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Objective: To observe the effect and safety of the traditional Chinese medicine (TCM) Linggui Formula (LGF) in the treatment of asthenospermia with kidney deficiency and blood stasis., Methods: This randomized controlled trial included 90 cases of asthenospermia with kidney deficiency and blood stasis treated in our hospital from September 2022 to September 2023, 45 by oral medication with LGF (the trial group) and the other 45 with oral levocarnitine solution (the control group), all for 12 weeks. We followed up the patients for 12 weeks, recorded the semen parameters, TCM syndrome scores, sexual hormone levels, pregnancy rates, and DNA fragmentation index (DFI) of the patients, and compared them between the two groups before and after treatment., Results: Totally, 82 of the patients completed the study, 42 in the trial and 40 in the control group. After treatment, the patients in the trial group showed significant increases in the percentage of progressively motile sperm (PMS) (from ［19.25±3.08］% to ［38.57±4.99］%, P< 0.05), total sperm motility (from ［32.29±3.64］% to ［46.50±4.77］%, P< 0.05) and sperm concentration (from ［83.9±37.2］ to ［95.1±34.9］× 10⁶/ml ］, P< 0.05), and so did the controls in PMS (from ［19.75±4.28］% to ［34.46±5.07］%, P< 0.05), total sperm motility (from ［33.02±4.93］% to ［43.11±4.72］%, P< 0.05) and sperm concentration (from ［85.2±39.7］ to ［88.1±35.2］ × 10⁶/ml , P< 0.05), all even more significant in the trial than in the control group (P< 0.05). No statistically significant difference was observed in the semen volume either in the trial (from ［3.38±0.38］ to ［3.24±0.45］ ml, P> 0.05) or in the control group (from ［3.46±0.52］ to ［3.30±0.37］ ml, P> 0.05), or between the trial and control groups (P> 0.05), or in the sexual hormone levels, pregnancy rates, and sperm DFI between the two groups before and after treatment (P> 0.05). Both groups of patients had good safety profiles without serious adverse reactions., Conclusion: Linggui Formula can improve the percentage of PMS in asthenospermia patients with kidney deficiency and blood stasis, potentially enhancing pregnancy rates and with a good safety.

Oligoasthenozoospermia (OAS) is one of the most common types of male infertility, which, however, still lacks effective treatment. An increasing number of studies have shown the potential therapeutic value of omega-3 polyunsaturated fatty acid (ω-3 PUFA) in the treatment of OAS. This article presents an overview of the studies on the effects of ω-3 PUFA on fatty acid composition and metabolism, inflammatory response, and oxidative stress in OAS, hoping to provide some new ideas for the treatment of the disease.

Objective: To observe the clinical effect of combined application of Compound Amino Acid Capsule (8-11) (CAAC8-11) and L-carnitine (LC) in the treatment of idiopathic asthenospermia (IAS), and to explore its possible therapeutic mechanism., Methods: Based on the principle of double-blind and control, we selected 120 cases of IAS meeting the diagnostic criteria of asthenospermia in the WHO Manual for the Examination and Processing of Human Semen (5th Ed) and randomly divided them into three groups of an equal number: CAAC8-11 + LC, LC control and blank control, the former given CAAC8-11 in addition to LC oral liquid, and the latter two given LC oral liquid and life intervention, respectively, all for 12 weeks. We collected semen samples from all the patients before and after treatment, and examined perm motility, the contents of neutral α- glucosidase (NAG) and reactive oxygen species (ROS), sperm DNA fragmentation index (DFI), and the expression of the Nrf2 protein., Results: Compared with the baseline, the total sperm motility was significantly improved in the IAS patients after treated with CAAC8-11 + LC (［27.50 ± 0.77］% vs ［32.50 ± 0.74］%, P < 0.05) or LC only (［27.60 ± 0.66］% vs ［30.90 ± 0.70］%, P < 0.05), dramatically higher in the CAAC8-11 + LC than in the LC and blank control groups (P < 0.01). The content of NAG in the epididymis was remarkably increased after treatment in the CAAC8-11 + LC than in the LC and blank control groups (［23.90 ± 0.56］ vs ［21.20 ± 0.49］ and ［16.80 ± 0.42］ mU, P < 0.05), so was the expression of Nrf2 (P < 0.05), while the ROS level was markedly decreased in the former than in the latter two groups (［81.60 ± 2.50］ vs ［88.50 ± 2.50］ and ［88.70 ± 2.40］ μg/ml, P < 0.05)., Conclusion: CAAC8-11 + LC has a good clinical effect on asthenospermia, with no adverse reactions, which may be attributed to its ability to regulate the high expression of Nrf2, decrease the production of ROS and reduce the damage of oxidative stress to sperm motility.

Objective: To investigate the mechanism of Xianfang Huoming Decoction (XHD) improving sperm motility in mice with asthenospermia (AS)., Methods: Thirty normal BALB/c mice were randomly divided into six groups, blank control, AS model control, low-dose XHD, medium-dose XHD, high-dose XHD and levocarnitine + vitamin E (LC+VE). The AS model was established in the latter five groups by injection of methotrexate at 0.5 mg/kg once a week, and the mice in the blank control group were injected with the same volume of normal saline, all for 8 weeks. From the ninth week, the animals in the blank control and AS model control groups were treated with PBS at 0.1 ml/d, those in the low-, medium- and high-dose XHD groups with XHD at 7.13, 14,2 and 28.52 g/kg/ d respectively, and those in the LC+VE group with LC+VE (30:1) at 0.55 g/kg/d, all for 4 weeks. Then, the bilateral epididymides were harvested from all the mice for preparation of a sperm suspension and observation of the total numbers of sperm and motile sperm. The testis tissues were obtained for to determination of the expressions of Nrf-2- and HO-1-related mRNA and proteins by fluorescence staining, RT-PCR and Western blot., Results: Compared with the AS model controls, the mice treated with low-, medium- and high-dose XHD showed dramatically increased sperm concentration (［22.36 ± 16.02］ vs ［39.04 ± 4.50］, ［40.76 ± 6.57］ and ［41.04 ± 8.39］ ×10⁶/ml, P < 0.01) and motility (［22.89 ± 14.96］% vs ［47.98 ± 4.74］%, ［48.53 ± 6.03］% and ［49.31 ± 6.24］%, P< 0.01), decreased level of reactive oxygen species (ROS) (［16.82 ± 14.96］% vs ［12.08 ± 3.26］%, ［10.77 ± 2.21］% and ［9.56 ± 2.08］%, P< 0.01), and up-regulated expressions of Nrf-2- and HO-1-related mRNA and proteins in the testis tissue (P < 0.05 or P < 0.01)., Conclusion: Xianfang Huoming Decoction inhibits the development of oxidative stress by up-regulating the expressions of Nrf-2- and HO-1-related mRNA and proteins in the testis tissue, which has provided theoretical evidence for its clinical application in the treatment of asthenospermia.

Objective: To observe the therapeutic efficacy of Baihe Yuzi Prescription (BYP) in the treatment of clinical syndrome-free asthenospermia and its effects on semen parameters, sperm DNA fragmentation index (DFI) and the expression of the cystic fibrosis transmembrane conductance regulator (CFTR) in the sperm., Methods: We randomly divided 112 patients with clinical syndrome-free asthenospermia into a control group (n = 55) and an experimental group (n = 57), the former treated orally with L-carnitine liquid combined with vitamin E capsules and the latter with BYP in addition, both for 3 months. After treatment, we obtained the total sperm count, sperm motility, percentages of progressively motile sperm (PMS) and morphologically normal sperm (MNS), sperm DFI and expression of CFTR in the sperm, and compared the above parameters between the two groups of patients before and after medication., Results: The total effectiveness rate was significantly higher in the experimental group (82.46%) than in the control (65.45%) (P < 0.05). Compared with the baseline, the patients in the experimental group showed significant improvement after treatment in the total sperm count (��53.5��3.5�� vs ��86.5��3.9�� ��106, P < 0.05), sperm motility (��23.5��3.5��% vs ��38.8��3.7��%, P < 0.05), PMS (��20.1��3.2��% vs ��30.3��3.3��%, P < 0.05), MNS (��2.3��0.3��% vs ��3.9��0.4��%, P < 0.05), sperm DFI (��37.3��3.1��% vs ��25.2��3.4��%, P < 0.05) and the expression of CFTR (P < 0.05), and even better improvement than the controls in sperm motility (��23.8��3.7��% vs ��30.2��3.4��%, P < 0.05), PMS (��19.6��3.1��% vs ��25.3��2.9��%, P < 0.05), MNS (��2.4��0.4��% vs ��3.1��0.3��%, P < 0.05), and sperm DFI (��36.6��3.3��% vs ��30.3��3.1��%, P < 0.05). The total sperm count and the expression of CFTR, however, were not significantly improved in the control group after treatment (P > 0.05)., Conclusion: Baihe Yuzi Prescription can increase sperm count and motility, improve sperm morphology and DFI in patients with clinical syndrome-free asthenospermia, which may be related to the up-regulated expression of CFTR in the sperm.

Objective: To observe the clinical efficacy of "Huayu Jiedu Shengjing Decoction" (HJSD) in the treatment of varicocele (VC)-induced asthenospermic infertility and its action mechanism., Methods: Using computer-generated random numbers, we equally divided 88 patients meeting the study criteria into an experimental and a control group, the former treated orally with HJSD plus or minus, while the latter with Maizhiling Tablets and levocarnitine, both for a course of 12 weeks. After medication, we obtained TCM syndrome scores, sperm motility, sperm DNA fragmentation index (DFI), the seminal cord venous ultrasonographic index, and levels of nitric oxide (NO), reactive oxygen species (ROS) and superoxide dismutase (SOD) in the seminal plasma from the patients, compared the therapeutic effects between the two groups, and analyzed the correlation among the obtained parameters., Results: The total effectiveness rate was dramatically higher in the experimental than in the control group (86.04% vs 73.74%, P < 0.01). The TCM syndromes scores, sperm motility, sperm DFI, and seminal plasma NO, ROS and SOD were all more significantly improved in the former than in the latter group (P < 0.05)., Conclusion: Huayu Jiedu Shengjing Decoction can improve semen quality and reduce TCM syndrome scores without adverse reactions in patients with VC-induced asthenospermic infertility, which may be attributed to its effect of improving antioxidation and local blood flow.

Objective: To observe the clinical efficacy of Jujing Decoction combined with lipoic acid in the treatment of asthenospermia and teratospermia., Methods: Fifty patients with asthenospermia and teratospermia meeting the inclusion criteria were randomly divided into a blank control (n = 10) and a medication group (n = 40), the former provided with fertility guidance and the latter treated with Jujing Decoction combined with lipoic acid. After 12 weeks of treatment, the clinical therapeutic effects were evaluated by comparing the semen volume, sperm concentration, percentages of progressively motile sperm (PMS) and morphologically abnormal sperm (MAS), rate of acrosome integrity, sperm DNA fragment index (DFI) and pregnancy rate between the two groups., Results: Compared with the control group, the medication group achieved a significantly higher overall effectiveness rate (10% ［1/10］ vs 88.89% ［32/36］, P < 0.05) and pregnancy rate (0% ［0/10］ vs 8.33% ［3/36］, P < 0.05) after treatment. The medication group also showed remarkably increased PMS from (21.04 ± 6.49)% to (32.66 ± 7.05)%, decreased MAS from (98.31 ± 1.28)% to (96.52 ± 1.11)%, elevated acrosome integrity from (42.18 ± 16.67)% to (60.42 ± 11.61)%, and reduced sperm DFI from (21.92 ± 6.96)% to (12.37 ± 3.79)%, all with statistically significant differences compared with the blank control group., Conclusion: Jujing Decoction combined with lipoic acid can significantly improve sperm motility, reduce MAS and DFI and increase the pregnancy rate through antioxidant stress, and has a high clinical safety.

Objective: To investigate the clinical effects of the L-carnitine-astaxanthin compound nutrients Menglankang (MLK) on idiopathic oligospermia (OS) and asthenospermia (AS)., Methods: This study included 73 cases of OS and 220 cases of AS treated with MLK once a bag, bid, for 3 successive months. Before and at 1, 2 and 3 months after treatment, we obtained and analyzed the semen parameters and sperm DNA fragmentation index (DFI) of the patients., Results: Compared with the baseline, the OS patients showed remarkable increases after 1 and 2 months of treatment in the semen volume (［3.07 ± 1.47］ vs ［3.26 ± 1.26］ and ［3.30 ± 1.28］ ml), sperm concentration (［10.96 ± 6.09］ vs ［16.74 ± 11.15］ and ［17.56 ± 9.92］ ×10⁶/ml, P < 0.05), total sperm count (［29.78 ± 17.48］ vs ［52.98 ± 32.07］ and ［57.67 ± 36.98］ ×106, P < 0.05) and the percentages of progressively motile sperm (PMS) (［39.8 ± 11.66］% vs ［45.3 ± 14.03］% and ［46.42 ± 10.69］%, P < 0.05) and morphologically normal sperm (MNS) (［1.71 ± 1.07］% vs ［1.79 ± 0.91］% and ［1.84 ± 0.96］%), and so did the AS patients in PMS (［19.23 ± 8.32］% vs ［25.46 ± 13.86］% and ［27.33 ± 12.88］%, P < 0.05). After 3 months of medication, the OS patients exhibited even more significant increases in the semen volume (［3.63 ± 1.39］ ml) (P < 0.05), sperm concentration (［20.56 ± 14.7］ ×10⁶/ml) (P < 0.05), total sperm count (［66.35 ± 55.91］ ×106) (P < 0.05), PMS (［49.24 ± 13.45］%) (P < 0.05) and MNS (［2.59 ± 0.93］%) (P < 0.05), and so did the AS patients in the semen volume (［3.27 ± 1.42］ vs ［3.85 ± 1.59］ ml, P < 0.05), PMS (［29.11 ± 13.58］%) (P < 0.05) and NMS (［2.01 ± 1.14］% vs ［2.57 ± 1.15］%, P < 0.05). In comparison with the baseline, the sperm DFI was not significantly improved at 1 month after treatment, but remarkably decreased at 2 and 3 months in the OS patients (［25.87 ± 13.76］% vs ［18.66 ± 10.83］% and ［16.48 ± 11.46］%, P < 0.05) and the AS patients as well (［26.40 ± 12.28］% vs ［19.35 ± 11.54］% and ［15.32 ± 10.89］%, P < 0.05)., Conclusions: The L-carnitine-astaxanthin compound nutrients Menglankang can significantly improve the semen quality of the patients with idiopathic oligospermia or asthenospermia.

Objective: To investigate the clinical effect of Luobufukebiri Pills (LP) on asthenospermia and its action mechanism., Methods: A total of 206 patients with asthenospermia in Henan Provincial Hospital of Traditional Chinese Medicine from March 2018 to December 2018 were randomly assigned to receive oral LP (the experimental group, n = 103) bid 10 pills each time or vitamin E soft capsules (the control group, n = 103) bid 100 mg each time for a course of 12 weeks. We compared the semen volume, sperm concentration, sperm motility, levels of α-glucosidase (α-Glu), fructose (Fru), malondialdehyde (MDA) and superoxide dismutase (SOD) in the seminal plasma, and the number of pregnancies between the two groups of patients before and after treatment., Results: All the patients finished the experiment except 1 in the control group due to personal reasons. After 12 weeks of medication, the patients in the experimental group showed significant increases over the baseline in sperm concentration (［36.27 ± 11.05］ vs ［25.96 ± 8.63］ ×10⁶/ml, P < 0.05), grade a sperm (［16.92 ± 5.72］% vs ［9.34 ± 3.18］%, P < 0.05), grade a+b sperm (［36.08 ± 6.84］% vs ［19.88 ± 4.65］%, P < 0.05), total sperm motility (［50.37 ± 10.38］% vs ［24.62 ± 6.12］%, P < 0.05), and the levels of α-Glu (［46.94 ± 9.16］ vs ［32.25 ± 8.30］ U/ml, P < 0.05), Fru (［28.08 ± 5.72］ vs ［16.38 ± 4.62］ μmol/ml, P < 0.05) and SOD (［182.28 ± 18.44］ vs ［100.37 ± 10.22］ U/ml, P < 0.05), but a decrease in the content of seminal plasma MDA (［10.37 ± 2.93］ vs ［15.62 ± 4.68］ nmol/ml, P < 0.05). Increases were also observed in the control group over the baseline in grade a sperm (［12.40 ± 6.33］% vs ［9.26 ± 2.94］%, P < 0.05), grade a+b sperm (［25.42 ± 5.24］% vs ［19.43 ± 4.17］%, P < 0.05), total sperm motility (［40.22 ± 9.72］% vs ［23.99 ± 5.77］%, P < 0.05), and levels of α-Glu (［40.31 ± 8.22］ vs ［31.06 ± 7.51］ U/ml, P < 0.05) and SOD (［139.71 ± 14.08］ vs ［102.11 ± 9.24］ U/ml, P < 0.05), but a decrease in the content of seminal plasma MDA (［12.72 ± 3.11］ vs ［15.62 ± 4.68］ nmol/ml, P < 0.05). The total clinical effectiveness rate was remarkably higher in the experimental than in the control group (87.38% vs 58.82%, P < 0.05)., Conclusions: Luobufukebiri Pills are safe and effective for the treatment of asthenospermia, which may be attributed to their ability of improving oxidative stress damage.

Objective: To observe the clinical effect of Yihechun Capsules (YHC) on oligozoospermia and asthenospermia., Methods: A total of 181 male patients with infertility were randomly divided into a YHC+Levocarnitine (LC) group (n = 93, including 42 cases of oligozoospermia, 20 cases of asthenospermia and 31 cases of oligoasthenospermia) and an LC control group (n = 88, including 39 cases of oligozoospermia, 22 cases of asthenospermia and 27 cases of oligoasthenospermia), the former treated with YHC (［0.3 g per capsule］, once 4 capsules, bid, 30 minutes after meal) combined with LC oral liquid (2－3 g/d, tid, at mealtime) and the latter with LC oral liquid only (2－3 g/d, tid, at mealtime). After 3 months of treatment, comparisons were made between the two groups of patients in sperm concentration, the percentages of grade a and grade a+b sperm, and the rate of pregnancy., Results: Of the 181 patients, 5 in the YHC+LC group and 2 in the LC control group failed to complete the course of treatment. There were no statistically significant differences between the two groups of patients in the baseline sperm concentration and the percentages of grade a and grade a+b sperm (P > 0.05), wich were all markedly increased in both the YHC+LC and the LC control groups (P < 0.05) after 3 months of treatment. And the patients of the YHC+LC group, compared with the controls, showed even more significant increases, as the oligozoospermia patients in sperm concentration (［21.07 ± 6.98］ vs ［16.56 ± 1.82］ ×10⁶/ml, P < 0.05) and the percentages of grade a sperm (［27.53 ± 3.34］% vs ［26.88 ± 1.35］%, P < 0.05) and grade a+b sperm (［53.32 ± 3.16］% vs ［52.63 ± 2.48］%, P < 0.05), the asthenospermia patients in sperm concentration (［26.36 ± 3.37］ vs ［24.42 ± 2.21］ ×10⁶/ml, P < 0.05) and the percentages of grade a sperm (［25.28 ± 4.64］% vs ［21.32 ± 3.28］%, P < 0.05) and grade a+b sperm (［49.19 ± 2.87］% vs ［45.64 ± 1.78］%, P < 0.05), and the oligoasthenospermia patients in sperm concentration (［19.38 ± 3.39］ vs ［18.75 ± 1.35］ ×10⁶/ml, P < 0.05) and the percentages of grade a sperm (［22.65 ± 4.81］% vs ［21.31 ± 2.42］%, P < 0.05) and grade a+b sperm (［48.74 ± 5.61］% vs ［44.36 ± 1.32］%, P < 0.05). The pregnancy rate was dramatically higher in the YHC+LC than in the LC control group (36.4% ［32/88］ vs 15.1% ［13/86］, P < 0.01)., Conclusions: Yihechun Capsules combined with Levocarnitine oral liquid is evidently effective for the treatment of oligozoospermia and asthenospermia.

Objective: To analyze the medication rules for oligoasthenozoospermia (OAZ) observed by Wang Qi, an academician, master of Traditional Chinese Medicine (TCM) and initiator of andrology in TCM., Methods: We collected the outpatient cases of OAZ treated by Wang Qi and established a database of clinical medical records using the TCM Inheritance Auxiliary Platform. Employing the integrated rule-based system for analysis of the software, we modified the mutual information method, complex system entropy clustering analysis and other data mining methods, and summarized the medication rules Wang Qi followed in the treatment of OAZ., Results: A total of 134 prescriptions made by Wang Qi for the treatment of OAZ were collected, involving 110 TCM drugs, which are mainly neutral and warm in nature and taste sweet and mostly act through the liver and kidney meridians. The core formula ingredients of the prescriptions included Morinda officinalis, Cuscuta chinensis, Lycium barbarum, Mulberry, Angelica sinensis, Astragalus mongholicus and Fish Maw, and most frequently Morinda officinalis, Cuscuta chinensis, Lycium barbarum and Mulberry., Conclusions: Wang Qi holds that kidney deficiency, dampness-heat, blood stasis and toxin are the main pathogenic factors for OAZ. The basic treatment of OAZ is to invigorate the kidney and replenish the essence, and meanwhile activate blood circulation, dissipate stasis and eliminate dampness-heat.

Objective: To explore the possible mechanism of Huanshao Capsules (HSC) protecting the reproductive function in rats with ornidazole-induced asthenozoospermia (AZS)., Methods: Forty SD male rats were randomly divided into four groups of equal number, blank control, AZS model control, HSC and L-carnitine (LC) intervention. The AZS model was established in the latter three groups of rats by intragastrical administration of ornidazole at 400 mg/kg/d for 28 days, and meanwhile the animals in the HSC and LC groups were treated by gavage of HSC at 0.31 g/kg/d and LC at 100 mg/kg/d, respectively. Then, all the rats were killed for examination of the LC content, sperm concentration, sperm motility and expression of OCTN2 mRNA in the epididymis and observation of the histopathological changes in the testis tissue., Results: Compared with the AZS model controls, the rats in the HSC and LC groups showed significantly increased LC content (2 880.3 vs 6 366.5 and 6 934.7 mg/L, P < 0.01), sperm concentration (［34.58 ± 10.25］ vs ［46.19 ± 14.23］ and ［42.25 ± 6.11］ ×10⁶/ml, P < 0.01), sperm motility (［42.59 ± 7.54］% vs ［61.34 ± 7.98］% and ［61.34 ± 7.98］%, P < 0.01) and expression of OCTN2 mRNA in the epididymis (26.07% vs 27.26% and 27.15%, P < 0.01). The animals of the HSC group exhibited a higher comparability than those of the LC group to the blank controls in the morphology, arrangement and activity of spermatogenic cells., Conclusions: HSC can protect the reproductive function and improve sperm concentration and motility in the model rats with ornidazole-induced AZS, which may be associated with its abilities of up-regulating the expression of OCTN2 mRNA and increasing the LC content in the epididymis.

Objective: To explore the protective effect of the Chinese medicinal prescription Linggui Fang (LGF) on the reproductive system of the ornidazole-induced asthenospermia (AS) rat and its possible action mechanisms., Methods: Forty male SD rats weighing 200－230 g were equally randomized into four groups, blank control, AS model control, LGF treatment and L-carnitine (LC) intervention. The AS models were made in the latter three groups by intragastrical administration of ornidazole at 400 mg/kg. Meanwhile, the rats in the LGF group were treated intragastrically with LGF at 17.5 g/kg, those in the LC group with LC at 100 mg/kg, and the control animals with 0.5% sodium carboxymethylcellulose (CMC-Na), all once a day for 4 successive weeks. Then, all the rats were sacrificed for examination of the semen parameters, determination of the LC content and OCTN2 mRNA expression in the epididymis and observation of the histopathological changes in the testis., Results: Compared with the AS model controls, the rats in the other groups showed significantly higher percentages of progressively motile sperm and total motile sperm (P < 0.01) as well as a higher LC content in the epididymis (P < 0.01), but no statistically significant difference in sperm concentration (P > 0.05). The expression of OCTN2 mRNA was remarkably upregulated in the LGF and LC groups in comparison with that in the AS model control (P < 0.05). Compared with the rats in the blank control group, the AS model controls exhibited markedly increased morphologically abnormal seminiferous tubules, irregularly arranged, with narrowed lumens and reduced numbers of sperm and sperm cells, as well as significantly increased hollow seminiferous tubules with deficient and disorderly arranged spermatogenic cells and partial epithelial degeneration and vacuolization. Those in the LGF and LC groups, however, manifested almost normal testicular histomorphology, with basically regular arrangement of different layers of seminiferous tubules., Conclusions: ①Ornidazole induces AS in rats by reducing the LC content in the epididymis, while LGF can improve the sperm motility and testicular morphology of the rats and upregulate the expression of OCTN2 mRNA in the epididymis by increasing the LC concentration.

Objective: To explore the regulatory effect of Huatan Qushi Decoction (HTQSD) on lipid metabolism and semen quality in obese rats with oligoasthenozoospermia (OA) and its underlying mechanisms., Methods: Ninety-six 8-week-old male Wistar rats were randomly divided into six groups of equal number: blank control, OA model control, Wuzi Yanzong Pills (WZYZP), and high-, medium- and low-dose HTQSD, the blank controls fed with a normal diet and the others with a high-fat diet, all for 8 weeks. Meanwhile, the rats in the blank control and OA model control groups were treated intragastrically with normal saline, those in the WZYZP group with WZYZP at 1.07 g/kg, and those in the high-, medium- and low-dose HTQSD groups with HTQSD at 26.25, 13.125 and 6.5625 g/kg, respectively. The body weights of the animals were obtained at 1, 4 and 8 weeks of modeling and intervention, the levels of serum TG, TC, HDL-C and LDL-C, the liver and testis indexes and semen quality detected at 4 and 8 weeks, and the expression of HO-1 mRNA determined at 8 weeks., Results: At 8 weeks of modeling and intervention, the rats in the model control group, compared with the blank controls, showed significant increases in the body weight (［523.1 ± 25.54］ vs ［451.50 ± 27.53］ g, P < 0.01) and levels of serum TG (［8.58 ± 0.39］ vs ［2.18 ± 0.28］ nmol/L, P < 0.001), TC (［4.41 ± 1.44］ vs ［1.68 ± 0.18］ nmol/L, P < 0.01) and LDL-C (［2.06 ± 0.17］ vs ［0.48 ± 0.57］ nmol/L,P<0.01), but decreases in the level of serum HDL-C (［27.92 ± 0.40］ vs ［57.47 ± 1.52］ nmol/L,P < 0.01), sperm motility (［11.31 ± 4.87］% vs ［39.66 ± 2.77］%, P < 0.01), sperm concentration (［31.07 ± 10.52］ vs ［65.37 ± 6.30］ ×10⁶/ml, P < 0.01) and the expression of HO-1 mRNA (0.16 ± 0.03 vs 1.06 ± 0.20, P < 0.01). The rats in the medium-dose HTQSD group, in comparison with the model controls, exhibited remarkable decreases in the body weight (［445.13 ± 34.19］ vs ［523.1 ± 25.54］ g, P < 0.01) and levels of serum TG (［2.05 ± 0.27］ vs ［8.58 ± 0.39］ nmol/L,P < 0.01), TC (［1.63 ± 0.21］ vs ［4.41 ± 1.44］ nmol/L,P < 0.01) and LDL-C (0.45 ± 0.07) vs ［2.06 ± 0.17］ nmol/L, P < 0.01), but increases in the level of serum HDL-C (［48.35 ± 3.63］ vs ［27.92 ± 0.40］ nmol/L, P < 0.01), sperm motility (［32.84 ± 6.22］% vs ［11.31 ± 4.877］%, P < 0.01) and sperm concentration (［46.90 ± 6.39］ vs ［31.07 ± 10.52］ ×10⁶/ml, P < 0.05), and the low-dose HTQSD group showed a significantly up-regulated expression of HO-1 mRNA (0.76 ± 0.13 vs 0.16±0.03, P < 0.01)., Conclusions: HTQSD can regulate the blood lipid level and improve semen quality in obese rats with oligoasthenozoospermia by promoting serum anti-oxidation and reducing oxidative stress.

Objective: To investigate the effect and action mechanism of Yu Si Granules (YSG) in the treatment methyl methanesulphonate (MMS)-induced oligoasthenozoospermia (OAZ) in mice., Methods: Thirty adult male mice were randomly divided into three groups of equal number, normal control, OAZ model control and YSG intervention. The OAZ model was established by oral administration of MMS and the model mice in the YSG intervention group were treated intragastrically with YSG suspension at 0.144 g/100 g of the body weight per day for 48 successive days. Then, all the mice were sacrificed and their epididymides harvested for detection of the sperm count and motility, observation of the morphology of the seminiferous tubules by HE staining, determination of the expressions of the germ cell-, sperm cell-, spermatocyte-, Sertoli cell- and blood-testis barrier-related genes by RT-PCR, and measurement of the levels of oxidative stress in the blood., Results: Compared with the normal control, the OAZ model mice showed significantly decreased sperm count (［49.2 ± 0.7］ vs ［23.6 ± 0.4］ ×107/ml/g, P < 0.05) and sperm motility (［76.3 ± 0.7］% vs ［5.0 ± 5.8］%, P < 0.05), which were both remarkably increased after YSG intervention (［38.4 ± 0.5］ ×107/ml/g and ［71.5 ± 0.5］%) (P < 0.05). The OAZ model mice also exhibited degenerated and atrophic seminiferous tubules, thinner seminiferous epithelia, disorderly arranged cells at different levels, reduced number of sperm in the lumen and unclear layers of germ cells in the epididymis, while those after YSG intervention manifested regularly organized seminiferous tubules with orderly arrangement and clear layers. The expressions of the Vasa, Dazl and Snd1 genes were significantly decreased (P < 0.05), but not those of Gfra, Plzf, Stra8, Spo11, Sycp3, Sox9 and Vim (P > 0.05) in the OAZ model and YSG intervention groups as compared with those in the normal control group. The superoxide dismutase (SOD) activity in the serum was markedly reduced in the OAZ model mice as compared with that in the normal controls (P < 0.05) and increased again after YSP intervention (P < 0.05), but the opposite was the case with the expression of the superoxide anion., Conclusions: YSG can significantly reduce MMS-induced OAZ in mice, which may be associated with oxidative stress.

Objective: To study the protective effect of lipoic acid (LA) on the spermatogenic function of the male rats with oligoasthenozoospermia induced by ornidazole (ORN)., Methods: Seventy male SD rats were equally randomized into groups A (solvent control: 1 ml 0.5% CMC-Na + 1 ml olive oil), B (low-dose ORN model: 400 mg/kg ORN suspension + 1 ml olive oil), C (low-dose ORN + low-dose LA treatment: 400 mg/kg ORN + 50 mg/kg LA), D (low-dose ORN + high-dose LA treatment: 400 mg/kg ORN + 100 mg/kg LA), E (high-dose ORN model: 800 mg/kg ORN suspension + 1 ml olive oil), F (high-dose ORN + low-dose LA treatment: 800 mg/kg ORN + 50 mg/kg LA), and G (high-dose ORN + high-dose LA treatment: 800 mg/kg ORN + 100 mg/kg LA), and treated respectively for 20 successive days. Then all the rats were sacrificed and the weights of the body, testis, epididymis and seminal vesicle obtained, followed by calculation of the organ index, determination of epididymal sperm concentration and motility, and observation of the histomorphological changes in the testis and epididymis by HE staining., Results: Compared with group A, group E showed significantly decreased body weight (［117.67 ± 11.53］ vs ［88.11 ± 12.65］ g, P < 0.01) and indexes of the testis (［1.06 ± 0.12］ vs ［0.65 ± 0.13］ %, P < 0.01) and epididymis (［0.21 ± 0.03］ vs ［0.17 ± 0.01］ %, P < 0.01). In comparison with group E, group F exhibited remarkable increases in the epididymal index (［0.17 ± 0.01］ vs ［0.20 ± 0.02］ %, P < 0.01), and so did group G in the body weight (［88.11 ± 12.65］ vs ［102.70 ± 16.10］ g, P < 0.05) and the indexes of the testis (［0.65 ± 0.13］ vs ［0.95 ± 0.06］ %, P < 0.01) and epididymis (［0.17 ± 0.01］ vs ［0.19 ± 0.02］ %, P < 0.05), but no obvious difference was observed in the index of seminal vesicle among different groups. Compared with group A, group B manifested significant decreases in sperm motility (［74.12 ± 8.73］ vs ［40.25 ± 6.08］ %, P < 0.01), and so did group E in sperm count (［38.59 ± 6.40］ vs ［18.67 ± 4.59］ ×105/100 mg, P < 0.01) and sperm motility (［74.12 ± 8.73］ vs ［27.58 ± 8.43］ %, P < 0.01). Sperm motility was significantly lower in group B than in C and D (［40.25 ± 6.08］ vs ［58.13 ± 7.62］ and ［76.04 ± 8.44］%, P < 0.01), and so were sperm count and motility in group E than in F and G (［18.67 ± 4.59］ vs ［25.63 ± 9.66］ and ［29.92 ± 4.15］ ×105/100 mg, P < 0.05 and P < 0.01; ［27.58 ± 8.43］ vs ［36.56 ± 11.08］ and ［45.05 ± 9.59］ %, P < 0.05 and P < 0.01). There were no obvious changes in the histomorphology of the testis and epididymis in groups A, B, C and D. Compared with group A, group E showed necrotic and exfoliated spermatogenic cells with unclear layers and disorderly arrangement in the seminiferous tubules and remarkably reduced sperm count with lots of noncellular components in the epididymal cavity, while groups F and G exhibited increased sperm count in the seminiferous tubules and epididymis lumen, also with exfoliation, unclear layers and disorderly arrangement of spermatogenic cells, but significantly better than in group E., Conclusions: LA can reduce ORN-induced damage to the spermatogenetic function of rats, improve sperm quality, and protect the reproductive system.

Objective: To evaluate the clinical therapeutic effect of L-carnitine (LC) in combination with coenzyme Q10 (CoQ10) on idiopathic oligoasthenozoospermia (iOAT)., Methods: Using the computer-generated random number sequence, we randomly assigned 262 infertile men with iOAT to four groups to receive oral administration of LC at 10 mL bid (n = 62), CoQ10 (n = 63) at 20 mg tid, LC combined with CoQ10 at the above dose (n = 63), and vitamin B1 as the placebo control (n = 74). After 3 months of treatment, we obtained sperm concentration, sperm motility, the percentage of progressively motile sperm, sperm DNA fragmentation index, the rate of sperm acrosome reaction, and the outcomes of clinical pregnancy and compared them among the four groups of patients., Results: After treatment, the combination group, as compared with the LC, CoQ10 and control groups, showed significantly higher sperm motility and percentage of progressively motile sperm (P <0.05). The percentage of sperm DNA fragments was markedly lower in the combination group than in the control (P <0.05), while the rate of clinical pregnancy remarkably higher in the former than in the latter group (30.0% vs 6.8%, P <0.008). There were no statistically significant differences among the four groups in the rates of sperm acrosome reaction and abortion (P >0.05)., Conclusions: Combination of LC and CoQ10 can improve the semen parameters and outcome of clinical pregnancy in the iOAT patient.

Objective: To observe the clinical effects of Huanshao Capsules (HSC) combined with levocarnitine (LC) on asthenospermia, oligospermia, teratozoospermia, and the semen parameters of the patients., Methods: This randomized controlled clinical study included 186 infertility patients with spleen and kidney asthenia. We randomly divided them into three groups of equal number and treated them orally with HSC at the dose of 3 capsules tid, LC at 10 ml tid, and HSC+LC, respectively, all for 12 weeks. At 4, 8, and 12 weeks after treatment, we obtained the semen parameters from the patients and compared them among the three groups., Results: Totally, 180 of the patients completed the study, 61 in the HSC, 59 in the LC and 60 in the HSC+LC group. After 12 weeks of medication, the patients of the HSC+LC group showed an increase of 42.77% in the semen volume, 142.37% in sperm concentration, 28.61% in sperm motility, and 24.39% in the percentage of grade a+b sperm and a decrease of 6.27% in the percentage of morphologically abnormal sperm as compared with the baseline (P <0.05). The patients treated with HSC+LC showed significantly more improvement in all the above parameters than those treated with LC alone (P <0.05) as well as in sperm motility and the percentage of progressively motile sperm than those treated with HSC alone (P <0.05). The HSC group exhibited remarkable improvement in the above parameters after treatment as compared with the baseline (P <0.05) and higher semen volume and sperm concentration than the LC group (P <0.05)., Conclusions: Huanshao Capsulescombined with levocarnitinedeserves a wide clinical application as a safe and efficacious therapy forasthenospermia, oligospermia,and teratozoospermia.

Objective: To investigate the therapeutic efficacy and safety of Gujing Maisiha Tablets combined with natural vitamin E in the treatment of idiopathic asthenospermia., Methods: This study included 135 outpatients with idiopathic asthenospermia received in our hospital from February 2015 to January 2016. We randomly divided them into a treatment group (n = 65, aged 22－44 ［mean 32.8］ yr) and a control group (n = 55, aged 21－43 ［mean 33.7］ yr) to be treated with Gujing Maisiha Tablets combined with natural vitamin E or natural vitamin E only, both for 90 days. We obtained total sperm motility and the percentage of progressively motile sperm (PMS) from the patients before and after medication and evaluated the clinical effects by comparing the collected parameters and pregnancy rates between the two groups., Results: The baseline total sperm motility and PMS were (25.23 ± 5.57)% and (17.53 ± 5.78)% in the treatment group, with no statistically significant differences from (26.05 ± 6.77)% and (15.11 ± 6.55)% in the control (P >0.05). After 90 days of medication, both the treatment and the control groups showed remarkable increases in total sperm motility (［48.73 ± 8.66］% and ［36.54 ± 8.09］%, P <0.05) and PMS (［32.77 ± 6.04］% and ［26.99 ± 6.87］%, P <0.05). However, both total sperm motility and PMS were significantly higher in the treatment than in the control group after medication (P <0.05), and so was the total rate of clinical effectiveness (73.85% vs 54.55%, P <0.05). No adverse reactions were observed in either of the two groups during the treatment., Conclusions: Gujing Maisiha Tablets combined with natural vitamin E is safe and effective for the treatment of idiopathic asthenospermia.

Objective: To observe the effect of Huangjing Zanyu Capsule (HZC) on sperm mitochondrial membrane potential (MMP) in asthenozoospermia patients., Methods: We assigned 70 asthenozoospermia patients to a treatment group (n = 39) and a control group (n = 31), the former treated with oral HZC at the dose of 4 capsules tid for 3 months while the latter left untreated. We obtained semen parameters from the patients and detected their sperm mitochondrial membrane potentials (MMP) by JC-1 staining and flow cytometry before and after medication, followed by comparison between the two groups., Results: The total effectiveness rate was 71.05% in the treatment group and natural pregnancy was achieved in 3 cases during the medication. A total of 35 patients in the treatment group and 30 controls completed all the laboratory examinations after a 3-month observation. Compared with the controls, the patients treated with HZC exhibited significant improvement after medication in MMP (variation value: ［1.19 ± 10.36］% vs ［20.28 ± 14.21］%, P <0.01), total sperm motility (variation value: ［3.46 ± 8.67］% vs ［20.68 ± 14.12］%, P <0.01), the percentage of progressively motile sperm (variation value: ［2.26 ± 8.29］% vs ［17.58 ± 12.73］%, P <0.01), and the percentage of morphologically normal sperm (variation value: ［0.23 ± 3.48］% vs ［3.37 ± 3.99］%, P <0.01). MMP was significantly correlated with total sperm motility (r = 0.69, P <0.01), progressive sperm motility (r = 0.75, P <0.01) and normal sperm morphology (r = 0.26, P <0.01)., Conclusions: Huangjing Zanyu Capsule can enhance sperm mitochondrial membrane potential and sperm mitochondrial function, thus improving total sperm motility, progressive sperm motility and normal sperm morphology. It is safe and effective for the treatment of asthenospermia.

Industrialization and environmental pollution are bringing more problems to human reproduction and increasing the prevalence of male infertility. Western medicine has shown its limitations in the management of male infertility, especially that of oligoasthenospermia. Traditional Chinese medicine (TCM), however, has long and rich experiences in the treatment of oligoasthenospermia, with a large variety of medicinal prescriptions based on the TCM theories, among which Qilin Pills shows a particularly significant therapeutic effect on oligoasthenospermia, especially when combined with Western medicine. At present, published studies on Qilin Pills are mainly in the stage of clinical observation, while basic researches and studies on its relevant mechanisms are rarely seen.

Objective: To investigate the effect of alpha-lipoic acid (α-LA) combined with tamoxifen citrate (TC) in the treatment of oligoasthenospermia., Methods: From June to November 2016, we treated 60 patients with oligoasthenospermia in our Department of Andrology, 30 (the trial group) with oral α-LA (0.6 g, qd) + TC (20 mg, qd) and the other 30 (the control group) with oral L-carnitine (1g, bid) + TC (20 mg, qd). Before and after 3 months of medication, we examined the semen parameters of the patients and the levels of their seminal oxidative stress biomarkers, including methylenedioxyamphetamine (MDA) and total antioxidant capacity (TAC) in the seminal plasma. We also compared the pregnancy rate and adverse reactions between the two groups., Results: Totally, 57 of the patients completed the treatment, 28 in the trial group and 29 in the control. Compared with the baseline, the patients of the trial group showed significant improvement after 3 months of medication in the semen volume (［2.50 ± 0.71］ vs ［3.37 ± 0.70］ ml, P <0.05), sperm concentration (［12.00 ± 1.65］ vs ［19.34 ± 2.04］ ×10⁶/ml, P <0.05), percentage of progressively motile sperm (PMS) (［18.01 ± 3.01］% vs ［35.41 ± 6.49］%, P<0.05), MDA level (［14.96 ± 2.76］ vs ［10.04 ± 1.04］ nmol/ml, P <0.05), and TAC in the seminal plasma (［9.83 ± 1.02］ vs ［12.25 ± 1.11］ U/ml, P <0.05), and so did the controls in the semen volume (［2.76 ± 0.67］ vs ［3.36 ± 0.93］ ml, P <0.05), sperm concentration (［11.47 ± 1.10］ vs ［17.77 ± 3.56］ ×10⁶/ml, P <0.05), percentage of PMS (［19.22 ± 1.41］ vs ［36.01 ± 5.22］ %, P <0.05), MDA level (［14.66 ± 2.75］ vs ［10.14 ± 1.01］ nmol/ml, P <0.05), and TAC in the seminal plasma (［9.84 ± 0.90］ vs ［11.14 ± 0.84］ U/ml, P <0.05). There were no statistically significant differences in the above post-medication parameters between the trial and control groups (P >0.05) except in TAC, which was markedly more improved in the former than in the latter (P <0.05), nor in the percentage of morphologically normal sperm before and after treatment in either of the two groups (P >0.05). After 3 months of treatment, 3 pregnancies were achieved in the trial group and 1 in the control (10.7% vs 3.45%, P >0.05). No obvious adverse events occurred during the treatment., Conclusions: Alpha-lipoic acid combined with tamoxifen citrate can evidently improve semen parameters in oligoasthenospermia patients by relieving oxidative stress injury.

Objective: To study the protective effect of Qilin Pills (QLP) on the reproductive function of rats with oligoasthenospermia (OAS) induced by tripterygium glycosides., Methods: Twenty-eight male SD rats were randomly divided into a normal control, an OAS model control, a low-dose QLP, and a high-dose QLP group of equal number. OAS models were made in the latter three groups by intragastrical administration of tripterygium glycosides at 40 mg per kg of the body weight per day, and meanwhile the animals in the low- and high-dose QLP groups were treated with QLP at 1.62 and 3.24 g per kg of the body weight per day, respectively, while those in the OAS model group with normal saline, all for 30 consecutive days. Then all the rats were executed for obtaining the testis weight, testis viscera index, epididymal sperm concentration and motility, reproductive hormone levels, and antioxidation indexes and observation of the histomorphological changes of the testis tissue by HE staining., Results: After 30 days of intervention, the low- and high-dose QLP groups, as compared with the OAS model controls, showed significantly improved epididymal sperm concentration (［14.57 ± 3.95］ and ［39.71 ± 11.31］ vs ［4.71 ± 1.25］ ×10⁶/ml, P <0.05) and motility (［3.71 ± 1.11］ and ［4.29 ± 1.80］ vs ［0.57 ± 0.53］%, P <0.05), increased levels of sex hormone binding globulin (SHBG) (［94.83 ± 11.17］ and ［88.05 ± 9.21］ vs ［56.74 ± 8.29］ nmol/L, P <0.05) and free testosterone (FT) (［27.27 ± 3.63］ and ［32.80 ± 2.51］ vs ［22.81 ± 2.75］ nmol/L, P <0.05), decreased level of follicle-stimulating hormone (FSH) (［1.49 ± 0.62］ and ［1.12 ± 0.83］ vs ［1.71 ± 0.52］ mIU/ml, P <0.05), but no significant change in the total testosterone (TT) level. Meanwhile, the level of superoxide dismutase (SOD) was markedly elevated in the low- and high-dose QLP groups in comparison with the OAS model control group (［277.14 ± 15.84］ and ［299.60 ± 20.83］ vs ［250.04 ± 31.06］ U/ml, P <0.05) while that of reactive oxygen species (ROS) remarkably reduced (［397.61 ± 62.71］ and ［376.84 ± 67.14］ vs ［552.20 ± 58.07］ IU/ml, P <0.05). HE staining showed that QLP intervention significantly increased the layers and quantity of spermatogenic cells in the testicular seminiferous tubules of the OAS rats., Conclusions: QLP can effectively protect the reproductive system of oligoasthenospermia rats by raising sperm quality, elevating reproductive hormone levels, reducing oxidative stress injury, and improving histomorphology of the testis.

Objective: To investigate the clinical therapeutic effects of Yijingfang, a Chinese medicinal liquid, on asthenospermia., Methods: We randomly divided 450 asthenospermia patients into a treatment group (n = 300) and a control group (n = 150), the former treated with Yijingfang once half a dose, bid, and the latter with Wuziyanzong Pills (9 g, bid) + L-carnitine oral liquid (10 ml, bid), both for 3 months. Before and at 1, 2, and 3 months after medication, we compared the semen volume, sperm concentration, percentages of progressively motile sperm (PMS) and total motile sperm (TMS), and semen liquefaction time between the two groups of patients., Results: No statistically significant difference was observed in the semen parameters between the treatment and control groups before medication (P >0.05). In comparison with the baseline, the treatment group showed significant differences at 1, 2, and 3 months after medication in sperm concentration (［35.96 ± 8.50］ vs ［49.66 ± 10.91］, ［55.21 ± 11.46］, ［74.90 ± 13.07］ ×10⁶/ml, P <0.01), PMS (［19.72 ± 2.06］ vs ［23.81 ± 2.56］, ［26.12 ± 2.34］, and ［32.17 ± 1.62］ %, P <0.01) and TMS (［28.86 ± 2.70］ vs ［34.17 ± 3.43］, ［36.59 ± 3.36］, and ［47.08 ± 2.97］ %, P <0.01), but not in the semen volume (［3.35 ± 0.99］ vs ［3.15 ± 1.06］, ［3.12 ± 0.90］, and ［3.27 ± 0.78］ ml, P >0.05) or semen liquefaction time (［32.31 ± 8.15］ vs ［31.68 ± 3.14］, ［30.38 ± 3.44］, and ［30.86 ± 2.42］ min, P >0.05); the control group exhibited similar results at the three time points in sperm concentration (［36.85 ± 6.88］ vs ［40.53 ± 8.32］, ［47.51 ± 12.73］, and ［56.14 ± 11.98］ ×10⁶/ml, P <0.01), PMS (［20.26 ± 2.73］ vs ［25.17 ± 2.64］, ［27.23 ± 2.25］, and ［31.89±2.27］ %, P <0.01), and TMS (［30.03 ± 2.67］ vs ［33.89±2.26］, ［37.38±4.79］, and ［40.35±3.06］ %, P <0.01), but not in the semen volume (［3.03 ± 1.09］ vs ［3.16±1.78］, ［3.15±0.96］, and ［3.12±0.65］ ml, P >0.05) or semen liquefaction time (［30.25 ± 5.20］ vs ［29.36±4.25］, ［28.21±3.26］, and ［28.33±3.59］ min, P >0.05). There were statistically significant differences between the treatment and control groups in the increase rates of sperm concentration and TMS after medication (P <0.01) but not in that of PMS (P >0.05)., Conclusions: Yijingfang is an effective drug for the treatment of asthenospermia, which can regulate the spermatogenesis, increase the percentage of PMS, and improve the total sperm motility of the patients.

Objective: To evaluate the clinical efficacy and safety of Qilin Pills in the treatment of oligoasthenospermia in infertile men., Methods: This multi-centered randomized double-blind controlled clinical trial included 216 infertile males with oligoasthenospermia, 108 in the trial group and the other 108 in the control, the former treated with Qilin Pills at the dose of 6 g tid while the latter with Wuziyanzong Pills at 6 g bid, both for 12 weeks. We examined the total sperm count, sperm motility and the count of progressively motile sperm of the patients before and at 4, 8 and 12 weeks after medication and evaluated the safety of the drug based on the adverse events and the laboratory results of blood and urine routine examinations and liver and kidney function tests., Results: Compared with the baseline, the patients in the trial group showed a significant time-dependent improvement after 4, 8 and 12 weeks of medication in sperm motility (21.75% vs 27.54%, 29.04% and 32.95%, P <0.05), total sperm count (156.27 ×106 vs 177.33, 188.18 and 205.44 ×106, P <0.05), and the count of progressively motile sperm (32.08 ×10⁶/ml vs 46.33, 50.98 and 61.10 ×10⁶/ml, P <0.05). The three parameters above were also improved in the controls, but more significantly in the trial group (P <0.05)., Conclusions: Qilin Pills can evidently improve the semen quality of oligoasthenospermia patients with no obvious adverse events.

Objective: To investigate the effects of the compound preparation Jinghuosu on oligospermia and asthenospermia., Methods: This multi-centered clinical study included 120 cases of mild to moderate idiopathic oligospermia or asthenospermia, all treated with oral Jinghuosu once a bag, bid, for 3 successive months. Before and at 1, 2 and 3 months after treatment, we detected sperm concentration, total sperm motility, progressive sperm motility and normal sperm morphology of each ejaculate, and recorded whether the patients had any adverse reactions., Results: After 3 months of treatment, all the patients showed obvious improvement in semen parameters, most significantly in sperm concentration, total sperm motility, and the percentages of progressive motile sperm and morphologically normal sperm (P <0.05). No significant adverse reactions were observed during the 3 months of medication., Conclusions: Jinghuosu has a significant efficacy and no obvious adverse effect in the treatment of mild to moderate oligospermia and asthenospermia.

Lipoic acid (LA) is widely present in the body as a disulfide compound with an extensive biological activity and a strong antioxidant capacity. LA plays an antioxidant role by removing oxygen free radicals, chelating metal ions, and regenerating other antioxidants in the body. Recent studies have shown the effects of LA in the prevention or treatment of male reproductive disorders, such as idiopathic oligoasthenozoospermia, diabetes mellitus-induced erectile dysfunction and infertility, serious infection in the reproductive system, and reproductive system injuries caused by chemotherapeutic agents, ionizing radiation, environmental toxins, testicular ischemia reperfusion, excessive exercise, and so on.

Objective: To investigate the protective effect of Wuziyanzong Pills (WYP) in the rat model of oligoasthenospermia (OAS) and its action mechanism., Methods: Sixty male SD rats were equally randomized into six groups: normal control, OAS model, Shengjing Capsules (1.6 g per kg of the body weight), low-dose WYP (1 g per kg of the body weight), medium-dose WYP (2 g per kg of the body weight), and high-dose WYP (4 g per kg of the body weight). The OAS model was established by intragastric administration of Tripterygium glucoside at 30 mg per g per d for 6 weeks. From the 3rd week of modeling, the rats of the medication groups were treated intragastrically with corresponding drugs for 4 weeks. Then all the rats were sacrificed for measurement of the testicular and epididymal organ coefficients, examination of epididymal sperm quality and apoptosis, and detection of the openness of the sperm mitochondrial permeability transition pore (MPTP). Histopathological changes in the testis were observed by HE staining and the apoptosis of spermatogenic cells determined by Hochest staining., Results: WYP obviously improved the organ coefficients of the testis and epididymis, increased sperm concentration, motility and viability, decreased the apoptosis of spermatogenic cells, and inhibited the abnormal openness of MPTP in the OAS model rats. HE staining showed that the number and levels of spermatogenic cells were significantly increased while Hochest staining manifested that the apoptosis of spermatogenic cells was remarkably inhibited in the seminiferous tubules of the testis in the WYP-treated rats., Conclusions: WYP can improve sperm quality and reduce the apoptosis of spermatogenic cells (including sperm) in OAS model rats, which may be related with its inhibitory effect on the abnormal openness of MPTP.

Objective: To investigate the therapeutic effect of apocynin on oligoasthenozoospermia (OAS) and its action mechanisms in mice., Methods: Forty male Kunming mice were randomly divided into four groups of equal number, blank control, OAS model, low-dose apocynin, and high-dose apocynin. OAS models were made in the latter three groups of mice by intraperitoneal injection of cyclophosphamide for five days. The animals in the blank control, OAS model, low-dose apocynin, and high-dose apocynin groups were given drinking water (［5.1±0.4］ ml daily) containing 0, 0, 200, and 1 000 μg/ml apocynin, respectively, for 30 days. Then all the mice were sacrificed for observation of pathological changes of the testicular tissue, examination of sperm quality, and measurement of malondialdehyde (MDA) and superoxide dismutase (SOD) levels in the testis., Results: Apocynin treatment raised sperm concentration from (2.94±0.57)×10⁶/ml in the OAS models to (3.88±0.43) and (4.12±0.53)×10⁶/ml in the low- and high-dose apocynin groups and elevated the percentage of progressively motile sperm from (6.25±3.40)% in the OAS models to (8.03±6.71) and (17.50±2.74)% in the low- and high-dose apocynin groups, respectively (P<0.05). The MDA level in the testicular tissue was decreased from (1.34±0.22) nmol/mg prot in the OAS models to (1.13±0.19) and (0.98±0.19) nmol/mg prot in the low- and high-dose apocynin groups (P<0.05), and the SOD level increased from (26.46±4.36) U/mg prot to (32.46±3.28) and (37.39±5.77) U/mg prot, respectively (P<0.05)., Conclusions: Apocynin can significantly improve sperm quality of oligoasthenozoospermia mice by eliminating reactive oxygen free radicals and improving antioxidant activity of the body. And it can be applied in the prevention and treatment of male infertility.

Objective: To study the therapeutic efficacy of compound amino acid combined with vitamin E in the treatment of idiopathic asthenospermia., Methods: This study included 120 cases of idiopathic asthenospermia treated in the Outpatient Department of our hospital between February 2014 and January 2015. We randomized the patients into a treatment group( n = 70,aged23- 43 [mean 32. 5] years) and a control group( n = 50,aged 23- 44 [mean 31. 7] years),the former treated with compound amino acid plus vitamin E while the latter with vitamin E only. After 90 days of medication, we evaluated the therapeutic effects by comparing the total sperm motility( progressive motility + non-progressive motility, PR + NP),the percentage of progressively motile sperm( PR),and the pregnancy rate between the two groups., Results: Before treatment, PR + NP and PR were(26. 24 ± 6. 56) %and(24. 65 ± 6. 43) % in the treatment group and(15. 13 ± 5. 68) % and(14. 73 ± 6. 16) in the control, with no statistically significant differences between the two groups( P > 0. 05). After 90 days of medication, PR + NP and PR were( 49. 63 ± 9. 78) % and(33. 33 ± 5. 64)% in the former and(37. 67 ± 7. 98)% and(27. 23 ± 6. 46)% in the latter, remarkably increased in both groups as compared with the baseline( P < 0. 05),but significantly more in the treatment than in the control group( P < 0. 05). Four pregnancies(5. 71%) were achieved in the former group but only 1(2. 00%) in the latter. The total rate of effectiveness was markedly higher in the treatment group than in the control(74. 28% vs 44. 00%,P < 0. 05). No adverse reactions were observed in either group., Conclusion: Compound amino acid combined with vitamin E can safely and effectively improve sperm motility in idiopathic asthenospermia patients.

Objective: To explore the mechanisms of Qianjing Decoction in the treatment of oligoasthenospermia (OAS)., Methods: We randomly divided 100 SPF male rats into five groups of equal number: normal, model, Huangjingzanyu, levocarnitine, and Qiangjing. OAS models were established in the animals followed by intragastrical administration of normal saline, ornidazole, Huangjingzanyu Capsules (200 mg per kg body weight per day), levocarnitine (100 mg per kg body weight per day), and Qianjing Decoction (10 g per kg body weight per day), respectively, qd, for 4 successive weeks. Then, we detected the concentration and motility of the epididymal sperm, obtained the contents of superoxide dismutase (SOD), malonaldehyde (MDA), glutathione peroxidase (GSH-Px), lactate dehydrogenase (LDH), α-glucosidase, and fructose in the epididymis, and determined the mRNA expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and succinate dehydrogenase (SDH) in the epididymal tissue of the rats by real-time PCR., Results: The concentration and motility of the epididymal sperm in the model, Huangjingzanyu, levocarnitine, and Qianging groups were (35.34 ± 4.22) x 10(6)/ml and (40.04 ± 7.05)%, (48.12 ± 5.56) x 10(6)/ml and (62.46 ± 7.12)%, (47.14 ± 4.87) x 10(6)/ml and (63.23 ± 6.34)%, and (50.25 ± 5.08) x 10(6)/ml and (66.34 ± 7.58)%, respectively, all significantly lower than in the normal group ([53.05 ± 4.55] x 10(6)/ml and [70.20 ± 8.54]%) (P < 0.05), but remarkably higher in the Huangjingzanyu, levocarnitine, and Qiangjing groups than in the model rats (P < 0.05). Compared with the thinned epididymal lumen walls, decreased sperm count, and disorderly and loose arrangement of the lumens in the OAS models, the rats in the Huangjingzanyu, levocarnitine, and Qiangjing groups showed evidently thicker epididymal lumen walls, with the lumens full of sperm cells and arranged regularly and compactly, similar to those of the normal rats. The levels of SOD and GSH-Px were significantly lower but that of MDA markedly higher in the model rats ([84.12 ± 23.25], [10.56 ± 3.02], and [14.04 ± 2.06] nmol/mg) than in the normal group ([110.04 ± 19.56], [17.25 ± 3.56], and [8.87 ± 1.35] nmol/mg) (P < 0.05), while the former two indexes remarkably higher and the latter one significantly lower in the animals treated with Qiangjing Decoction ([120.56 ± 23.68], [16.34 ± 3.12], and [8.45 ± 1.56] nmol/mg), Huangjingzanyu Capsules ([115.34 ± 21.35], [15.23 ± 3.67], and [8.33 ± 1.54] nmol/mg), and levocarnitine ([116.67 ± 22.67], [15.35 ± 3.45], and [8.05 ± 1.78] nmol/mg) than in the models (P < 0.05). The levels of fructose, LDH and α-glucosidase were decreased markedly in the OAS models ([100.22 ± 12.12] mg/[ ml x g], [322 ± 46.13] U/[ ml x g], and [10.48 ± 2.33] U/[ml x g]) as compared with the normal rats ([128.12 ± 13.45] mg/[ml x g], [428 ± 35.12] U/[ml x g], and [15.34 ± 3.12] U/[ ml x g]) (P < 0.05), remarkably higher in the rats treated with Qiangjing ([130.23 ± 13.67] mg/[ml x g] [455 ± 51.50] U/[ml x g], and [18.56 ± 4.67] U/[ml x g]), Huangjingzanyu ([124.16 ± 14.02] mg/[ml x g], [ 419 ± 43.14] U/[ml x g], and [17.64 ± 4.08] U/[ml x g]), and levocarnitine ([123.34 ± 14.02] mg/[ml x g], [430 ± 31.80] U/ [ml x g], and [16.85 ± 5.55] U/[ml x g]) than in the models (P < 0.05). The Nrf2 mRNA expression was significantly reduced in the models as compared with the normal rats (P < 0.05) but remarkably increased in the Huangingzanyu, Qiangjing and levocarnitine groups as compared with the model and normal animals (P < 0.05). The SDH mRNA expression was significantly lower in the model than in the normal rats (P < 0.05) but markedly elevated in the Huangjingzanyu, Qiangjing and levocarnitine groups as compared with the model and normal animals (P < 0.05), remarkably higher in the Qiangjing than in the Huangjingzanyu group (P < 0.05)., Conclusion: Ornidazole induces OAS in rats, which is closely associated with excessive oxidation and energy metabolism dysfunction. Qiangjing Decoction can improve and even reverse ornidazole-induced OAS in rats as well as improve the ultrastructure of their testicular and epididymal tissues. Antioxidation and improvement of energy metabolism are probably the action mechanisms of Qiangjing Decoction in the treatment of OAS.

Objective: To observe the clinical efficacy of Shugan Yiyang Capsules in the treatment of asthenospermia and its action mechanisms., Methods: We randomly assigned 135 asthenospermia patients to groups A (n = 47), B (n = 45), and C (n = 43) to be treated with Shugan Yiyang Capsules, oral levocarnitine, or combination of the two. We observed sperm quality and the level of α-glucosidase in the seminal plasma before and after medication., Results: The total effectiveness rate was 70.21% in group A (markedly effective in 16 cases and effective in 17), 68.89% in group B (markedly effective in 15 cases and effective in 16), and 83.72% in group C (markedly effective in 16 cases and effective in 20), significantly higher in C than in A and B (P < 0.05). Both sperm quality and the level of α-glucosidase in the seminal plasma were improved in the three groups of patients, most obviously in group C., Conclusion: Shugan Yiyang Capsules can be used for the treatment of asthenospermia, and its effect can be enhanced in combination with oral levocarnitine.

Objective: To observe the therapeutic effect of Qilin Pills combined with clomiphene on idiopathic oligoasthenospermia., Methods: We randomly assigned 300 patients with idiopathic oligoasthenospermia to a trial (n = 156) and a control group (n = 144) to be treated with Qilin Pills (6 g, tid) combined with clomiphene (50 mg, qd) and clomiphene alone (50 mg, qd), respectively, both for a course of 12 weeks. Before and after 4, 8, and 12 weeks of medication, we determined sperm concentration, the percentages of grade a and grade a + b sperm, sperm motility, and the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T), followed by evaluation of the clinical efficacy of Qilin Pills with the pregnancy rate in the patients' spouses as the secondaty therapeutic indexes., Results: Compared with the baseline, both groups of patients showed remarkably improved semen parameters and hormone levels after treatment (all P < 0.01). After 4, 8, and 12 weeks of medication, statistically significant differences were observed between the trial and control groups in sperm concentration ([17.06 ± 2.24] vs [15.07 ± 2.48], [22.10 ± 2.65] vs [18.11 ± 2.97], and [28.13 ± 3.59] vs [21.21 ± 3.60] x 10(6)/mL, P < 0.01), the percentage of grade a sperm ([15.03 ± 2.39] vs [13.08 ± 2.51], [21.08 ± 3.16] vs [16.04 ± 3.05], and [28.08 ± 4.70] vs [20.14 ± 4.74]%, P < 0.01), the percentage of grade a + b sperm ([30.10 ± 5.07] vs [26.21 ± 3.96], [38.08 ± 5.64] vs [30.07 ± 4.80], and [48.04 ± 6.49] vs [35.28 ± 4.77]%, P < 0.01), sperm motility ([42.04 ± 4.86] vs [40.29 ± 4.19], [52.05 ± 5.58] vs [48.03 ± 4.40], and [65.03 ± 5.13] vs [56.67 ± 4.99]%), the FSH level ([7.75 ± 1.38] vs [7.20 ± 1.17], [10.83 ± 1.23] vs [9.10 ± 1.32], and [14.22 ± 0.84] vs [12.06 ± 1.45] IU/L, P < 0.01), the LH level ([10.05 ± 1.68] vs [9.18 ± 1.54], [13.96 ± 1.68] vs [11.99 ± 1.71], and [19.01 ± 2.42] vs [15.86 ± 2.08] IU/L, P < 0.01) and the T level ([19.19 ± 192] vs [18.34 ± 1.79] [21.06 ± 1.63] vs [20.06 ± 1.56], and [24.63 ± 1.06] vs [22.03 ± 1.49] nmol/L, P < 0.01). The pregnancy rate in the patients' spouses was significantly higher in the trial than in the control group at 4, 8, and 12 weeks (1.92 vs 0.69, 4.81 vs 3.47, and 11.54 vs 8.33%, P < 0.01). There were no statistically significant differences in drug tolerance between the two groups (P > 0.05). No obvious adverse reactions were observed., Conclusion: Qilin Pills combined with clomiphene can evidently improve the seminal quality and hormone level of oligoasthenospermia patients with no obvious adverse events. However, its long-term efficacy and tolerance deserve further clinical investigation.

Objective: To evaluate the effect and safety of L-carnitine in the treatment of idiopathic oligoasthenozoospermia based on current clinical evidence., Methods: We searched the Cochrane Library, PubMed, MEDLINE, EMBASE, CNKI, VIP, CBM and Wanfang Database from the establishment to April 2014 for the published literature on the treatment of idiopathic oligoasthenozoospermia with L-carnitine. We conducted literature screening, data extraction, and assessment of the methodological quality of the included trials according to the inclusion and exclusion criteria, followed by statistical analysis with the RevMan 5. 2 software., Results: Seven randomized controlled trials involving 751 patients with idiopathic oligoasthenozoospermia met the inclusion criteria, and 678 of them were included in the meta-analysis. L-carnitine treatment achieved a significantly increased rate of spontaneous pregnancy as compared with the control group (RR = 3.2, 95% CI 1.74 to 5.87, P = 0.0002). After 12-16 and 24-26 weeks of medication, total sperm motility (WMD = 5.21, 95% CI 2.78 to 7.64, P < 0.0001 and WMD = 9.29, 95% CI 1.28 to 17.29, P = 0.02) and the percentage of progressively motile sperm (WMD = 12.44, 95% CI 4.58 to 20.31, P = 0.002 and WMD = 9.76, 95% CI 3.56 to 15.97, P = 0.002) were remarkably higher than those in the control group, but no statistically significant differences were observed in sperm concentration between the two groups (WMD = 4.91, 95% CI -2.63 to 12.45, P = 0.2 and WMD = 0.93, 95% CI -3.48 to 5.34, P = 0.68). After 12-16 weeks of treatment, the percentage of morphologically abnormal sperm was markedly decreased in the L-carnitine group as compared with the control (WMD = -2.48, 95% CI -4.35 to -0.61, P = 0.009), but showed no significant difference from the latter group after 24-26 weeks (WMD = -4.38, 95% CI -9.66 to 0.89, P = 0.1). No statistically significant difference was found in the semen volume between the two groups after 12-16 or 24-26 weeks of medication (WMD = -0.13, 95% CI -0.43 to 0.18, P = 0.42 and WMD = 0.28, 95% CI -0.02 to 0.58, P = 0.07). No serious L-carnitine-related adverse events were reported in 4 of the randomniized controlled trials., Conclusion: The current evidence indicates that L-carnitine can improve spontaneous pregnancy and semen parameters in the treatment of idiopathic oligoasthenozoospermia, with no serious adverse reactions.

Objective: To explore the efficacy and safety of vitamin D (VD) in the treatment of idiopathic oligoasthenozoospermia., Methods: This study included 86 infertile men with idiopathic oligoasthenozoospermia, who were randomized to a VD and a control group of equal number, the former given oral VD 200 IU/d and calcium 600 mg/d,qd, while the latter administered oral vitamin E 100 mg and vitamin C 100 mg, tid. After 3 months of medication, we compared the semen parameters, adverse reactions, and pregnancy rate between the two groups., Results: After medication, the count of progressively motile sperm per ejaculate was increased from (9.82 ± 3.72) x 10(6) to (21.47 ± 6.52) x 10(6) ( P < 0.05) and the proportion of progressively motile sperm from (18.41 ± 9.82)% to (28.27 ± 4.47)% (P < 0.05) in the VD group. In comparison, the count of progressively motile sperm per ejaculate was elevated from (9.51 ± 6.31) x 10(6) to (12.36 ± 4.43) x 10(6) (P > 0.05) and the proportion of progressively motile sperm from (17.79 ± 5.25)% to (21.35 ± 2.41)% (P > 0.05) in the control group. Pregnancy was achieved in 7 cases (16.3%) in the VD group, but only lease (2.3%) in the control (P < 0.05). No adverse reactions were observed in either of the groups., Conclusion: Vitamin D, as a safe option for the treatment of idiopathic oligoasthenozoospermia, can effectively improve the semen quality, especially the progressive sperm motility of the patient.

Objective: To assess the efficacy of Yiqi Zhujing Particle in the treatment of idiopathic oligoasthenozoospermia., Methods: We equally randomized 78 patients with idiopathic oligoasthenozoospermia to a control group and a Yiqi Zhujing group, the former treated with oral medication of zinc gluconate liquid (10 ml, bid) and vitamin E (100 mg, bid), and the latter given Yiqi Zhujing Granule (1 packet, bid) in addition, both for 3 months. We compared the semen parameters and biochemical indexes of the seminal plasma obtained before and after medication between the two groups of patients., Results: After 3 months of treatment, remarkable improvement was observed in the percentage of progressively motile sperm and sperm viability in the control group (P < 0.05) as well as in the total sperm count, sperm concentration, percentage of progressively motile sperm, and sperm viability in the Yiqi Zhujing group (P < 0.05). The total sperm count, sperm concentration, percentage of progressively motile sperm, and sperm viability were even more significantly improved in the Yiqi Zhujing than in the control group (P < 0.05). Besides, both groups showed different degrees of improvement in the biochemical indexes of the seminal plasma, and the Yiqi Zhujing group exhibited even more significant improvement in seminal plasma zinc, alpha-glucoside enzyme, seminal plasma fructose, and acid phosphatase than the control (P < 0.05). The improvement of sperm concentration was correlated positively with the change of seminal plasma zinc (r = 0.201, P < 0.05) but negatively with that of seminal plasma fructose after treatment (r = -0.136, P < 0.05). There was a positive correlation between the alpha-glucoside enzyme level and sperm viability (r = 0.314, P < 0.05)., Conclusion: Yiqi Zhujing Particle is effective for idiopathic oligoasthenozoospermia by significantly improving the total sperm count, sperm concentration, percentage of progressively motile sperm, sperm viability, seminal plasma zinc, seminal plasma fructose, and alpha-glucoside enzyme.

Objective: To observe the efficacy of the combination of Qilin Pills and levofloxacin in the treatment of asthenospermia accompanied with accessory sex gland infection., Methods: We randomly assigned 80 asthenospermia patients with accessory sex gland infection to groups 1 and 2 of equal number, the former treated with Qilin Pills + levofloxacin, and the latter with levofloxacin only. Qilin Pills were administered at the dose of 6 g tid for 30 days, and levofloxacin at the dose of 0.5 g qd for 20 days. We obtained semen parameters, including the percentage of progressively motile sperm and peroxidase-positive white blood cell (WBC) count, before and after medication, and compared the clinical effects between the two groups., Results: All the patients accomplished the clinical trial. The therapeutic effectiveness rates in improving progressive sperm motility were 60% in group 1 and 17.5% in group 2, with statistically significant differences between the two groups (P < 0.05). As for the peroxidase-positive WBC count in semen, the effectiveness rates were 87.5% and 82.5%, respectively, with no significant differences between the two groups (P > 0.05)., Conclusion: For the treatment of asthenospermia accompanied with accessory sex gland infection, Qilin Pills combined with levofloxacin is evidently better than levofloxacin alone in improving sperm motility, and it has no obvious adverse effects.

Objective: To observe the therapeutic effect of Qilin Pills combined with bromocriptine on idiopathic hyperprolactinemic (HPRL) oligoasthenospermia., Methods: We conducted a randomized controlled study on 40 cases of idiopathic HPRL oligoasthenospermia, who were equally assigned to a trial group and a control group to be treated with Qilin Pills (6 g tid) combined with bromocriptine and bromocriptine alone, respectively, both for a course of 12 weeks. Then we observed the changes in the semen volume, sperm concentration, sperm motility and the levels of serum prolactin and testosterone, and compared the therapeutic results between the two groups before and after medication., Results: Compared with the parameters before medication, both the trial and the control group showed significant improvement after treatment in sperm concentration ([11.60 +/- 3.90] x 10(6)/ml vs [28.10 +/- 13.50] x 10(6)/ml and [12.03 +/- 4.10] x 10(6)/ml vs [18.85 +/- 8.50] x 10(6)/ml), the percentage of grade a sperm ([8.75 +/- 6.65]% vs [24.35 +/- 13.25 ]% and [8.70 +/- 6.70] % vs [19.65 +/- 10.05]%), the percentage of grade a + b sperm ( [28.45 +/- 11.35]% vs [45.80 +/- 16.55]% and [27.65 +/- 10.65]% vs [35.66 +/-13.25]%), and sperm motility ([38.22 +/- 16.35]% vs [60.05 +/- 20.65]% and [37.25 +/- 15.75 ]% vs [52.65 +/- 18.25 ]%) (all P<0.01). No significant differences were found in semen volume (P>0.05). The serum prolactin levels were significantly decreased in the trial and control groups ([152.00 +/- 22.32] and [160.45 +/- 26.65] mIU/L), as compared with premedication ([482.25 +/- 65.32] and [477.32 +/- 60.25] mIU/L) (P<0.01), while the serum testosterone levels were remarkably higher ([16.35 +/- 5.52] and [11.15 +/- 4.65] nmol/L) than before treatment ([3.75 +/- 1.10] and [4.05 +/- 1.30] nmol/L) (P<0.01). There were no statistically significant differences in the serum prolactin and testosterone levels between the two groups after treatment (P>0.05)., Conclusion: Qilin Pills combined with bromocriptine have a significantly better efficacy than bromocriptine alone in the treatment of idiopathic HPRL oligoasthenospermia.

Objective: To evaluate the effect of short-course kidney-invigorating therapy on near-term semen quality in asthenozoospermic men with kidney deficiency., Methods: Based on the differential types in traditional Chinese medicine, 121 asthenozoospermia patients received at our clinic of andrology were divided into groups A (kidney-yin deficiency), B (kidney-yang deficiency) and C (spleen and kidney deficiency), and treated with Yougui Decoction plus Wuziyanzong Pills, Jinkuishenqi Pills plus Wuziyanzong Pills, and Shizi Decoction plus Liujunzi Decoction, respectively, all given once daily for 4 weeks. Sperm parameters of the patients were analyzed with the computer-assisted sperm analysis system before and after treatment and compared among the three groups., Results: The baseline sperm concentrations in groups A, B and C ([70.4 +/- 38.6], [73.5 +/- 40.2] and [56.0 +/-34.4] x 10(6)/ml) showed no significant differences from those after medication ([74.4 +/- 32.6], [67.0 +/- 30.8] and [58.6 +/- 24.6] x 10(6)/ml) (P > 0.05). The percentages of grade a sperm in the three groups were (12.9 +/- 5.3)%, (13.7 +/- 7.7)% and (12.9 +/- 6.4)% respectively after treatment, significantly higher than (9.9 +/- 6.7)%, (9.3 +/- 5.4)% and (9.0 +/- 6.8)% before treatment (P < 0.05), and so were the percentages of grade a + b sperm ([37.4 +/- 10.2 ]%, [35.7 +/- 13.7]% and [35.9 +/- 12.3]% after treatment versus [29.6 +/- 13.2]%, [27.5 +/- 10.4]% and [28.3 +/- 12.1]% before treatment, P < 0.05). All the three groups showed significantly increased sperm motility after treatment ([53.8 +/- 10.5]%, [52.6 +/- 15.2]% and [51.1 +/- 13.1]%) as compared with the baseline levels ([44.3 +/- 14.0]%, [43.5 +/- 15.0]% and [42.4 +/- 14.9]%) (P < 0.05). The cure rate and total effectiveness rate were significantly higher in group B than in A (P < 0.05), but had no significant differences between either A and C or B and C (P > 0.05)., Conclusion: Short-course kidney-invigorating therapy can significantly improve near-term semen quality in asthenozoospermic men with kidney asthenia, especially in those with kidney-yang deficiency, and it has no obvious adverse effects.

Objective: To investigate the effects of Yijing Recipe on sperm apoptosis and mitochondrial membrane potential (MMP) in patients with idiopathic oligoathenoteratospermia., Methods: Using the self-control method, we examined sperm apoptosis and MMP in 30 patients with oligoathenoteratospermia before and after treated with Yijing Recipe., Results: The rates of early sperm apoptosis (AV +/PI -) and MMP loss were significantly reduced after treatment as compared with pre-medication ([2.86 +/- 1.47]% vs [4.26 +/- 2.79]% and [21.77 +/- 13.46]% vs [41.73 +/- 20.30]%, P<0.05). No statistically significant difference was observed in the sperm death rate (PI+) before and after treatment ([34.10 +/- 16.26]% vs [30.21 +/- 13.50]%, P>0.05)., Conclusion: Yijing Recipe can reduce early sperm apoptosis and improve MMP, which may be one of the mechanisms underlying its efficacy on oligoathenoteratospermia.

Objective: To investigate the clinical efficacy of Shengjing prescription for oligoasthenozoospermia and its action mechanism., Methods: We equally assigned 120 patients with oligoasthenozoospermia to receive Shengjing prescription (treatment group) and vitamin E (control group), respectively, for 12 weeks. Before and after the treatment, were obtained sperm concentration, sperm motility, the percentage of morphologically normal sperm, the levels of serum follicle-stimulating hormone (FSH), testosterone (T) and luteinizing hormone (LH), sperm DNA fragmentation index (DFI), the percentage of hypotonic swelling sperm, and the levels of seminal plasma elastase, x-glucosidase, fructose, zinc and acrosin., Results: Compared with vitamin E, Shengling prescription significantly improved sperm concentration, motility and morphology (P < 0.01), decreased the serum FSH level, elevated the serum T level (P <0. 01) , reduced DFI and seminal plasma elastase, and increased the percentage of hypotonic swelling sperm as well as the levels of seminal plasma cx-glucosidase, fructose, zinc and acrosin., Conclusion: Shengjing prescription improves semen parameters of patients with oligoasthenozoospermia at multiple levels and through multiple channels.

Objective: To explore the therapeutic effect of natural vitamin E (VitE) on oligospermia and asthenospermia in in- fertile men., Methods: We conducted a prospective multi-centered randomized controlled study on 64 infertile men with oligospermia (31 as controls treated with Tamoxifen 10 mg bid and 33 as experimental cases treated with Tamoxifen 10 mg bid + VitE 100 mg tid) and 42 cases of asthenospermia (20 as controls treated with Levocarnitine oral solution 1 bottle bid and 22 as experimental cases treated with Levocarnitine oral solution 1 bottle bid + VitE 100 mg tid). We compared the control and experimental groups in sperm concentration and percentage of progressively motile sperm before and 3 months after medication, as well as the rate of clinical pregnancy and adverse events., Results: Among the oligospermia patients, the average sperm concentrations in the control and experimental groups were 8.00 x 10(6)/ml and 10.66 x 10(6)/ml before medication (P > 0.05). After medication, the numbers of cases evaluated as with no, slight, moderate and marked improvement in sperm concentration were 10 and 9 (P > 0.05), 16 and 14 (P > 0.05), 5 and 4 (P > 0.05) and 0 and 0 (P >0.05); and the numbers of natural pregnancies were 0 and 6 in the control and experimental groups (P < 0.01). Among the asthenospermia patients, the average rates of progressively motile sperm were 17.00% and 18.10% in the control and experimental groups before medication (P > 0.05). After medication, the numbers of cases evaluated as with no, slight, moderate and marked improvement in the percentage of progressively motile sperm were 7 and 2 (P < 0.01), 4 and 8 (P < 0.01), 3 and 2 (P > 0.05) and 1 and 1 (P > 0.05), and the numbers of natural pregnancies were 5 and 9 in the two groups (P < 0.01), but no adverse events were observed., Conclusion: As a safe and effective adjuvant agent for the treatment of oligospermia and asthenospermia, vitamin E can improve sperm concentration, the percentage of progressively motile sperm, and finally the rate of natural pregnancy.

Objective: To evaluate the clinical effect of the Chinese medicine Yangjing Decoction on idiopathic asthenospermia., Methods: This study included 62 patients with idiopathic asthenospermia diagnosed with the computer-assisted semen analysis system and other methods based on the WHO guidelines. The patients were equally randomized to a trial and a control group, the former treated with Yangjing Decoction at the dose of 400 ml bid, and the latter with Yougui Capsules tid, both for a course of 6 months. Then we analyzed the changes in sperm concentration and percentage of grade a + b sperm in the patients, as well as the pregnancy in their wives., Results: Compared with the controls, the patients of the trial group showed a significantly elevated percentage of grade a + b sperm after 6 months medication (P < 0.01), though no statistically significant differences were observed in sperm concentration (P > 0.05). The total rate of effectiveness was 87.09% and 7 pregnancies were achieved in the trial group, as compared with 66.74% and 3 pregnancies in the controls (P < 0.05)., Conclusion: Yangjing Decoction can significantly improve sperm vitality, and has a desirable effect on idiopathic asthenospermia.

Objective: One of the important reasons for male infertility is asthenozoospermia, for which there is no specific cure for the time being. The authors explored the clinical effect of L-carnitine for infertile males with asthenozoospermia., Methods: A total of 135 patients with asthenozoospermia were randomly divided into Groups A (n = 68) and B (n = 67), the former treated with L-carnitine (2 g/d) and vitamin E, while the latter with vitamin E only, both for 3 months. All the patients received semen analyses before and after the treatment, and were observed for adverse effects. The pregnancy rates of their wives were recorded., Results: Group A showed a significantly increased percentage of forward motile sperm after the treatment (45.4% +/- 11.1%) as compared with pretreatment (28.6% +/- 9.2%) (P < 0.01), but no statistically significant differences were found in sperm density and the percentage of the sperm of normal morphology (P > 0.05). The rate of pregnancy was significantly higher in Group A (31.1%) than in B (3.8%) after the treatment (P < 0.01). No adverse events were found during the treatment., Conclusion: L-carnitine, capable of significantly improving sperm motility and raising the rate of pregnancy, is a safe and effective therapeutic option for asthenozoospermia.

Objective: To investigate the clinical effect of the Chinese medicinal preparation Shengling Capsule on patients with oligoasthenospermia., Methods: A total of 270 male patients with infertility induced by oligoasthenospermia were equally divided into a treatment and a control group, the former medicated with Shengling Capsule at the dose of 1.6 g tid, and the latter given Vit E at 50 mg tid, both for a course of 12 weeks. Then we analyzed the changes in the patients'seminal parameters and the pregnancy of their wives., Results: After 12 weeks of medication, both the seminal parameters of the patients and pregnancy of their wives were remarkably improved, with extremely significant differences from pre-treatment and the control (P < 0.01)., Conclusion: Shengjing Capsule can improve sperm motility and vitality as well as sperm count. With few adverse effects, it can be used as a safe and effective therapeutic for male infertility induced by oligoasthenospermia.

Objective: To explore the protective effect of L-carnitine (LC) on the reproductive function of male rats with asthenospermia induced by ornidazole (ORN)., Methods: Forty male SD rats (200-230 g) were randomly divided into Groups A (control: 0.5% carboxymethylcellulose solution), B (medium-dose ORN: 400 mg/kg/d), C (medium-dose ORN + LC: ORN 400 mg/kg/d + LC 100 mg/kg/d), D (high-dose ORN: 800 mg/kg/d), and E (high-dose ORN + LC: ORN 800 mg/kg/d + LC 100 mg/kg/d). All the rats were treated via gastric gavage for 20 days consecutively, and then killed for the detection of sperm motility and the sperm count of the cauda epididymis., Results: Compared with Group A, there was a significant decrease in sperm motility and sperm count in Groups B and D (P < 0.05), while Group C showed a significant increase in both the parameters as compared with B (P < 0.05), but with no significant difference from A (P > 0.05). Group E exhibited no obvious improvement in sperm motility and sperm count, with no difference from D (P > 0.05)., Conclusion: L-carnitine can improve the sperm motility and sperm count of the male rats with ornidazole-induced asthenospermia.

Objective: To evaluate the clinical efficacy of combined L-carnitine and acetyl-L-carnitine on idiopathic asthenospermia., Methods: Thirty patients with idiopathic asthenospermia were treated by combined L-carnitine and acetyl-L-carnitine for 3 months after failure to respond to the integrated therapy of Chinese and Western medicine. Semen samples were obtained, analyzed and graded according to the WHO laboratory manual before and after the treatment. Twenty-five of the patients completed the whole study., Results: Combined L-carnitine and acetyl-L-carnitine statistically improved the sperm vitality (24.89 +/- 12.28)%, grade a + b sperm motility (16.04 +/- 8.33)% and the total sperm count per ejaculate (76.79 +/- 43.14) x 10(6), with a significant difference from pre-treatment (P < 0.05)., Conclusion: Combined L-carnitine and acetyl-L-carnitine has a supplementary effect in the treatment of idiopathic asthenospermia and improves the semen quality of the patient.

Objective: To study the effect of different concentrations of the extract of acanthopanacis senticosus on human sperm motility in vitro and to investigate its possible mechanism., Methods: By computer-assisted sperm analysis (CASA) system, we observed the effect of different concentrations of the extract of acanthopanacis senticosus on human sperm motility in vitro. The sperm obtained by masturbation and prepared by swim-up technique from 35 men with asthenospermia was incubated in different concentrations of the extract of acanthopanacis senticosus, and all the specimens were measured at 30, 60, 120 and 180 min respectively., Results: Different concentrations of the extract of acanthopanacis senticosus obviously improved the sperm motility of asthenospermia patients. The extract at the concentrations of 5 and 10 g/L increased the rate of motility (MOT), the percentage of progressive mobile sperm, the curvilinear velocity (VCL), the straight line velocity (VSL) and the average path velocity (VAP). Compared with the control group, the difference was significant (P < 0.05)., Conclusion: The extract of acanthopanacis senticosus can improve the sperm motility of asthenospermia patients in vitro and its optimal concentration is 10 g/L. The study may provide a new drug therapy for asthenospermia.

Objective: To investigate the effects of LY294002, a phosphatidylinositol 3-kinase inhibition, on sperm motility in asthenozoospermia patients in vitro, and further analyze the possible molecular mechanism., Methods: Sperm aseptically obtained by masturbation and prepared by swim-up technique from 10 patients with asthenozoospermia and 10 healthy fertile men were incubated with different concentrations of LY294002. Measurements of motility were carried out at 10, 30 and 60 min in all specimens by CASA., Results: The sperm in asthenozoospermia patients treated with LY294002 showed a significant increase in sperm progressive motility, the percentage of motile cells, VSL and VAP., Conclusion: LY294002 can enhance the motility of sperm in asthenozoospermia patients in vitro.

Objective: To evaluate the efficacy of L-carnitine on asthenospermia with epididymal knob., Methods: Thirty-five patients aged 25-39 years with asthenospermia with epididymal knob were received at our clinic of andrology from May 2003 to July 2004, and given oral L-carnitine 2 g/d for 3 months. The sperm parameters of the patients were analyzed by computer-assisted sperm analysis system before and after L-carnitine treatment., Results: Of the 32 patients who accomplished the 3-month L-carnitine therapy, only 4 remained unimproved in sperm parameters, while the other 28 were significantly improved in sperm concentration, forward sperm motility, total sperm motility, straight line velocity, curvilinear velocity and average path velocity. Four of the patients wives were pregnant and one patient fathered a child., Conclusion: Oral L-carnitine therapy is efficacious for asthenospermia with epididymal knob.