Department of Physiology, Faculty of Medicine, MAHSA University, Jalan SP2, Bandar Saujana Putra, 42610 Jenjarom, Selangor, Malaysia; American Center for Reproductive Medicine, Cleveland Clinic, 10681 Carnegie Avenue, Cleveland, OH 44195, USA.
American Center for Reproductive Medicine, Cleveland Clinic, 10681 Carnegie Avenue, Cleveland, OH 44195, USA.
Reprod Biomed Online. 2018 Mar;36(3):311-326. doi: 10.1016/j.rbmo.2017.11.007. Epub 2017 Dec 7.
To manage male infertility caused by hormonal imbalance, infections and other predicaments, multifarious treatment strategies are emerging worldwide. Contemporary treatments, such as assisted reproductive techniques, are costly with low success rates of only 10-30%; however, herbal remedies are gaining more attention as an alternative or supplementary therapeutic modality for male infertility. The beneficial effects induced by oral intake of the roots of a small evergreen shrub, Withania sominifera (Ashwagandha) on semen quality of infertile men have previously been studied. Oral intake of Ashwagandha roots has been found to inhibit lipid peroxidation, improve sperm count and motility, and regulate reproductive hormone levels. The molecular mechanisms of these effects, however, are yet to be unveiled. In this review, we will discuss the role of herbal medicines in male infertility; provide a detailed analysis of various human and animal studies involving Withania somnifera; describe a proposed direct oxidative mechanism involving mitigation of oxidative stress as well as an indirect mechanism consisting of a gamma-aminobutyric acid-like-mimetic pathway ameliorating hormonal balance through crosstalk among different endocrine glands to improve male fertility; and how Withania somnifera supplementation mitigates risk factor-induced male infertility as well as ameliorates male fertility.
为了治疗由激素失衡、感染和其他疾病引起的男性不育，全球范围内正在涌现出多种治疗策略。现代的治疗方法，如辅助生殖技术，费用昂贵，成功率只有 10-30%；然而，草药疗法作为治疗男性不育的替代或补充治疗方法越来越受到关注。先前已经研究过口服小常绿灌木南非醉茄（Ashwagandha）的根对不育男性精液质量的有益影响。口服 Ashwagandha 的根已被发现可以抑制脂质过氧化，提高精子数量和活力，并调节生殖激素水平。然而，这些作用的分子机制尚待揭示。在这篇综述中，我们将讨论草药在男性不育中的作用；详细分析涉及南非醉茄的各种人体和动物研究；描述一种拟议的直接氧化机制，包括通过减轻氧化应激以及一种间接机制来改善激素平衡，间接机制通过不同内分泌腺之间的串扰来模拟γ-氨基丁酸样物质，从而改善男性生育能力；以及 Ashwagandha 补充剂如何减轻由风险因素引起的男性不育并改善男性生育能力。
