Re: Ashwagandha Improves Multiple Parameters Affecting Infertile Men
Ahmad MK, Mahdi AA, Shukla KK, et al. Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males. Fertil Steril. Jun 5, 2009. [Epub ahead of print].
Human semen
contains antioxidants to counter the oxidative effects of reactive oxygen
species (ROS) produced by sperm cell metabolism. Excessive production of ROS
causes seminal oxidative stress that is linked to idiopathic male infertility.
Ashwagandha (Withania somnifera) is
traditionally used as an aphrodisiac, and it inhibits lipid peroxidation in
animals under stress. In vivo studies have shown that it enhances reproductive
functions in mature and immature male rats. This clinical study was designed to
assess the effects of ashwagandha on the semen profile, oxidative biomarkers,
and reproductive hormone levels of infertile men.
The
researchers obtained ashwagandha roots from the Central Council for Research in
Unani Medicine in New Delhi,
India. The
roots were shade-dried and ground into a fine powder. The study was conducted
between February 2007 and August 2008 at the ChhatrapatiShahujiMaharajMedicalUniversity
in Lucknow, India. The authors recruited 75
infertile men aged 25-40 years. They were aged-matched to the control group
(n=75), which included healthy men who had initiated at least 1 pregnancy and
had a normal semen profile (sperm concentration>20 x 106/ml,
motility>40%, >40% normal morphology). The 3 treatment groups included 25
infertile men with normal semen profiles (normozoospermic group), 25 men with
low sperm concentrations (<20 x 106/ml, oligozoospermic group),
and 25 men with low sperm motility (<40%, asthenozoospermic group). The
treatment groups took 5 g/day ashwagandha root powder with milk for 3 months.
They provided semen samples following 3-4 days of abstinence before and after
treatment. The control group provided 1 semen sample. The samples were used to
assess semen profile following the World Health Organization (WHO) procedures.
Seminal plasma obtained as supernatant after repeated centrifugation was used
to assess biochemical parameters, and venous blood samples were taken to
measure hormone levels.
After
treatment, sperm concentration and motility were significantly increased
compared to baseline levels in all 3 treatment groups (P<0.01 for all). The
sperm motility was still "less than optimal" in the asthenozoospermic
treatment group (24.44%). Following treatment, semen volume increased
significantly compared to baseline levels in the normozoospermic and
oligozoospermic treatment groups (P<0.01 for both), but not in the
asthenozoospermic treatment group.
The levels
of lipid peroxides (LPO) and protein carbonyl groups were significantly higher
compared to the control group in all 3 treatment groups at baseline (P<0.01
for all). After treatment, levels of LPOs and protein carbonyl groups were
significantly lower compared to baseline levels in all 3 treatment groups
(P<0.01). Seminal plasma superoxide dismutase (SOD) activity was
significantly lower than that of the control group in the 3 treatment groups
before supplementation (P<0.01). Pre-treatment catalase activity was also
significantly lower compared to the control group in all 3 treatment groups
(normozoospermic and oligozoospermic groups: P<0.05, asthenozoospermic:
P<0.01). Similarly, glutathione activity was significantly lower in the 3
treatment groups compared to the control group at baseline (P<0.01 for all).
Following treatment, SOD, catalase, and glutathione activities all increased
significantly compared to baseline levels in all 3 treatment groups (P<0.01
for all).
Pre-treatment
levels of vitamins A, E, and C and fructose were all significantly lower in the
seminal plasma of the treatment groups compared to the control group (P<0.01
for all). After treatment, the levels of vitamins A, E, and C had significantly
improved compared to baseline levels in the 3 treatment groups (P<0.01 for
all). Fructose levels were also significantly improved in all 3 groups compared
to baseline levels (P<0.05). Before treatment, the serum testosterone and
luteinizing hormone (LH) levels of the 3 groups were significantly lower than
those of the control group (P<0.01 for both). Following treatment,
testosterone and LH levels were both significantly improved compared to
pre-treatment levels in the 3 treatment groups (P<0.01 for all). LH
stimulates the production of testosterone, which stimulates spermatogenesis
(sperm production). Pre-treatment serum levels of follicle stimulating hormone
(FSH) and prolactin were significantly higher in the asthenozoospermic and
oligozoospermic groups compared to the control group (P<0.01-0.05).
Following treatment, the asthenozoospermic and oligozoospermic groups' serum
FSH and prolactin levels were significantly lower compared to baseline levels
(P<0.01-0.05). FSH was significantly lower after treatment than at baseline
for the normozoospermic group (P<0.05).
The authors
conclude that low levels of LH and testosterone were "very good indicators
of infertility," while high levels of FSH and prolactin were good but less
accurate infertility markers. The authors also conclude that treatment with
ashwagandha increased sperm counts and motility and seminal levels of
antioxidants, while decreasing oxidants and improving the serum hormone
profiles of infertile men. More research is needed to determine the mechanism
of action and active constituents responsible for these effects.