Modern possibilities of phytotherapy for male infertility from the standpoint of evidence-based medicine
DOI:
https://doi.org/10.18413/rrpharmacology.9.10060Abstract
Introduction: Male infertility is an topical medical and social problem of modern reproductive medicine. Its pharmacotherapy is often empirical in nature, and the most popular method remains the use of various herbal substances (phytotherapy), the effectiveness of which remains still understudied in the framework of evidence-based medicine.
Materials and Methods: The results of research, thematic, systematic and Cochrane reviews and meta-analyses were searched in Medline/PubMed medical databases over the past 5 years using the search queries "plants male infertility", "plants sperm", "phytotherapy male infertility", "phytomedicinal therapeutics male infertility", "systematic review", "meta-analysis", and "review".
Results: The vast majority of herbal substances offered for the treatment of male infertility demonstrate insufficient or contradictory evidence base for their clinical effectiveness, although some of them can be very useful pharmacotherapeutic options in the combined therapy of male infertility.
Conclusion: Not all plant substances with a "reproductive effect" positioned in them actually have proven reproductive effects in studies in humans, therefore, the choice of phytotherapeutic agents in the treatment of idiopathic male infertility should be currently approached extremely carefully, especially in cases when we choose phytotherapy as an option for empirical monotherapy of male reproductive disorders.
Graphical Abstract
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Keywords:
male infertility, medicinal plants, phytotherapy, herbal agents, efficacy, meta–analysis, systematic reviewReferences
Abarikwu SO, Onuah CL, Singh SK (2020) Plants in the management of male infertility. Andrologia 52(3): e13509. https://doi.org/10.1111/and.13509 [PubMed]
Aghajani MMR, Mahjoub S, Mojab F, Namdari M, Gorji NM, Dashtaki A, Mirabi P (2021) Comparison of the effect of Ceratonia siliqua L. (Carob) syrup and vitamin E on sperm parameters, oxidative stress index, and sex hormones in infertile Men: A randomized controlled trial. Reproductive Sciences 28(3): 766–774. https://doi.org/10.1007/s43032-020-00314-3[PubMed]
Ahmad A, Husain A, Mujeeb M, Khan SA, Najmi AK, Siddique NA, Damanhouri ZA, Anwar F (2013) A review on therapeutic potential of Nigella sativa: A miracle herb. Asian Pacific Journal of Tropical Biomedicine 3(5): 337–352. https://doi.org/10.1016/S2221-1691(13)60075-1[PubMed] [PMC]
Ahmadian M, Salari R, Noras MR, Bahrami-Taghanaki H (2022) Herbal medicines for idiopathic male infertility: A systematic review. Current Drug Discovery Technologies 19(6): e200822207800.202220. https://doi.org/10.2174/1570163819666220820122101 [PubMed]
Alcalde AM, Rabasa J (2020) Does Lepidium meyenii (Maca) improve seminal quality? Andrologia 52(10): e13755. https://doi.org/10.1111/and.13755 [PubMed]
Alghamdi SA (2020) Effect of Nigella sativa and Foeniculum vulgare seeds extracts on male mice exposed to carbendazim. Saudi Journal of Biological Sciences 27(10): 2521–2530. https://doi.org/10.1016/j.sjbs.2020.04.016 [PubMed] [PMC]
Alshinnawy AS, El-Sayed WM, Taha AM, Sayed AA, Salem AM (2020) Astragalus membranaceus and Punica granatum alleviate infertility and kidney dysfunction induced by aging in male rats. Turkish Journal of Biology 44(4): 166–175. https://doi.org/10.3906/biy-2001-5 [PubMed] [PMC]
Aoki Y, Tsujimura A, Nagashima Y, Hiramatsu I, Uesaka Y, Nozaki T, Ogishima T, Shirai M, Shoyama Y, Tanaka H, Horie S (2018) Effect of Lepidium meyenii on in vitro fertilization via improvement in acrosome reaction and motility of mouse and human sperm. Reproductive Medicine and Biology 18(1): 57–64. https://doi.org/10.1002/rmb2.12251 [PubMed] [PMC]
Baiee FH, Wahid H, Rosnina Y, Ariff O, Yimer N, Jeber Z, Salman H, Tarig A, Harighi F (2018) Impact of Eurycoma longifolia extract on DNA integrity, lipid peroxidation, and functional parameters in chilled and cryopreserved bull sperm. Cryobiology 80: 43–50. https://doi.org/10.1016/j.cryobiol.2017.12.006 [PubMed]
Boroujeni SN, Malamiri FA, Bossaghzadeh F, Esmaeili A, Moudi E (2022) The most important medicinal plants affecting sperm and testosterone production: a systematic review. JBRA Assisted Reproduction 26(3): 522–530. https://doi.org/10.5935/1518-0557.20210108 [PubMed] [PMC]
Cannarella R, Condorelli RA, Mongioì LM, Barbagallo F, Calogero AE, La Vignera S (2019) Effects of the selective estrogen receptor modulators for the treatment of male infertility: A systematic review and meta-analysis. Expert Opinion on Pharmacotherapy 20(12): 1517–1525. https://doi.org/10.1080/14656566.2019.1615057 [PubMed]
Chan KQ, Stewart C, Chester N, Hamzah SH, Yusof A (2021) The effect of Eurycoma Longifolia on the regulation of reproductive hormones in young males. Andrologia 53(4): e14001. https://doi.org/10.1111/and.14001 [PubMed]
Choowong-In P, Sattayasai J, Boonchoong P, Poodendaen C, Wu AT, Tangsrisakda N, Sawatpanich T, Arun S, Uabundit N, Iamsaard S (2021) Protective effects of Thai Mucuna pruriens (L.) DC. var. pruriens seeds on sexual behaviors and essential reproductive markers in chronic unpredictable mild stress mice. Journal of Traditional and Complementary Medicine 12(4): 402–413. https://doi.org/10.1016/j.jtcme.2021.12.001 [PubMed] [PMC]
Chung WJ, Chan KL, Lee CY (2021) Comparing the pharmacokinetics of 13α,21-dihydroeurycomanone and eurycomanone exclusively enriched in Eurycoma longifolia extracts and their spermatogenesis enhancement in andrographolide-induced oligospermia in rats. The Journal of Pharmacy and Pharmacology 73(2): 161–168. https://doi.org/10.1093/jpp/rgaa026
D'Anza E, Albarella S, Galdiero G, Tafuri S, Del Prete C, Cocchia N, Ciani F, Mastellone V, Pasolini MP, Carotenuto D, Selvaggi M, Ciotola F, Peretti V (2021) DNA fragmentation and morphometric studies in sperm of stallions supplemented with maca (Lepidium meyenii). Zygote 29(4): 325–330. https://doi.org/10.1017/S0967199420000751 [PubMed]
de Ligny W, Smits RM, Mackenzie-Proctor R, Jordan V, Fleischer K, de Bruin JP, Showell MG (2022) Antioxidants for male subfertility. The Cochrane Database of Systematic Reviews 5(5): CD007411. https://doi.org/10.1002/14651858 [PubMed] [PMC]
Ding XM, Xu R, Lin WD (2021) Morinda officinalis how extract up-regulates the expression of SPAG11T and inhibits that of miR-210 in the testis tissue of varicocele rats. Zhonghua Nan Ke Xue 27(3): 201–207. [PubMed]
Durg S, Shivaram SB, Bavage S (2018) Withania somnifera (Indian ginseng) in male infertility: An evidence-based systematic review and meta-analysis. Phytomedicine 50: 247–256. https://doi.org/10.1016/j.phymed.2017.11.011 [PubMed]
Ezzat SM, Okba MM, Ezzat MI, Aborehab NM, Mohamed SO (2019) Rho-kinase II inhibitory potential of eurycoma longifolia new isolate for the management of erectile dysfunction. Evidence-Based Complementary and Alternative Medicine 2019: 4341592. https://doi.org/10.1155/2019/4341592 [PubMed] [PMC]
Faramarzi A, Aghaz F, Golestan Jahromi M, Bakhtiari M, Khazaei M (2019) Does supplementation of sperm freezing/thawing media with Ceratonia siliqua improve detrimental effect of cryopreservation on sperm parameters and chromatin quality in normozoospermic specimens? Cell and Tissue Banking 20(3): 403–409. https://doi.org/10.1007/s10561-019-09779-2[PubMed]
Ganjkhani M, Nourozi S, Bigonah R, Rostami A, Shokri S (2019) Ameliorating impacts of ginseng on the apoptosis of spermatogenic cells and sperm quality in temporal lobe epilepsy rat model treated with valproate. Andrologia 51(9): e13348. https://doi.org/10.1111/and.13348[PubMed]
García-Baquero R, Fernández-Ávila CM, Álvarez-Ossorio JL (2020) Empiric therapy for idiopathic oligoasthenoteratozoospermia. Actas Urologicas Españolas 44(5): 281–288. https://doi.org/10.1016/j.acuro.2019.10.007 [PubMed]
George A, Henkel R (2014) Phytoandrogenic properties of Eurycoma longifolia as natural alternative to testosterone replacement therapy. Andrologia 46(7): 708–721. https://doi.org/10.1111/and.12214 [PubMed]
Gholamnezhad Z, Havakhah S, Boskabady MH (2016)
Preclinical and clinical effects of Nigella sativa and its constituent, thymoquinone: A review. Journal of Ethnopharmacology 190: 372–386. https://doi.org/10.1016/j.jep.2016.06.061[PubMed]
Ghorbaninejad Z, Eghbali A, Ghorbaninejad M, Ayyari M, Zuchowski J, Kowalczyk M, Baharvand H, Shahverdi A, Eftekhari-Yazdi P, Esfandiari F (2023) Carob extract induces spermatogenesis in an infertile mouse model via upregulation of Prm1, Plzf, Bcl-6b, Dazl, Ngn3, Stra8, and Smc1b. Journal of Ethnopharmacology 301: 115760. https://doi.org/10.1016/j.jep.2022.115760[PubMed]
Greco A, Del Prete C, De Biase D, Palumbo V, Albanese S, Bruzzese D, Carotenuto D, Ciani F, Tafuri S, Meomartino L, Mancini M, Paciello O, Cocchia N (2021) Effects of oral administration of lepidium meyenii on morphology of mice testis and motility of epididymal sperm cells after tetrahydrocannabinol exposure. Frontiers in Veterinary Science 8: 692874. https://doi.org/10.3389/fvets.2021.692874 [PubMed] [PMC]
Heidari H, Abdollahi M, Khani S, Nojavan F, Khani S (2021) Effect of Alpinia officinarum extract on reproductive damages in streptozotocin induced diabetic male rats. Journal of Diabetes and Metabolic Disorders 20(1): 77–85. https://doi.org/10.1007/s40200-020-00711-0 [PubMed] [PMC]
Iamsaard S, Arun S, Burawat J, Yannasithinon S, Tongpan S, Bunsueb S, Lapyuneyong N, Choowong-In P, Tangsrisakda N, Chaimontri C, Sukhorum W (2020) Evaluation of antioxidant capacity and reproductive toxicity of aqueous extract of Thai Mucuna pruriens seeds. Journal of Integrative Medicine 18(3): 265–273. https://doi.org/10.1016/j.joim.2020.03.00 [PubMed]
Jayusman PA, Mohamed IN, Alias E, Mohamed N, Shuid AN (2018)
The effects of quassinoid-rich eurycoma longifolia extract on bone turnover and histomorphometry indices in the androgen-deficient osteoporosis rat model. Nutrients 10(7): 799. https://doi.org/10.3390/nu10070799 [PubMed] [PMC]
Kolangi F, Shafi H, Memariani Z, Kamalinejad M, Bioos S, Jorsaraei SGA, Bijani A, Shirafkan H, Mozaffarpur SA (2019) Effect of Alpinia officinarum Hance rhizome extract on spermatogram factors in men with idiopathic infertility: A prospective double-blinded randomised clinical trial.Andrologia 51(1): e13172. https://doi.org/10.1111/and.13172 [PubMed]
Ku JY, Park MJ, Park HJ, Park NC, Joo BS (2020) Combination of Korean Red Ginseng Extract and Hydrogen-Rich Water Improves Spermatogenesis and Sperm Motility in Male Mice. Chinese Journal of Integrative Medicine 26(5): 361–369. https://doi.org/10.1007/s11655-019-3047-1[PubMed]
Lakkab I, Hajaji HE, Lachkar N, Bali BE, Lachkar M, Ciobica A (2018) Phytochemistry, bioactivity: Suggestion of Ceratonia siliqua L. as neurodegenerative disease therapy. Journal of Complementary & Integrative Medicine 15(4). https://doi.org.doi/10.1515/jcim-2018-0013[PubMed]
Lapyuneyong N, Tangsrisakda N, Choowong-In P, Chaisiwamongkol K, Uabundit N, Sawatpanich T, Arun S, Wu AT, Iamsaard S (2022) Seed extract of Thai Mucuna pruriens reduced male reproductive damage in rats induced by chronic stress. Pharmaceutical Biology 60(1): 374–383.https://doi.org/10.1080/13880209.2022.2034896 [PubMed] [PMC]
Lee HW, Kil KJ, Lee Y, Lee MS (2018) Ginseng for improving semen quality parameters: A protocol of systematic review. Medicine 97(4): e9732. https://doi.org/10.1097/MD.0000000000009732 [PubMed] [PMC]
Lee HW, Lee MS, Qu F, Lee JW, Kim E (2022) Maca (Lepidium meyenii Walp.) on semen quality parameters: A systematic review and meta-analysis. Frontiers in Pharmacology 13: 934740. https://doi.org/10.3389/fphar.2022.934740 [PubMed] [PMC]
Lee MS, Lee HW, You S, Ha KT (2016) The use of maca (Lepidium meyenii) to improve semen quality: A systematic review. Maturitas 92: 64–69. https://doi.org/10.1016/j.maturitas.2016.07.013 [PubMed]
Leisegang K, Almaghrawi W, Henkel R (2021) The effect of Nigella sativa oil and metformin on male seminal parameters and testosterone in Wistar rats exposed to an obesogenic diet. Biomedicine & pharmacotherapy 133: 111085. https://doi.org/10.1016/j.biopha.2020.111085[PubMed]
Li D, Ren J, He L, Sun J, Liu P, Li Y (2021) Combined effects of oligopeptides isolated from Panaxginseng C.A. meyer and ostrea gigas thunberg on sexual function in male mice. International Journal of Environmental Research and Public Health 18(5): 2349. https://doi.org/10.3390/ijerph18052349 [PubMed] [PMC]
Li KP, Yang XS, Wu T (2022) The effect of antioxidants on sperm quality parameters and pregnancy rates for idiopathic male infertility: A network meta-analysis of randomized controlled trials. Frontiers in Endocrinology 13: 810242. https://doi.org/10.3389/fendo.2022.810242[PubMed] [PMC]
Mabrouk A, Ben Cheikh H (2016) Thymoquinone supplementation ameliorates lead-induced testis function impairment in adult rats. Toxicology and Industrial Health 32(6): 1114–1121. https://doi.org/10.1177/0748233714548474 [PubMed]
Mehraban Z, Gaffari Novin M, Golmohammadi MG, Nazarian H (2021) Effect of ceratonia siliqua L. extract on DNA fragmentation of sperm in adult male mice treated with cyclophosphamide. Reproductive Sciences 28(4): 974–981. https://doi.org/10.1007/s43032-020-00322-3[PubMed]
Mosbah R, Djerrou Z, Mantovani A (2018) Protective effect of Nigella sativa oil against acetamiprid induced reproductive toxicity in male rats. Drug and Chemical Toxicology 41(2): 206–212. https://doi.org/10.1080/01480545.2017.1337127 [PubMed]
Nasimi Doost Azgomi R, Zomorrodi A, Nazemyieh H, Fazljou SMB, Sadeghi Bazargani H, Nejatbakhsh F, Moini Jazani A, Ahmadi AsrBadr Y (2018) Effects of Withania somnifera on reproductive system: A systematic review of the available evidence. BioMed Research International 2018: 4076430. https://doi.org/10.1155/2018/4076430 [PubMed] [PMC]
Pathania R, Chawla P, Khan H, Kaushik R, Khan MA (2020) An assessment of potential nutritive and medicinal properties of Mucuna pruriens: A natural food legume. 3 Biotech 10(6): 261. https://doi.org/10.1007/s13205-020-02253-x [PubMed] [PMC]
Pillai MK, Young DJ, Bin Hj Abdul Majid HM (2018) Therapeutic potential of alpinia officinarum.Mini Reviews in Medicinal Chemistry 18(14): 1220–1232. https://doi.org/10.2174/1389557517666171002154123 [PubMed]
Qiu C, Cheng Y (2019) Effect of Astragalus membranaceus polysaccharide on the serum cytokine levels and spermatogenesis of mice. International Journal of Biological Macromolecules 140: 771–774. https://doi.org/10.1016/j.ijbiomac.2019.08.191 [PubMed]
Qureshi A, Naughton DP, Petroczi A (2014) A systematic review on the herbal extract Tribulusterrestris and the roots of its putative aphrodisiac and performance enhancing effect. Journal of Dietary Supplements 11(1): 64–79. https://doi.org/10.3109/19390211.2014.887602 [PubMed]
Ramgir SS, Renu K, Vellingiri B, George A, Tirupapuliyur D, Thiagarajan P, Valsala Gopalakrishnan A (2022) Phytomedicinal therapeutics for male infertility: Сritical insights and scientific updates. Journal of Natural Medicines 76(3): 546–573. https://doi.org/10.1007/s11418-022-01619-0 [PubMed]
Roozbeh N, Amirian A, Abdi F, Haghdoost S (2021)
A systematic review on use of medicinal plants for male infertility treatment. Journal of Family & Reproductive Health 15(2): 74–81. https://doi.org/10.18502/jfrh.v15i2.6447 [PubMed] [PMC]
Salahshoor MR, Haghjoo M, Roshankhah S, Makalani F, Jalili C (2018) Effect of Thymoquinone on Reproductive Parameter in Morphine-treated Male Mice. Advanced Biomedical Research 7: 18. https://doi.org/10.4103/abr.abr_69_17 [PubMed] [PMC]
Salonia A, Bettocchi C, Carvalho J, Corona G, Jones TH, KadiogluА. et al. EAU Guidelines on Sexual and Reproductive Health. European Association of Urology, 2022, pp. 133-172.
Sanagoo S, Farshbaf-Khalili A, Asgharian P, Hazhir S, Oskouei BS (2021) Comparison of the effect of Ceratonia siliqua L. fruit oral capsule and vitamin E on semen parameters in men with idiopathic infertility: a triple-blind randomized controlled clinical trial. Journal of Complementary & Integrative Medicine 18(4): 791–796. https://doi.org/10.1515/jcim-2020-0095 [PubMed]
Sanagoo S, Sadeghzadeh Oskouei B, Gassab Abdollahi N, Salehi-Pourmehr H, Hazhir N, Farshbaf-Khalili A (2019) Effect of Tribulus terrestris L. on sperm parameters in men with idiopathic infertility: A systematic review. Complementary Therapies in Medicine 42: 95–103. https://doi.org/10.1016/j.ctim.2018.09.015 [PubMed]
Santos HO, Cadegiani FA, Forbes SC (2022) Nonpharmacological Clinical therapeutics: A Scoping review. Clinical Therapeutics 44(8): 1129–1149. https://doi.org10.1016/j.clinthera.2022.06.006[PubMed]
Santos HO, Howell S, Teixeira FJ (2019) Beyond tribulus (Tribulus terrestris L.): The effects of phytotherapics on testosterone, sperm and prostate parameters. Journal of Ethnopharmacology 235: 392–405. https://doi.org/10.1016/j.jep.2019.02.033 [PubMed]
Shahid MN, Khan TM, Neoh CF, Lean QY, Bukhsh A, Karuppannan M (2021)
Effectiveness of pharmacological intervention among men with infertility: A systematic review and network meta-analysis. Frontiers in Pharmacology 12: 638628. https://doi.org/10.3389/fphar.2021.638628 [PubMed] [PMC]
Shan M, Zhang X, Fang X, Tian J, Song L, Chen Y, Qiu Z, Zhu D, Luo H, Wang Z (2021) Structural analysis of Panax ginseng glycoproteins and its anti-oligoasthenozoospermia effect in vivo. International Journal of Biological Macromolecules 193(PtA): 778–788. https://doi.org/10.1016/j.ijbiomac.2021.10.136 [PubMed]
Shepherd A, Brunckhorst O, Ahmed K, Xu Q (2022) Botanicals in health and disease of the testis and male fertility: A scoping review. Phytomedicine 106: 154398. https://doi.org/10.1016/j.phymed.2022.154398 [PubMed]
Smits RM, Mackenzie-Proctor R, Yazdani A, Stankiewicz MT, Jordan V, Showell MG (2019) Antioxidants for male subfertility. The Cochrane Database of Systematic Reviews 3(3): CD007411. https://doi.org/10.1002/14651858 [PubMed] [PMC]
Soleimanzadeh A, Kian M, Moradi S, Mahmoudi S (2020) Carob (Ceratonia siliqua L.) fruit hydro-alcoholic extract alleviates reproductive toxicity of lead in male mice: Evidence on sperm parameters, sex hormones, oxidative stress biomarkers and expression of Nrf2 and iNOS. Avicenna Journal of Phytomedicine 10(1): 35–49. [PubMed] [PMC]
Tafuri S, Cocchia N, Vassetti A, Carotenuto D, Esposito L, Maruccio L. et al. Lepidium meyenii (Maca) in male reproduction.Nat Prod Res. 2021;35(22):4550–4559. https://doi.org/10.1080/14786419.2019.1698572
Tahvilzadeh M, Hajimahmoodi M, Rahimi R (2016) The role of date palm (phoenix dactylifera l) pollen in fertility: A comprehensive review of current evidence. Journal of Evidence-Based Complementary & Alternative Medicine 21(4): 320–324. https://doi.org/10.1177/2156587215609851 [PubMed]
Tahvilzadeh M, Hajimahmoodi M, Toliyat T, Karimi M, Rahimi R (2016) An evidence-based approach to medicinal plants for the treatment of sperm abnormalities in traditional Persian medicine. Andrologia 48(8): 860–879. https://doi.org/10.1111/and.12676 [PubMed]
Tatar T, Akdevelioğlu Y (2018) Effect of pollen, pit powder, and gemmule extract of date palm on male infertility: A systematic review. Journal of the American College of Nutrition 37(2): 154–160. https://doi.org/10.1080/07315724.2017.1364183 [PubMed]
Thu HE, Mohamed IN, Hussain Z, Jayusman PA, Shuid AN (2017) Eurycoma Longifolia as a potential adoptogen of male sexual health: a systematic review on clinical studies. Chinese Journal of Natural Medicines 15(1): 71–80. https://doi.org/10.1016/S1875-5364(17)30010-9[PubMed]
Tsai CH, Fang TC, Liao PL, Liao JW, Chan YJ, Cheng YW, Li CH (2020) The powdered root of eurycoma longifolia jack improves beta-cell number and pancreatic islet performance through pdx1 induction and shows antihyperglycemic activity in db/db mice. Nutrients 12(7): 2111. https://doi.org/10.3390/nu12072111 [PubMed] [PMC]
Uchendu IK, Okoroiwu HU (2021) Evaluation of blood oxidant/antioxidant changes and testicular toxicity after subacute exposure to cadmium in albino rats: Therapeutic effect of nigella sativaseed extracts. Combinatorial Chemistry & High Throughput Screening 24(1): 79–87. https://doi.org/10.2174/1386207323666200526134923 [PubMed]
Umar Z, Qureshi AS, Rehan S, Ijaz M, Faisal T, Umar S (2017) Effects of oral administration of black seed (Nigella sativa) oil on histomorphometric dynamics of testes and testosterone profile in rabbits. Pakistan Journal of Pharmaceutical S ciences30(2): 531–536. [PubMed]
Wei G, Zhou Z, Cui Y, Huang Y, Wan Z, Che X, Chai Y, Zhang Y (2021) A meta-analysis of the efficacy of L-carnitine/L-acetyl-carnitine or N-acetyl-cysteine in men with idiopathic asthenozoospermia. American Journal of Men's Health 15(2): 15579883211011371. https://doi.org/10.1177/15579883211011371 [PubMed] [PMC]
Zhang JH, Xin HL, Xu YM, Shen Y, He YQ, Hsien-Yeh, Lin B, Song HT, Juan-Liu, Yang HY, Qin LP, Zhang QY, Du J (2018) Morinda officinalis How. - A comprehensive review of traditional uses, phytochemistry and pharmacology. Journal of Ethnopharmacology 213: 230–255. https://doi.org/10.1016/j.jep.2017.10.028 [PubMed]
Zheng Y, Ren W, Zhang L, Zhang Y, Liu D, Liu Y (2020) A review of the pharmacological action of astragalus polysaccharide. Frontiers in Pharmacology 11: 349. https://doi.org/10.3389/fphar.2020.00349 [PubMed] [PMC]
Zhu Z, Zhao X, Huang F, Wang F, Wang W (2019)
morinda officinalis polysaccharides attenuate varicocele-induced spermatogenic impairment through the modulation of angiogenesis and relative factors. Evidence-Based Complementary and Alternative Medicine 2019: 8453635. https://doi.org/10.1155/2019/8453635 [PubMed] [PMC]
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