testis, liver, spleen and kidneys.

GC-MS metabolomics reveals dysregulated lipid metabolic pathways and metabolites in diabetic testicular toxicity: Therapeutic potentials of raffia palm (Raphia hookeri G. Mann & H. Wendl) wine

ETHNOPHARMACOLOGICAL RELEVANCE

Raffia palm (Raphia hookeri G. Mann & H. Wendl) wine (RPW) is a natural beverage obtained from the R. hookeri consumed for refreshment and medicinal purposes. For medicinal purposes, it is used singly or as macerating agent for other medicinal plants for the treatment of several diseases.

AIM

This study investigates the effect of Raffia palm wine on dysregulated lipid metabolic pathways in testicular tissues of type 2 diabetic (T2D) rats.

METHODS

Raffia palm wine (150 and 300 mg/kg bodyweight) was administered to two T2D groups respectively, another T2D group was not administered treatment and served as negative control, while metformin served as the standard drug. After 6 weeks of treatment, the rats were sacrificed, and the testes collected. After weighing, the organs were homogenized in 20% methanol/ethanol and centrifuged at 20,000 g to extract the lipid metabolites.

RESULTS

GC-MS analysis of the supernatants revealed an alteration of the metabolites on induction of T2D, with concomitant generation of 10 metabolites. Raffia palm wine inhibited the T2D-generated metabolites while replenishing cholesterol and squalene levels, with concomitant generation of 7 and 8 metabolites for low and high dose treatment respectively. Pathway enrichment analysis of the metabolites revealed a decreased level of steroid biosynthesis and increased level of fatty acid biosynthesis. Raffia palm wine inactivated glycerolipid, fatty acid, and arachidonic acid metabolisms, fatty acid biosynthesis and fatty acid elongation in mitochondria pathways, and activated pathways for plasmalogen synthesis, mitochondrial beta-oxidation of long chain saturated fatty acids.

CONCLUSION

The replenishment and generation of these metabolites and additional ones as well as activation of pathways involved in energy generation, phospholipids, antioxidant activity, steroidogenesis and spermatogenesis suggest a therapeutic effect of Raffia palm wine against hyperglycemic-induced testicular dysfunction.

The effect of Apium graveolens L., Levisticum officinale and Calendula officinalis L. on cell viability, membrane integrity, steroidogenesis, and intercellular communication in mice Leydig cells in vitro

Several plants have the potential to protect essential reproductive processes such as spermatogenesis or steroidogenesis, however, effective concentrations and main mechanisms of action are still unknown. This in vitro study was aimed to assess the effects of Apium graveolens L., Levisticum officinale, and Calendula officinalis L. extracts on the structural integrity, functional activity and gap junctional intercellular communication (GJIC) in mice Leydig cells. TM3 cells were grown in the presence of experimental extracts (37.5; 75; 150 and 300 µg/ml) for 24 h. For the present study, high-performance liquid chromatography analysis was used to quantify flavonoids or phenolic acids. Subsequently, Leydig cell viability was assessed by alamarBlue assay, while the cell membrane integrity was detected by 5-carboxyfluorescein diacetate-acetoxymethyl ester. The level of steroid hormones production was determined by enzyme-linked immunosorbent assay. Additionally, GJIC was assessed by scalpel loading/dye transfer assay. According to our results, Apium graveolens L. significantly increased the viability and cell membrane integrity at 75 µg/ml (109.0±4.3%) followed by a decline at 300 µg/ml (89.4±2.3%). In case of Levisticum officinale and Calendula officinalis L. was observed significant decrease at 150 µg/ml (88.8±11.66%; 87.4±6.0%) and 300 µg/ml (86.2±9.3%; 84.1±4.6%). Furthermore, Apium graveolens L. significantly increased the progesterone and testosterone production (75 and 150 µg/ml) however, Levisticum officinale and Calendula officinalis L. significantly reduced steroid hormones synthesis at 150 and 300 µg/ml. Finally, the disturbance of GJIC was significantly affected at 300 µg/ml of Levisticum officinale (82.5±7.7%) and Calendula officinalis L. (79.8±7.0%). The balanced concentration ratio may support the Leydig cell function, steroidogenesis as well as all essential parameters that may significantly improve reproductive functions.

Comparison of the effect of Ceratonia siliqua L. fruit oral capsule and vitamin E on semen parameters in men with idiopathic infertility: a triple-blind randomized controlled clinical trial

OBJECTIVES

To compare the effect of oral Ceratonia siliqua (Carob) and vitamin E on sperm parameters in idiopathic infertile men.

METHODS

In this triple-blind randomized controlled trial study, fifty 20-45-year-old infertile men with idiopathic abnormal sperm parameters were selected among men referring to the infertility clinic of Al Zahra-Iran Hospital, and randomly allocated into two groups. The first group received Carob capsules, 500 mg, and the second group received vitamin E capsules three times a day for 90 days. The primary outcomes of this study were the sperm parameters (count, motility, and morphology).

RESULTS

After the intervention, the mean of sperm count increased from 49.08 to 60.22 million/mL in the carob vs. it increased from 47.64 to 58.88 million/mL in the vitamin E group (adjusted mean difference (aMD)=1.124 million/ml, 95% CI: -12.892 to 15.141). The mean sperm motility increased from 45.90 to 52.90% in the carob group but decreased from 55.23 to 38.10% in the vitamin E group (aMD=17.22%, 95% CI: 8.53 to 25.92). The mean sperms with normal morphology increased from 11.52 to 67.05% in the carob, and from 10.20 to 77.47% in the vitamin E group (aMD=-10.88%, 95% CI: -22.30 to 0.536). There was no serious side effect during the treatment course.

CONCLUSIONS

Taking 1,500 mg oral dose of Carob capsule per day for 90 days improved sperm motility but had no significant effect for improving morphology and count comparing to vitamin E capsule.

Ocimum tenuiflorum mitigates iron-induced testicular toxicity via modulation of redox imbalance, cholinergic and purinergic dysfunctions, and glucose metabolizing enzymes activities

Oxidative stress is a primary culprit in the pathophysiology of infertility conditions in males. This study investigated the effects of Ocimum tenuiflorum on redox imbalance, cholinergic and purinergic dysfunctions and glucose dysmetabolism in oxidative-mediated testicular toxicity using in vitro, ex vivo and in silico models. Induction of oxidative testicular injury was carried out by incubating normal testicular tissue with 0.1 mM FeSO₄ and treated by co-incubating with different concentrations of O. tenuiflorum infusion for 30 min at 37°C. O. tenuiflorum displayed significant ferric reducing power activity while scavenging DPPH and hydroxyl (OH˙) free radicals in vitro. Oxidative testicular injury significantly reduced the glutathione level and superoxide dismutase and catalase activities with concomitant elevation of malondialdehyde and nitric oxide levels and acetylcholinesterase, ATPase, fructose-1,6-bisphosphatase and glycogen phosphorylase (GlyP) activities. Incubation with the infusion significantly reversed these levels and activities. The phytochemical constituent of the infusion was detected by gas chromatography-mass spectroscopy analysis and revealed favourable binding energies when docked with some of the studied proteins. These results suggest O. tenuiflorum exerts a protective effect against Fe²⁺ induced testicular toxicity via mitigation of redox imbalance while modulating metabolic dysfunctions linked to male infertility.

The effect of lutein and Urtica dioica extract on in vitro production of embryo and oxidative status in polycystic ovary syndrome in a model of mice

BACKGROUND

Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrinopathies in women during the reproductive age. Herbal medicines are used increasingly alone or in supplement with chemical medicines for the treatment of different diseases and dysfunctions. This study was aimed to evaluate the effects of lutein and nettle (Urtica dioica) extract on the biochemical parameters and the reproductive function in the PCOS model of mice.

METHODS

Following the induction of PCOS by dehydroepiandrosterone (DHEA), the mice (n = 98) were randomly assigned into seven groups, each consisting of fourteen mice; the groups were included control group (received solvent), PCOS group (received 6 mg/100 g B.W/day IP, DHEA for 21 days), PCOS+ Nettle extract (200 and 400 mg/kg), PCOS+ Lutein (125 and 250 mg/kg), and PCOS+ NL (200 mg/kg nettle extract and 125 mg/kg lutein). The nettle extract and lutein were administrated using gavage for 30 consecutive days after PCOS induction. Malondialdehyde (MDA), total antioxidant capacity (TAC), and estrogen were measured in serum, ovary, and uterus samples by the ELISA method. The total number of oocytes, oocyte quality, fertilization rate, 2-cell blastocyst, and arrested embryos (type I, type II, and type III) were also investigated.

RESULTS

A combination treatment of the nettle and lutein produced the lowest concentration of MDA in comparison to other groups which affected by the PCOS. The lowest level of TAC was observed in the PCOS group without treatment. The number of oocytes, oocyte quality, fertilization rate, and 2-cell blastocyst were significantly higher in the control group, but the lowest values were observed in the PCOS group without any treatment.

CONCLUSIONS

The most favorable findings include improving antioxidant capacity, oocyte and embryo quality were observed in the PCOS+ 125 L group.

Current Insights and Latest Updates in Sperm Motility and Associated Applications in Assisted Reproduction

Spermatozoon is a motile cell with a special ability to travel through the woman’s reproductive tract and fertilize an oocyte. To reach and penetrate the oocyte, spermatozoa should possess progressive motility. Therefore, motility is an important parameter during both natural and assisted conception. The global trend of progressive reduction in the number and motility of healthy spermatozoa in the ejaculate is associated with increased risk of infertility. Therefore, developing approaches for maintaining or enhancing human sperm motility has been an important area of investigation. In this review we discuss the physiology of sperm, molecular pathways regulating sperm motility, risk factors affecting sperm motility, and the role of sperm motility in fertility outcomes. In addition, we discuss various pharmacological agents and biomolecules that can enhance sperm motility in vitro and in vivo conditions to improve assisted reproductive technology (ART) outcomes. This article opens dialogs to help toxicologists, clinicians, andrologists, and embryologists in understanding the mechanism of factors influencing sperm motility and various management strategies to improve treatment outcomes.

The influence of graded levels of Cyathula prostrata (Linn.) Blume on semen quality characteristics of adult New Zealand white bucks

Cyathula prostrata (Linn.) Blume is a tropical herbal plant known for its important phytochemical contents and medicinal properties. But its impact on animal reproduction and fertility is yet to be fully established. Therefore, we tested the hypothesis that C. prostrata (Linn.) Blume will improve the semen quality characteristics of New Zealand White buck rabbit. Twenty-eight post-pubertal buck rabbits were used for the study. The animals were randomly assigned to four treatment groups (n = 7 per treatment) where they were fed either the control diet—0 g C. prostrata (Linn.) Blume or any of the three experimental diets containing the graded levels of C. prostrata (Linn.) Blume incorporated into rabbit pellets at 10, 20 or 30 g C. prostrata (Linn.) Blume per kg feed. The results showed that the semen volume and pH were not different between groups. Interestingly, sperm motility significantly decreased (P < 0.05) in a dose-dependent manner. Similarly, the sperm morphology also decreased in a dose-related fashion with 20 g (77.75 ± 1.31%) and 30 g (79.00 ± 2.20%) C. prostrata (Linn.) Blume being significantly (P < 0.05) lower compared with groups 0 g (88.50 ± 1.44%) and 10 g (87.50 ± 4.33%) C. prostrata (Linn.) Blume, respectively. In conclusion, the addition of C. prostrata (Linn.) Blume into the normal rabbit feeds had a positive effect on sperm count, but reduced sperm motility and morphology, and may be associated with spermatogenesis-related problems.

Chemotherapeutic Potential of Epimedium brevicornum Extract: The cGMP-Specific PDE5 Inhibitor as Anti-Infertility Agent Following Long-Term Administration of Tramadol in Male Rats

Epimedium brevicornum Maxim (EbM) is a well-known Chinese herb that has been widely used for the treatment of several diseases. The main purpose of this study is to examine the role of Epimedium brevicornum extract in certain andrological parameters in rats as a natural modulator for adverse viewpoints associated with chronic administration of tramadol (TAM). Fifty rats were categorized into five groups. Untreated rats were known as Group I, whereas rats in Groups II and III were administered 2.43 g/kg/day of E. brevicornum extract and 50 mg/kg/day of TAM for 130 consecutive days, respectively. Both of Groups IV and V were administered TAM for 65 successive days, followed by concomitant use of both drugs for another 65 days, with the E. brevicornum extract at doses of 0.81 and 2.43 g/kg/day, respectively. TAM showed an injurious effect on sperm attributes, serum hormones, tissue malondialdehyde, superoxide dismutase, and nitric oxide. Elevation of the apoptotic marker Bax and a reduction of Bcl2 were recorded. Histopathological abnormalities have been reported in rat testicles. Rats treated with E. brevicornum extract with TAM showed an improvement in all the parameters tested. It could be presumed that E. brevicornum extract plus TAM exhibits a promising effect on the enhancement of male anti-infertility effects.

Plants in the management of male infertility

This review attempts to collate existing data and provide the perspectives for future studies on the effects of plants on the male gonads. For many of these medicinal plants such as Lepidium meyenii, Rupus coreanus, Tribulus terrestres, Panax ginseng, Petasites japonicas, Apium graveolens, Eurycoma longifólia, Pedalium murex, Corchorus depressus, Mucuna pruriens, Astragalus membranaceus, Nigella sativa, Crataegus monogyna, Fagara tessmannii, Phaleria macrocarpa, Anacyclus pyrethrum, Cynomorium songaricum and Morinda officinalis, the mechanism of actions of their active principles and crude extracts has been shown in both laboratory animals, in vitro, and human studies, and includes their antioxidant, anti-inflammatory, spermatogenesis-inducing, aphrodisiac, smooth muscle relaxing and androgenic properties. Several active chemical leads including glucosinolates, anthocyanins, protodioscin, ginsenosides, sesquiterpenes, phyto-oestrogens, quassinoids, diosgenin, thymoquinone, proanthocyanidins and bajijiasu isolated from these plants are known to have target effects on the testis, but efforts have been limited in their application at the clinical level. There still appear to be many more extracts of medicinal plants that have not been characterised to determine the phytochemicals unique to them that have target effects on the gonads. Further, collaborative efforts at isolating pro-drug candidates from medicinal plants for studies at the molecular, cellular and clinical level towards elucidating their mechanisms of action on the testes are therefore warranted in the light of the current male fertility crisis.

Herbal remedies used for the treatment of infertility in males and females by traditional healers in the rural areas of the West Bank/Palestine

Background

Infertility is considered one of the global public health problems and during human history, it is also considered one of the unsolved problems of the continuous human race. This study aimed to collect and document the ethnopharmacological data on herbal remedies, which traditionally used by Palestinian healers in the rural areas of the West Bank area for the treatment of infertility in males and females.

Methods

Using a semi-structured questionnaire, an ethnopharmacological survey of medicinal plants used for the treatment of infertility in the West Bank area of Palestine was investigated. This survey involved 51 traditional healers which were interviewed in rural areas from 9 Palestinian regions.

Results

Information about 31 plants used in the treatment of infertility in females and 24 plants used in the treatment of infertility in males were collected. This information including names of plants, parts used, mode and methods of preparation which were obtained from 51 traditional healers interviewed in rural areas of 9 regions of the West Bank/Palestine. This investigation is the first scientific work in the Middle East area which collected information about herbal remedies used by local Palestinian traditional healers for the treatments of infertility in males and females. The highest Frequency of Citation (FC) of herbal remedies used in case of infertility in females, were 98.04% for pollen grains from Ceratonia siliqua, 88.24% for Anastatica hierochuntica fruits and 84.31% for Parietaria judaica leaves, while the highest Frequency of Citation (FC) of herbal remedies used in case of infertility in males were 96.08% for Ferula hermonis roots, 88.24% for Phlomis brachyodon leaves and 86.27% for Phoenix dactylifera pollen grains.

Conclusion

Herbal healers in the West Bank area of Palestine have a wide range of herbal remedies used in case of infertility in males and in females. Unfortunately, most of them lack scientific evidence of pharmacological or toxicological nature. Therefore, the information obtained in this study can serve as a scientific base for further investigations to determine their efficacy and safety which might contribute to better integration of Palestinian traditional medicine into the global health system in the future.

The effect of celery (Apium graveolens L.) on fertility: A systematic review

Background

Fertility and infertility problems are among the complex issues in medicine. The use of herbal products in the treatment of fertility has been considered as an alternative to synthetic drugs. Celery containing known compounds can have an impact on the fertility rate. The aim of this study was to do a systematic review on conducted studies in conjunction with the celery and reproduction.

Methods

Required papers were searched from databases like Science direct, PubMed, Scopus, and Springer. Keywords used in this study were “Apium graveolens L.”, “fertility”, “reproductive system”, “sperm”, “testis”, “delivery”, “sexual hormone”, “LH”, “FSH”, “testosterone”, “semen”, “male”, and “female”. Out of 238 collected articles (published in the period 1995 to 2015), 222 were excluded due to non-relevance and lack of access to the original article.

Results

The notable points were the different results seen by different researchers during different treatment periods or at different doses. Of the 16 studies reviewed in this study, 13 studies have mentioned the positive effect of celery on fertility, while three studies reported the inhibitory effects of this plant.

Conclusions

Celery can have protective effects against substances such as sodium valproate, propylene glycol, and diethyl phthalate causing damages to the testicular structure and spermatogenesis. In this regard, the doses used and the treatment time while using the plant must be accurately investigated. Since there are compounds such as apigenin, the celery can induce inhibitory effects on fertility in case of chronic use or high concentration.

Mimosa pudica Protects the Testes Against Cadmium-Induced Inflammation and Oligospermia: Potential Benefits in Treatment of Heavy Metal Toxicity

Cadmium is a known environmental and industrial pollutant with an enormous tissue disrupting potential. Mimosa pudica (M. pudica) is a creeping annual or perennial herb known to possess anti asthmatic, anti-epileptic, anti-tumour, anti-fertility, aphrodisiac, analgesic, anti-depressant, sedative, emetic properties and a strong radical scavenging activity. This research was aimed at investigating the ameliorative effects of M. pudica on cadmium-induced testicular damage in adult male Sprague Dawley rats. Twenty adult Sprague Dawley rats were employed in the study. They were divided into 4 groups (A-D) of 5 rats each, and toxicity was induced by administering 0.4 mg/ml cadmium chloride through drinking water to groups B-D for 21days. M. pudica extract was administered orally at 250 and 500 mg/kg to groups C and D. Animals in Groups C and D showed remarkable histological improvements in testicular tissue and markedly reduced damages when compared with group B.The active sperm motility of group B (6.00 ± 1.00%) was significantly (p = 0.0001) decreased compared to that of the groups A (15.00 ± 0.00%)) and C (13.00 ± 1.22%). Sperm count analysis of group B (1.36 ± 0.28 × 10⁶/cc), C (4.18 ± 0.81 × 10⁶/cc) and D (2.54 ± 1.13 × 10⁶/cc) were significantly lower (p = <0.05) when compared with group A (12.78 ± 0.92 × 10⁶/cc), respectively. Sperm morphology of group A (70.00 ± 3.16%), B (66.00 ± 2.50), C (74.00 ± 2.45%) and D (64.00 ± 2.45%) recorded no significant difference. This study demonstrates that M. pudica has potential protective and restorative properties on the histoarchitecture of the testes of cadmium-treated rats.

Cyclophosphamide-induced male subfertility in mice: An assessment of the potential benefits of Maca supplement

Effects of Lepidium meyenii (Maca) on cyclophosphamide (CYP)-induced gonadal toxicity in male mice were investigated. Mice were assigned to six treatment groups: Vehicle control, CYP control, CYP plus oral Maca (500 or 1,000 mg/kg), and oral Maca (500 or 1,000 mg/kg). CYP was administered via the intraperitoneal route (days 1-2), while vehicle or Maca were administered daily for 28 days. On day 28, half of the animals in each group were either sacrificed or paired with age-matched females for fertility assessment. Plasma testosterone assay, sperm analysis and assessment of tissue antioxidant/morphological status were also carried out. CYP administration was associated with oxidative stress, subfertility and morphometric/morphological indices of gonadal injury, while administration of Maca mitigated CYP-induced gonadal toxicity and subfertility. This study shows that Maca is beneficial in the mitigation of CYP-induced male gonadal insufficiency and/or testicular morphological changes; however, further studies will be needed to ascertain its usability for this purpose in humans.

Male Infertility: The Effect of Natural Antioxidants and Phytocompounds on Seminal Oxidative Stress

Defective sperm function has been identified as the most common cause of infertility. The objective of this study was to review recent findings on the effects of various antioxidants on male fertility. High amounts of poly unsaturated fatty acid are found in the mammalian spermatozoa membranes, thereby making them susceptible to lipid peroxidation. Although, free radicals and reactive oxygen species (ROS) play major roles in reproduction, they are strongly associated with oxidative stress. Furthermore, factors such as obesity, inflammation, pollutants and cigarette smoking are negatively correlated with spermatogenesis. Endogenous antioxidants system exists to mediate these damages. In a normal physiological state, the seminal plasma contains antioxidant enzyme mechanism that is capable of quenching these ROS as well as protecting the spermatozoa against any likely damage. However, high level of ROS triggered by inflammatory cells and oxidation of fatty acid in obese subjects may down play antioxidant mechanism resulting in oxidative stress. Evaluation of such oxidative stress is the first step in the treatment of male infertility through administration of suitable antioxidant. Notably, antioxidant such as vitamin E and C, carotenoids and carnitine have been found beneficial in restoring a balance between ROS generation and scavenging activities. There are emerging evidences that herbal products can also boost male reproductive functions. Nonetheless, a good lifestyle, regular exercise, avoidance of stress and observing safety rules at work are habits that can reverse male infertility.

Effect of standardized extract of Bacopa monnieri (CDRI-08) on testicular functions in adult male mice

ETHNOPHARMACOLOGICAL RELEVANCE

Bacopa monnieri (BM) has been used in India since the time of Rig-Veda for augmentation of learning, memory, brain health etc.

AIM OF THE STUDY

The memory augmenting effect of BM is well documented. CDRI-08 is a standardized extract of Bacopa monnieri, but its effect on the male reproductive health has not been investigated. Therefore, the aim of the present study was to examine the effect of CDRI-08 administration on the male reproductive organs with special emphasis on testis in adult mice.

MATERIALS AND METHODS

CDRI-08, containing at least 55% bacosides (the major constituent of BM), was investigated for its effect on testicular functions in adult Parkes (P) mice. A suspension of CDRI-08 was orally administered in doses of 40 and 80mgkg^-1 body weight day^-1 for 28 days and various male reproductive end points were evaluated.

RESULTS

Compared to control, CDRI-08 treatment caused a significant increase (p<0.05) in spermatogenic cell density (germinal epithelial height: control, 55.03±4.22 vs 40mg, 67.15±2.65 and 80mg, 69.93±3.76; and tubular diameter: control, 206.55±2.62 vs 80mg, 253.23±12.19), PCNA index (control, 59.85±2.09 vs 40mg, 82.17±1.56 and 80mg, 84.05±3.51) and in steroidogenic indices in the testis, and in sperm viability (control, 0.67±0.010 vs 80mg, 0.80±0.04) in cauda epididymidis of the treated mice. On the other hand, however, the same treatment caused a significant decrease (p<0.05) in abnormal sperm morphology (control, 21.72±1.06 vs 40mg, 10.63±1.50 and 80mg, 15.86±0.87) in cauda epididymidis, and in lipid peroxidation level in testis of the treated mice compared to controls.

CONCLUSION

The results suggest that treatment with CDRI-08 extract improves sperm quality, and spermatogenic cell density and steroidogenic indices in the testis of P mice.

Medicinal plants used in Lesotho for treatment of reproductive and post reproductive problems

ETHNOPHARMACOLOGICAL RELEVANCE

Reproductive healthcare has been highlighted as a major challenge in Lesotho mainly due to the high prevalence of HIV/AIDS and sexually transmitted infections. As a result other reproductive ailments have not received much attention, particularly because healthcare facilities are already limited and many of them are inaccessible. For these reasons, medicinal plants play a major role in primary healthcare system in the country, in addition the plants are easily accessible, more affordable, and their use forms part of the cultural heritage. However, documentation of medicinal plants used for reproductive ailments is scattered, more importantly the biological and pharmacological properties, as well as toxicity of many of these plants are not yet known.

AIM OF THE STUDY

To document the plants used by both male and female Basotho (residing in Lesotho) for the treatment of reproductive ailments, to explore their recorded biological and pharmacological effects as well as their toxicity, and to establish if these plants are used for similar purposes in other southern African cultures.

MATERIALS AND METHODS

The results stem from published findings of recent interviews of traditional medicinal practitioners in the Maseru District of Lesotho, first author's own experiences and observations from the Qacha's Nek District as well as comprehensive literature survey including numerous books and unpublished data. Electronic databases such as Google, Google Scholar, PubMed, and ScienceDirect were also used to search for the chemical compounds, pharmacological activity, and toxicity of the plants.

RESULTS

A total of 87 plant species are reported to be used for the treatment of several reproductive problems such as infertility, complications associated with pregnancy (twelve plants are used to treat conditions such as colic, heartburn, nausea, and constipation), cleansing and/ or toning of the uterus (with a purpose either to induce pregnancy or to get rid of the placenta, for example Withania somnifera and Zantedeschia albomaculata), difficult childbirth, as well treatment of breast and cervical cancer, cysts, fibroids, and testicular tumours (e.g. Hypoxis hemerocallidea). For the toning of the uterus, it is common to use a combination of plants, e.g. Gunnera perpensa, Scabiosa columbaria, and Eriospermum ornithogaloides.

CONCLUSIONS

Of the 87 plants used for reproductive healthcare, the highest number (31) is used for the treatment of infertility (in both men and women). The pharmacological effects, active compounds, and toxicology of many of these plants are not yet known.

Supplementation with Pfaffia glomerata (Sprengel) Pedersen does not affect androgenic-anabolic parameters in male rats

ETHNOPHARMACOLOGICAL RELEVANCE

Paffia spp (Amaranthacea) has a widespread use of in Brazil as a possible hormonal supplement and a substitute of Panax ginseng, although information on its reproductive effects is missing.

AIM OF THE STUDY

To evaluated possible anabolic-androgenic or anti-androgenic effects of Pfaffia glomerata (PG) extract using intact eight-months-old male rats and pre-pubertal castrated rats.

MATERIALS AND METHODS

Three different dose levels of PG (8.5, 30 and 85 mg/kg/day) were administered to eight-months-old rats for 28 days or to castrated males for 7 days (Hershberger assay). In the experiment with intact animals, 24h fecal samples were collected for quantification of fecal metabolites of androgens throughout treatment. At the end of the treatment period, animals were euthanized for evaluation of serum testosterone, reproductive organ weights, number of spermatids per testis, diameter of seminiferous tubules and cross-sectional area of soleus muscle fibers. In the Hershberber assay, androgenic or anti-androgenic effects were evaluated by the weights of androgen-dependent tissues: ventral prostate, seminal vesicle, glans penis and levator ani muscle/bulbocavernosus muscle.

RESULTS

No effects were observed in the concentrations of fecal metabolites of androgens monitored during the treatment of intact eight-months-old rats. Moreover, at the end of treatment, no changes were seen in any of the investigated parameters. In the Hershberger assay, the PG extract did not induce androgenic or anti-androgenic effects at the dose levels tested. Significant effects were only observed in animals treated with testosterone and testosterone plus flutamide, which were used as positive controls for androgenicity and anti-androgenicity, respectively.

CONCLUSIONS

At the dose levels tested, PG extract does not induce anabolic-androgenic or anti-androgenic effects in rats.

South African plants and male reproductive healthcare: conception and contraception

ETHNOPHARMACOLOGICAL RELEVANCE

Traditional remedies from plants have been use to treat male reproductive related disorders for ages in South Africa.

AIM

This study reviewed the current status of medicinal plants used in male reproductive healthcare as well as their effectiveness as a mode of treatment.

METHODOLOGY

A detailed literature search was done by consulting books, peer-reviewed papers, scientific databases such as Scopus, Science direct and PubMed, and Google scholars. Keywords such as aphrodisiacs, conception, erectile dysfunction, fertility, infertility and sterility in relation to medicinal plants were used during the search. Plant species were selected based on their traditional use in different aspects of male reproductive healthcare.

RESULTS

A total of 61 plants species were found to be used in treating male impotency or as aphrodisiacs. However, only six species have been evaluated scientifically and these plants showed significant activities either in promoting conception by improving fertility and promoting erection or in contraception by decreasing sperm motility, virility and membrane integrity.

CONCLUSION

The importance of herbal products in the treatment of male infertility and related sexual disorders is undeniable. Scientific evaluations of the six species have proved the empirical use of these plants in the improvement of male sexual disorders as well as validating their traditional uses.

Évaluation des effets prosexuels des extraits de Bridelia ferruginea chez le rat mâle naïf

Bridelia ferruginea (BF, Euphorbiaceae) est un arbre dont les écorces du tronc et les feuilles sont utilisées en médecine traditionnelle pour remédier à plusieurs problèmes et en particulier l’impuissance masculine. La présente étude vise à identifier les effets prosexuels (fréquences d’érection, de monte, d’intromission et d’éjaculation) des extraits aqueux (100 mg/kg) et éthanolique (100 mg/kg) des écorces du tronc de BF administrés par voie orale à des rats Wistar adultes mâles (intacts ou castrés) sexuellement inexpérimentés pendant zéro, un et sept jours. Le comportement sexuel des rats normaux recevant une administration unique de l’extrait aqueux de BF (100 mg/kg) a été aussi évalué après prétraitement par le L-omega-nitro-arginine methyl ester (Lω-NAME, 10 mg/kg), l’halopéridol (10 mg/kg) ou l’atropine (10 mg/kg). Les animaux témoins ont reçu per os de l’eau distillée (10 ml/kg) pour le témoin neutre et une injection sous-cutanée de testostérone propionate (20 mg/kg par jour pendant trois jours avant le début du test) pour le témoin positif. Les résultats de l’étude montrent que la durée du traitement a un impact significatif (p < 0,05) sur les fréquences d’érection pénienne, de monte et d’intromission aussi bien chez les rats normaux que chez les animaux castrés. Une tendance à l’augmentation des paramètres de performance sexuelle a été aussi observée. La fréquence d’intromission des rats intacts était plus élevée (p < 0,05–0,01) à J1 et particulièrement chez les rats recevant l’extrait aqueux de BF. Chez les rats castrés, par contre, seuls les animaux traités par la testostérone ont présenté une augmentation statistique (p < 0,01–0,001) des paramètres copulatoires. Les effets prosexuels de l’extrait aqueux de BF étaient abolis par l’atropine et l’halopéridol, tandis qu’une préadministration de Lω-NAME était sans effet sur l’activité copulatoire des animaux. Ces effets stimulants sexuels de BF pourraient être attribués à la présence des flavonoïdes et des stérols, substances bioactives qui agiraient par voie dopaminergique et/ou cholinergique, et soutiennent l’intérêt de l’emploi de BF en médecine traditionnelle comme stimulant sexuel.

Potential protective effect on key steroidogenesis and metabolic enzymes and sperm abnormalities by fenugreek steroids in testis and epididymis of surviving diabetic rats

The current study showed that the daily oral treatment of fenugreek steroids, designated F(steroids), to diabetic rats during 30 days demonstrated a significant (p < 0.05) decrease of blood glucose level and a considerable increase of the area of insulin-immunoreactive beta-cells in diabetic rats. Interestingly, this study showed that F(steroids) potentially unregulated the key steroidogenesis enzymes such as 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA reductase), malic enzyme, 3beta-hydroxysteroid dehydrogenase (3beta-HSD) and glucose-6-phosphate dehydrogenase (G6P-DH) activities as cholesterol rate in testis, which considerably enhanced testosterone and estradiol levels in the plasma of surviving diabetic rats. More interestingly, F(steroids) obviously prevented the alteration of the key carbohydrate enzymes such as hexokinase and pyruvate kinase activities as well as testicular glycogen and seminal fructose contents in surviving diabetic rats. Furthermore, F(steroids) administration to surviving diabetic rats significantly decreased the sperm shape abnormality and improved the sperm count. Above all, the potential protective action of reproductive systems was approved by the histological study of testis and epididymis.