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中草药治疗男性因素不孕的效果:一项随机对照试验的研究方案。

The effect of Chinese herbal medicine on male factor infertility: study protocol for a randomized controlled trial.

机构信息

Foshan Clinical Medical School of Guangzhou University of Chinese Medicine, Foshan, Guangdong, China.

TCM Gynecology Department, Foshan Fosun Chancheng Hospital, Foshan, Guangdong, China.

出版信息

Front Endocrinol (Lausanne). 2024 Jul 22;15:1418936. doi: 10.3389/fendo.2024.1418936. eCollection 2024.

DOI:10.3389/fendo.2024.1418936
PMID:39104817
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11298452/
Abstract

BACKGROUND

The global prevalence of infertility is 9%, with male factors potentially accounting for 40% to 60% of cases. Conventional treatments can be ineffective, invasive, costly, and linked to adverse effects and high risks. Previous studies have shown that, Chinese herbal medicine (CHM) can regulate the hypothalamus-pituitary-testis axis, improve sperm abnormalities and quality, mitigate oxidative stress, and decrease DNA fragmentation index (DFI). Yet, the evidence backing the use of Chinese herbal medicine (CHM) for treating male factor infertility lacks conviction due to study design limitations, and there remains a scarcity of studies on the live birth rate following CHM treatment for male factor infertility. Here, we describe the rationale and design of a randomized waitlist-controlled trial to evaluate the effect of CHM on the live birth rate among males with infertility.

METHODS

This study is a single-center, randomized, waitlist-controlled study. A total of 250 couples diagnosed with male factor infertility will be enrolled in this study and then randomly allocated into two groups in a 1:1 ratio. Male participants in CHM group (treatment group) will receive CHM once a day for 3 months. Male participants in the waitlist group (control group) will not receive any treatment for 3 months. After 3 months, participants in both groups need to be followed up for another 12 months. The primary outcome will be the live birth rate; secondary outcomes include semen quality parameters, DFI and pregnancy related outcomes. Safety will also be assessed.

DISCUSSION

The purpose of this trial is to explore the effects and safety of CHM on the live birth rate among couples dealing with male factor infertility. The outcome of this trial may provide a viable treatment option for male factor infertility.

TRIAL REGISTRATION

Chinese Clinical Trial Registry: ChiCTR2200064416. Registered on 7 October 2022, https://www.chictr.org.cn.

摘要

背景

全球不孕症的患病率为 9%,男性因素可能占 40%至 60%的病例。传统的治疗方法可能无效、有创、昂贵,且与不良反应和高风险相关。先前的研究表明,中草药(CHM)可以调节下丘脑-垂体-睾丸轴,改善精子异常和质量,减轻氧化应激,降低 DNA 碎片指数(DFI)。然而,由于研究设计的限制,支持使用中草药(CHM)治疗男性因素不孕的证据缺乏说服力,并且关于 CHM 治疗男性因素不孕后的活产率的研究仍然很少。在这里,我们描述了一项随机等待对照试验的原理和设计,以评估 CHM 对男性不孕夫妇活产率的影响。

方法

这是一项单中心、随机、等待对照研究。共有 250 对被诊断为男性因素不孕的夫妇将被纳入本研究,并以 1:1 的比例随机分为两组。CHM 组(治疗组)的男性参与者将每天服用 CHM 一次,持续 3 个月。等待组(对照组)的男性参与者将在 3 个月内不接受任何治疗。3 个月后,两组参与者均需再随访 12 个月。主要结局将是活产率;次要结局包括精液质量参数、DFI 和妊娠相关结局。安全性也将进行评估。

讨论

本试验的目的是探讨 CHM 对男性因素不孕夫妇活产率的影响和安全性。该试验的结果可能为男性因素不孕提供一种可行的治疗选择。

试验注册

中国临床试验注册中心:ChiCTR2200064416。于 2022 年 10 月 7 日注册,网址:https://www.chictr.org.cn。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8790/11298452/c62cb4ee2188/fendo-15-1418936-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8790/11298452/c62cb4ee2188/fendo-15-1418936-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8790/11298452/c62cb4ee2188/fendo-15-1418936-g001.jpg

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本文引用的文献

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European Association of Urology Guidelines on Male Sexual and Reproductive Health: 2021 Update on Male Infertility.欧洲泌尿外科学会男性性健康和生殖健康指南:男性不育症 2021 年更新版。
Eur Urol. 2021 Nov;80(5):603-620. doi: 10.1016/j.eururo.2021.08.014. Epub 2021 Sep 10.
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Diagnosis and Management of Infertility: A Review.不孕不育的诊断与管理:综述。
JAMA. 2021 Jul 6;326(1):65-76. doi: 10.1001/jama.2021.4788.
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The effect of antioxidants on male factor infertility: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial.
抗氧化剂对男性因素不孕的影响:男性、抗氧化剂和不孕(MOXI)随机临床试验。
Fertil Steril. 2020 Mar;113(3):552-560.e3. doi: 10.1016/j.fertnstert.2019.11.008. Epub 2020 Feb 25.
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Effect of Folic Acid and Zinc Supplementation in Men on Semen Quality and Live Birth Among Couples Undergoing Infertility Treatment: A Randomized Clinical Trial.叶酸和锌补充剂对接受不孕治疗的夫妇的精液质量和活产率的影响:一项随机临床试验。
JAMA. 2020 Jan 7;323(1):35-48. doi: 10.1001/jama.2019.18714.
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A Randomized Trial to Evaluate the Effects of Folic Acid and Zinc Supplementation on Male Fertility and Livebirth: Design and Baseline Characteristics.一项评估叶酸和锌补充剂对男性生育力和活产影响的随机试验:设计和基线特征。
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Cochrane Database Syst Rev. 2019 Mar 14;3(3):CD007411. doi: 10.1002/14651858.CD007411.pub4.
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Environmental Toxins and Male Fertility.环境毒素与男性生育能力
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