Withania somnifera (Indian ginseng) in male infertility: An evidence-based systematic review and meta-analysis
Durg S, et al
Published in Phytomedicine
Methodology
Evidence-based systematic review and meta-analysis following PRISMA; searches of PubMed/MEDLINE, EMBASE, Scopus, the Cochrane Library and DHARA, plus grey literature from the WHO ICTRP and ClinicalTrials.gov; meta-analysis performed on observational pre- versus post-treatment data only.
Key Findings
This PRISMA systematic review of Withania somnifera in male infertility found only four clinical trials (five publications): four observational and just one randomised controlled trial, so no meta-analysis of randomised data was possible. In oligospermic men, 90 days of treatment increased sperm concentration by 167%, semen volume by 59% and sperm motility by 57% versus baseline (p <= 0.002), with testosterone up 17% and luteinizing hormone up 34%. Pooling the observational before-and-after studies showed increases in semen volume (0.28 mL, 95% CI 0.12 to 0.43), sperm concentration (13.57 million/mL, 95% CI 11.12 to 16.01) and motility (8.50%, 95% CI 7.36 to 9.63), with a 14% pregnancy success rate in normozoospermic men and no reported adverse effects. The authors judge the data too limited to be robust.
Conclusions
Due to a small number of eligible studies, the available data, though promising, are too limited to provide novel and sufficiently robust evidence of the benefits of W. somnifera in male infertility.
Limitations
Only one randomised trial existed; the pooled results come from uncontrolled before-and-after observational studies, which cannot separate treatment effect from natural variation, regression to the mean or placebo response. All studies were small and from a narrow set of research groups.
Supplements Studied
The available data, though promising, are too limited to provide novel and sufficiently robust evidence of the benefits of W. somnifera in male infertility.
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