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Effect of garlic (Allium sativum) on male fertility: a systematic review

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Introduction: Fertility in men mainly depends on the number, quality, motility, and morphology of the sperms, and disruption of each of these factors leads to infertility. A large number of couples suffer from infertility problems. Among the various therapies, medicinal herbs are used in many countries to treat male infertility. Current systematic review was conducted to study the effects of garlic on male fertility. Methods: The information of this systematic review was collected by searching the key words: treatment, fertility, infertility, male, herbal medicine, garlic, Allium sativum, medicinal plant, sperm, sex hormones, testis and spermatogenesis in international databases such as: Web of Science (ISI), PubMed, Scopus and Embase until March 2018. This study was conducted in accordance with the PRISMA statement for systematic reviews and meta- analysis. and the SYRCLE risk of bias tool was used for qualitative assessment. Results: A total of 18 experimental studies were included in the study. Thirteen studies evaluated garlic and 5 studies compared garlic effect with adriamycin, titanium dioxide, furan, vitamin E, N-acetylcysteine and cadmium. All studies were conducted in in vivo condition. The results of the studies indicated the potential effect of garlic on enhancing fertility and spermatogenesis, increasing the level of testosterone and improving the testicular structure. Conclusion: Garlic can increase fertility probably due to its antioxidant properties. However, more clinical trials are recommended.
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Journal of Herbmed Pharmacology
J Herbmed Pharmacol. 2018; 7(4): 306-312.
Effect of garlic (Allium sativum) on male fertility: a systematic
review
Hadis Musavi1
ID
, Malihe Tabnak2, Farzaneh Alaei Sheini3, Maryam Hasanzadeh Bezvan4, Fardin Amidi5, Mojtaba
Abbasi6*
ID
1Department of Biochemistry, Faculty of Basic Science, Razi University Kermanshah, Kermanshah, Iran
2Department of Basic Sciences, East Tehran Branch, Islamic Azad University, Tehran, Iran
3Department of Biology, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
4Department of Microbiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran
5Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
6Veterinary Medicine, Faculty of Veterinary Medicine, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
*Corresponding author: Mojtaba Abbasi, Tel: +989131852230, Email:
Dr_Abbasi_m@yahoo.com
Implication for health policy/practice/research/medical education:
This article presented useful information about garlic, especially on fertility and reproduction system which could help
pharmacists and scientists in the provision of new drugs.
Please cite this paper as: Musavi H, Tabnak M, Alaei Sheini M, Hasanzadeh Bezvan M, Amidi F, Abbasi M. Effect of garlic
(Allium sativum) on male fertility: a systematic review. J Herbmed Pharmacol. 2018;7(4):306-312. doi: 10.15171/jhp.2018.46.
Introduction: Fertility in men mainly depends on the number, quality, motility, and
morphology of the sperms, and disruption of each of these factors leads to infertility. A large
number of couples suffer from infertility problems. Among the various therapies, medicinal
herbs are used in many countries to treat male infertility. Current systematic review was
conducted to study the effects of garlic on male fertility.
Methods: The information of this systemat ic review was collected by searching the key words:
treatment, fer tility, infertilit y, male, herbal medicine, ga rlic, Allium sativu m, medicinal plant,
sperm, sex hormones, testis and spermatogenesis in international databases such as: Web of
Science (ISI), PubMed, Scopus and Embase until March 2018. This study was conducted in
accordance with the PRISMA statement for systematic reviews and meta- analysis. and the
SYRCLE risk of bias tool was used for qualitative assessment.
Results: A total of 18 experimental studies were included in the study. Thirteen studies
evaluate d garlic and 5 studie s compared garlic effec t with adria mycin, titanium d ioxide, fura n,
vitamin E, N-acetylcysteine and cadmium. All studies were conducted in in vivo condition.
The results of the studies indicated the potential effect of garlic on enhancing fertility and
spermatogenesis, increasing the level of testosterone and improving the testicular structure.
Conclusion: Garlic can increase fertility probably due to its antioxidant properties. However,
more clinical trials are recommended.
A R T I C L E I N F O
Keywords:
Garlic
Allium sativum
Fertility
Infertility
Spermatogenesis
Medicinal plants
Article History:
Received: 7 March 2018
Accepted: 10 September 2018
Article Type:
Review
A B S T R A C T
Introduction
Failure to have a child is an unpleasant event in the lives of
infertile people (1). Inability to become pregnant after one
year of regular intercourse, without using contraception,
is defined as infertility (2). About 30%-50% of the causes
of infertility are related to male problems (3). Each
day, the number of medical reports about the extent of
infertility in the world increases, according to a systematic
review in this regard, about 48.5 million couples around
the world affected by this problem (4). The total mean
of infertility in Iran is estimated about 11%-19%, which
is more in the age group of 20-39 years (5). Infertility is
a multi-parameter phenomenon with a wide range of
factors that affects spermatogenesis and sperm quality
(6). Spermatogenesis is a process in which male sex cells
are produced and the disorder in each of these stages
can cause infertility (7). Fertility in men depends largely
on the number, quality, motility, and morphology of the
sperm, and the disruption of each of these factors leads
to infertility in men (3). Infertility, as a psychological
crisis, imposes a lot of stress on infertile couples and in
different ways threatens their mental health. The most
http://www.herbmedpharmacol.com doi: 10.15171/jhp.2018.46
Journal of Herbmed Pharmacology, Volume 7, Number 4, October 2018
http://www.herbmedpharmacol.com 307
Eect of garlic on male fertility: a systematic review
emotional and psychological problems of infertile couples
are disappointment, frustration, fear and anxiety, and are
less associated with anger and aggression. However, the
rate of divorce and remarriage among infertile couples
has risen. In addition to mental problems, the economical
treatment of infertility imposes a relative high cost on
infertile couples (8).
Nowadays, various methods are used to treat infertility,
including: hormone therapy, surgical procedures, assisted
reproductive technology (ART) that include in vitro
fertilization (IVF), intra uterine insemination (IUI), zygote
intrafallopian transfer (ZIFT), gamete intrafallopian
transfer (GIFT), intracytoplasmic sperm injection (ICSI)
and third-party fertilization (donation eggs, donation
sperm, uterus, and donated embryos) (9).
ART is one of the costly treatments among infertile
couples, but many people are not able to do so because
financial problems, and surgical procedures have a
lot of stress and complications for the family, and in
addition they are expensive (8). Hormone therapy is
also prohibited in some people, and in many people
with impaired hypothalamic-pituitary-gonadal axis
function, this treatment is not responsive therefore, due
to individual and social problems caused by infertility,
couples always try to find low-cost, safe and effective
treatments (10). Regarding the problems that have been
observed among couples and the high costs of medical
interventions, people have turned to complementary
medicine (11). Among different therapeutic methods,
herbs are used in many countries to treat male infertility
(1,12,13). Plants are more affordable and accessible than
invasive and chemical treatments (14). Medicinal herbs
with high antioxidant properties are used to treat sperm
abnormalities, sexual dysfunction, erectile and ejaculatory
disorders (1,15). Among the plants that improve male
fertility, celery (16), fennel (17), black seed (18), German
chamomile (19), saffron (20), Fumaria parviflora (21),
Origanum vulgare (22) and carrot (23) can be mentioned.
Some plants change the number and motility of the sperm
by changing sex hormones. Other plants with androgenic
properties affect the hypothalamus-pituitary axis and
increase sex hormones (24). Garlic with its antioxidant
properties, have been shown to increase the weight of the
epididymis, seminal vesicles and increases the number of
sperms (25). Garlic is one of the most potent and most
prominent species of plants, which is a part of the onion
family (7). Garlic has been known since 5000 years ago. In
ancient times, Babylonians, Egyptians, Vikings, Chinese,
Greeks, Romans and Hindus used garlic (26). In 3000 BC
garlic was used for heart disease, arthritis, uterine disease,
pulmonary disease, skin diseases, diarrhea, headache,
wound healing and tumor (27,28). It is native to Western
Asia, also found in most regions of Iran, especially in the
northern regions (29). The perennial plant, has a height of
100-300 cm, has flowers in pink or green (16). It is used
commonly as a medicinal herb and food flavor, and it is one
of the herbs that have a long history of medical uses (30).
Garlic contains many compounds, including vitamins B2,
B6, B1, A and C, a lot of antioxidants, flavonoids, sulfur
compounds and allicin (7). Allicin (dialkly thiosulfinate)
plays a key role in the garlic medicinal properties,
however, this compound is not found in fresh garlic, and
made by action of allinase on alliin (S-alkyl-l-cysteine
sulfoxide). Ajoene is another important compound in
garlic (Figure 1) (31). Garlic protects the liver and has
anticholesterolemic, antithrombotic, antihypertensive and
antimicrobial activity (30), and consumption of garlic acts
like insulin receptor and reduces glucose levels in diabetic
patients (3). Solving infertility problem is a fundamental
issue in every community’s health system. Considering
the complications and limitations of chemical drugs and
surgical procedures, and according to the mentioned
therapeutic effects of garlic, this systematic review was
conducted to investigate the effects of garlic on male
fertility.
Methods
Study protocol
Current systematic review was reported in accordance
with PRISMA (Preferred Reporting Items for Systematic
Reviews and Meta-analyses) guidelines (32). In this study,
the search process was done aimed to find studies in
English without time limitations.
Search strategy
Data were collected by searching the key words: treatment,
fertility, infertility, male, herbal medicine, garlic, medicinal
plant, sperm, sex hormones and spermatogenesis in
international databases such as: Web of Science (ISI),
PubMed, Scopus and Embase until March 2018.
Inclusion criteria
- To conduct experimental studies or clinical trials
- Randomization in studies
- Evaluation of fertility, spermatogenesis or male sex
hormones
- Mentioning of ethical considerations in articles
Figure 1: The main compounds of garlic.
Journal of Herbmed Pharmacology, Volume 7, Number 4, October 2018 http://www.herbmedpharmacol.com
308
Musavi et al
Exclusion criteria
- Absence of proper sampling method in studies
- Evaluation of fertility in female, not male, samples
- Not mentioning moral considerations
Selection of studies and data extraction
The articles’ information was reviewed independently by
two authors based on inclusion and exclusion criteria.
Finally, both of authors classified the information and, in
cases that the information was inconsistent, the comments
of the third author were used. The information obtained
from the articles was entered into the checklist considering
the quality approval of the articles. The checklist
contained: authors name, year of the study, type of study,
molecular change, type of sample, type of administration,
dosage, part of plant and period of extract administration.
SYRCLE risk of bias tool was used for assessment of the
quality. This tool is an advanced and improved model of
the past quality assessment tools that is specific to animal
and pre-clinical studies (33) and solve some of defects of
the previous tools that was related to clinical trials.
Results
In the first stage of search, 980 articles were found.
After removing duplicates and unrelated articles, 18
experimental studies included in this systematic review
(Figure 2).
Thirteen studies evaluated garlic and 5 studies compared
garlic effects with other drugs. A study compared aged
garlic extract with adriamycin, a study compared aged
garlic extract with titanium dioxide, a study compared
garlic oil extract with furan, a study compared garlic blue
extract with vitamin E and N-acetyl cysteine and a study
compared garlic extract and onion with cadmium.
Qualitative assessment showed that most studies were in
high risk for bias. In most of these studies, randomization
in animal housing, randomization in sampling, researcher
and statistical analyzers blinding were not me n tioned
clearly (Tab l e 1).
In 10 studies garlic extract was prescribed as crude
plant and powder for animals. The maximum sample
size was 62 mice and the lowest sample size was 10 mice
that were examined in experimental studies. All studies
were conducted in the in vivo condition. The control
group received distilled water, normal saline or powder
containing starch, and the treatment group received
aged garlic extract, adriamcyin, titanium dioxide, garlic
oil, N-acetylcyseinne, vitamin E, cadmium, cooked
garlic or garlic juice. The treatment period varied
from 7 to 120 days and complications such as impaired
spermatogenesis, apoptosis, abnormal sperm, decreased
sperm motility, seminal vesicle disorder, increased blood
cholesterol, leukocytosis, decreased testicular weight,
decreased Leydig cells, increased prostate weight and
increased cortisol were mentioned in the studies. All of
these complications were reported as chemical substances
toxicity. Further information is presented in Tab l e 2.
Discussion
The present study was a systematic review of the effects of
garlic on fertility. In general, in this paper, 18 studies were
reviewed. Thirteen studies were conducted on the effect of
garlic on fertility treatment. Due to the lack of side effects,
as well as containing flavonoids, vitamins, fructose and
sulfur compounds, garlic can help with neutralizing free
radicals (1). Sulfur compounds in garlic, with a direct effect
on the metabolism of cytochrome P450 and glutathione
-s-transferase, have a protective effect on spermatogenesis.
In addition to sulfur compounds, garlic has antioxidant
properties and can increase fertility by reducing lipid
peroxidation (32). Given the above mentioned factors,
garlic is recommended for the treatment of infertility. In
a study by Asadpour et al it was indicated that garlic has
antioxidant activity due to presence of vitamin E, which
prevents oxygen peroxide (49). Also, the results of the
study by Nasr showed that garlic antioxidant properties
can reduce the toxicity of harmful drugs on the testes and
increase the spermatogenesis and fertility in men (35).
In the study by Akabawy and Sherif, it was concluded
that garlic inhibited caspase-3 and cytochrome P450
2E1 (CYP2E1) enzymes, which had a toxic effect on the
testes and, by decreasing these two enzymes, improved
the testicular performance and spermatogenesis (37).
6
Figure 2: Trend of screening and choosing articles based on PRISMA guidelines
Thirteen studies evaluated garlic and 5 studies compared garlic effects with other drugs. A study compared
aged garlic extract with adriamycin, a study compared aged garlic extract with titanium dioxide, a study
compared garlic oil extract with furan, a study compared garlic blue extract with vitamin E and N-acetyl
cysteine and a study compared garlic extract and onion with cadmium.
Records identified through
database searching
(n = 968)
Screening
Included
Eligibility
Identification
Additional records identified
through other sources
(n = 12)
(n = 85)
Records screened
(n = 85)
Records excluded
(n = 65)
Full-text articles assessed
for eligibility
(n = 20)
Full-text articles excluded,
with reasons
(n =2)
Studies included in
qualitative synthesis
(n = 18)
6
Figure 2: Trend of screening and choosing articles based on PRISMA guidelines
Thirteen studies evaluated garlic and 5 studies compared garlic effects with other drugs. A study compared
aged garlic extract with adriamycin, a study compared aged garlic extract with titanium dioxide, a study
compared garlic oil extract with furan, a study compared garlic blue extract with vitamin E and N-acetyl
cysteine and a study compared garlic extract and onion with cadmium.
Records identified through
database searching
(n = 968)
Screening
Included
Eligibility
Identification
Additional records identified
through other sources
(n = 12)
Records after duplicates removed
(n = 85)
Records screened
(n = 85)
Records excluded
(n = 65)
Full-text articles assessed
for eligibility
(n = 20)
Full-text articles excluded,
with reasons
(n =2)
Studies included in
qualitative synthesis
(n = 18)
Figure 2. Trend of screening and choosing articles based on
PRISMA guidelines.
Journal of Herbmed Pharmacology, Volume 7, Number 4, October 2018 http://www.herbmedpharmacol.com
309
Musavi et al
Hammami and Abdelmalik (38) concluded that garlic
contains phytoestrogens, which have a direct effect on
estrogen. It is a precursor to testosterone production, so
it is possible that garlic stimulates the sexual cells and
sex hormones (38,43). The results in the study by Oi et al
indicated that garlic supplementation boosts LH from the
pituitary gland, and this stimulates testosterone secretion
from the testicles (46). Nonetheless, in the study by
Bahrami et al (7), it was recommended that the cooked
garlic has better therapeutic effects and, while affecting the
reproduction of the sexual cells in testes and epididymis,
improves spermatogenesis (7).
Due to presence of dialyldisulfide in its biochemical
structure, garlic affects the hypothalamic-pituitary
axis. Diallyldisulfide stimulates the basophilic cells and
secretion of LH sex hormones by affecting the anterior
pituitary. LH stimulates Leydig cells in the testes, which
in turn is a precursor to secretion and regulation of
testosterone (50). Also, diallyldisulfide reduces oxygen
free radicals, enhances and strengthens the blood-testis
barrier and increases the circulation in the testicles, thus
protects the sexual organs (39). By increasing blood flow
to the testicles (due to the consumption of garlic), phenol
and phenolic glycosides are released which increase the
glutathione peroxidase enzyme. The role of this enzyme
is to protect sperms in testicular and epididymal tissue
(51). The enzyme protects the sperm from the damage of
free radicals by placement in the plasma membrane and
the nucleus of sperm, epididymal fluid and epididymis,
and leads to ultimate maturation and development of the
sperm (52). Also, garlic can repair and protect the DNA
of the sperm, in addition to sperm maturation through
vitamins C, B, E, which are its potent antioxidants (53).
Approximately 45%-50% of infertility has a male cause,
but nevertheless, 30-45% is due to idiopathic causes (54).
Typically, infertility in men is indicated by oligozoospermia,
asthenozoospermia, or teratozoospermia and varicocele
(55). Recent studies have shown that, in physiological
conditions, reactive oxygen species play a very important
role in intracellular messaging processes. On the other
hand, during the last decade, reactive oxygen species have
been implicated in the development of male infertility,
due to excessive production of reactive oxygen species
or reduced ability of the antioxidant system of the genital
system and sperm. In pathological conditions, reactive
oxygen species result in male infertility through disruption
of the spermatogenesis process, sperm function and
structure, mobility, survival, acrosome reaction, sperm-
to-oocyte coupling and even reduced fertilization and
implantation (56).
Conclusion
Probably, due to the antioxidant power and the absence of
side effects of garlic, it can be useful in enhancing fertility.
Due to the limited number of clinical studies, there is no
definite overall and reassuring result. In order to ensure
the effects of this plant and its compounds, clinical studies
with a larger statistical population, as well as an increase
Table 1. Risk of bias for animal studies, using the SYRCLE risk of bias tool
Study
1 2 3 4 5 6 7 8 9 10
Selecon
bias 1
Selecon
bias 2
Selecon
bias 3
Performance
bias 1
Performance
bias 2
Detecon
bias 1
Detecon
bias 2
Arion
bias
Reporng
bias
Other
potenal
bias
Hajiuon (34) x ✓ ✓ ؟X؟X؟✓ ✓
Nasr (35) ✓ ✓ ؟X X ؟✓ ✓ ✓
Abu Zeid et al (36) ✓ ✓ ؟ ؟ ؟ ؟ ✓ ✓ ✓
El-Akabawy and El-
Sherif (37) ✓ ✓ ؟ ؟ x؟✓ ✓ ✓
Abdelmalik (38)✓ ✓ x؟X؟X؟✓ ✓
Ouarda and
Abdennour (39)؟؟ ؟ ؟ ؟ ؟ ؟ ؟
Ghalehkandi (40)✓ ✓ ؟ ؟ X؟ ؟ ؟ ✓ ✓
Bahrami et al (7)✓ ✓ ✓ ؟ ؟ ؟ ؟ x؟
Safaei et al (41)؟؟ ؟ ؟ ؟ ؟ ؟
Ola-Mudathir et al
(42) ✓ ✓ ؟ ؟ ؟ ؟ ✓ ✓
Omotoso et al (25) ✓ ✓ ؟ ؟ ؟ ؟ ؟ ✓ ✓
Nahdi et al (43)✓ ✓ ؟ ؟ ؟ ؟ ؟ ✓ ✓ ✓
Hammami et al (44)✓ ✓ ؟ ؟ ؟ ؟ ؟ ؟
Hammami et al (45) ✓ ✓ ؟ ؟ ؟ ؟ ؟ ✓ ✓
Oi et al (46)✓ ✓ ؟ ؟ ؟ ؟ ؟ ✓ ✓
Lee et al (47)✓ ✓ x؟ ؟ ؟ ؟ ✓ ✓ ✓
Abdullah et al (48) ✓ ✓ ؟ ؟ ؟ ؟ ✓ ✓
Asadpour et al (49)✓ ✓ x؟ ؟ ؟ ؟ ✓ ✓
Eect of garlic on male fertility: a systematic review
Journal of Herbmed Pharmacology, Volume 7, Number 4, October 2018
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Table 2. Effect of garlic on reproductive system and fertility
Eect of garlic Type of extract Duraon of
treatment Dose Administraon Sample
study
Part
used Result Ref.
Eects on sexual
hormones
Hydro alcoholic
extract
30 days 200 and 400 mg/kg Orally Rats Leaves ↓Testosterone levels, ↓Estrogen, ↑Progesterone (34)
Aged garlic extract 7-14 days 250 mg/kg
Orally Rats Seeds ↑Testosterone leves, ↓MDA concentraon, ↑GSH level, ↑GSH-Px, ↑CAT, and
SOD acvity
(35)
Aged garlic extract 65 days 2 mL/kg Orally Rats Leaves ↑Androgen levels (36)
Garlic oil NM 4 mg/kg Orally Rats NM ↓Testosterone levels, ↓Caspase-3, ↓Cytochrome P450 2E1 (37)
NM 120 days 30 g Orally Rats NM ↓Testosterone levels (38)
Eects on
spermatogenesis
and tescular
structure and
other results
NM 14 days 50 g Orally Rabbits Seeds ↑Sperm molity and viability, ↑Sperm speed, ↑White blood counts (39)
Garlic juice 30 days 60 and 120 mg/kg Gavage Rats Seeds ↓Semen MDA acvity, ↓TAS acvity (40)
NM 30 days 5% and 15% of raw garlic and
cooked garlic
Orally Rats Seeds In cooked garlic, ↓Weight Loss, ↑Number of spermatocyte cells, ↑Number
of spermatozoa, ↑Number of sperm cells, ↑Number of Sertoli cells, ↑Tescle
weight, ↑External diameter of the epididymide, ↑The inner diameter of
epididymide, ↑Sperm volume
(7)
Alcoholic extract 30 days 0.05%, 0.1% and 0.2% Orally Rooster Leaves Garlic alcoholic extract 0.2%: ↑Semen volume, ↑Tescle weight, ↑Sperm
counts, ↑Percentage of mobility and sperm biocompability, ↑Laydic cell count
(41)
NM Between 7-21
days
0.5 mL/100 g. BW Gavage Rats Leaves ↑LOP, ↑Glutathione S-transferase, ↑GSH, ↑SOD, ↑CAT, ↑Epididymal sperm
concentraon, ↑Sperm progress molity, ↓Lipid peroxidaon
(42)
Aqueous Extract 28 days 500 and 100 mg/kg Feeding tube Rats Leaves ↓Spermatozoa count, ↓SOD acvity in the blood (25)
NM NM 5%, 10% and 15% Orally Rats Leaves ↑Number of tubules deprived of spermatozoa, ↓Apoptosis of tescular germ
cells, ↓Testosterone levels
(43)
NM 30 days 5%, 10% and 15% of 30 g Orally Rats Seeds ↑CASP3 levels, ↑Caspase inhibitors BIRC3 and BIRC2, ↑IAP inhibitor DIABLO,
↓AMH, RHOX5 and CDKN1B, ↑GATA4
(44)
NM 30 days 5%, 10%, 15% and 30% of 9 g Orally Rats Seeds ↓Prostate weight, ↓Seminal vesicle weight, ↓Testosterone levels, ↑LH levels,
↑Phosphatase acid acvity
(45)
NM 28 days 8 g Intraperitoneal
injecon
Rats - ↑LH levels, ↑Tescular testosterone, ↓Plasma corcosterone (46)
Ethanolic extract 37 days 5, 10, 20 and 40 mg/kg/bw Perorally Rats Leaves ↓Weight loss, ↓Tescular weight, ↑Spermatogenesis (47)
NM 90 days 100 mg/kg/d Intraperitoneal
injecon
Mice Leaves ↑Weight of seminal vesicles and epididymides, ↑Sperm count, ↑Weight loss,
↑WBC, ↓RBC
(48)
NM 35 days 400 mg/kg Gavage Rats Leaves ↑Sperm molity and viability, ↑MDA level, ↑ SOD acvies (49)
NM: not menoned, MDA: malondialdehyde, GSH: glutathione, GSH-px: glutathione peroxidase, SOD: superoxide dismutase, CAT: catalase, TAS: total anoxidant status, BIRC3: baculoviral IAP repeat-containing protein 3, BIRC2: baculoviral
IAP repeat-containing protein2, AMH: an-Mullerian hormone, CDKN1B: cyclin-dependent kinase inhibitor 1B, LH: luteinizing hormone
Journal of Herbmed Pharmacology, Volume 7, Number 4, October 2018
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Eect of garlic on male fertility: a systematic review
in the duration of its administration, comparison with
safe drugs and the determination of the exact molecular
mechanism are recommended.
Authors’ contributions
All authors contributed equally in planning and carrying
out this work. All authors read the manuscript and
confirmed the publication for final version.
Conflict of interests
None.
Ethical considerations
Not applicable.
Funding/Support
There is no financial support for this work.
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... They can also increase the weight of epididymal and seminal vesicles and the sperm output (Musavi et al., 2018). In addition, they have the ability to scavenge ROS produced by lipid peroxidation via stimulation of the antioxidant enzyme defense system (Ayodele et al., 2015). ...
... This improvement is indirectly based on enhancement of antioxidant status, immunity, and energy metabolism (thyroid function). The antioxidant activity of phytogenic extracts of turmeric and garlic increases sperm output by decreasing the apoptosis of spermatocytes at different stages of spermatogenesis (Musavi et al., 2018). ...
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This study investigated the beneficial effect of phytogenic extracts on semen quality, reproductive hormones, thyroid activity, immunity, hepatic antioxidant activity, and fertility in rabbit bucks. We divided 70 bucks into seven groups (10 in each). Group 1 was fed a basal diet (control); groups 2, 3, and 4 were fed the control diet with 30, 60, and 90 mg/kg of turmeric, respectively; and groups 5, 6, and 7 were fed the control diet with 50, 75, and 100 mg/kg of garlic extract, respectively, for 8 weeks. Rectal and skin temperatures decreased, while follicle-stimulating hormone, luteinizing hormone, triiodothyronine, thyroxine, testosterone, immunoglobulin M, tumor necrosis factor-alpha, and interleukin-6 in blood serum and glutathione peroxidase in the liver increased in all groups (p < .05). Garlic extract (100 mg/kg diet) increased adenosine triphosphate and glutathione in the liver tissues. All treatments significantly increased net semen volume, percentages of progressive motility, livability, curled tail, and intact acrosomes of spermatozoa, sperm cell concentration, and outputs of total and motile spermatozoa, while significantly decreased percentage of sperm abnormality. In conclusion, dietary supplementation of turmeric or garlic extract can be used as a suitable tool for enhancing the hepatic antioxidant activity, immunity, and semen quality in rabbit bucks.
... Intracellular signals such as growth factors, oxidative stress, and loss of matrix attachment can induce apoptosis (Jan 2019). The key mediators of the apoptosis pathway include transcription factors (β-catenin, NF-κB), antiapoptosis proteins such as Bak and Bcl-2, pro-apoptosis proteins such as Bax, caspases, and several important signaling pathways including p53, PI3K/AKT, and mitogen-activated protein kinases (MAPKs) (Pfeffer and Singh, 2018;D'Arcy, 2019;Shafaei et al., 2017;Musavi et al., 2018;. In this study, TUNEL assays indicated that silibinin treatment notably induced apoptosis initiation in ovarian cancer A2780s and SKOV-3 cells. ...
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Background Silibinin, the principal flavonoid derived from milk thistle seeds, has been demonstrated to have strong inhibitory effects against human malignancies. The inhibitory function of silibinin on ovarian cancer, however, is not fully identified. In this essay, both in vivo and in vitro investigations were conducted to survey the silibinin's blocking effects on ovarian cancer. Methods The impacts of silibinin on two ovarian cancer cell lines, SKOV-3 and A2870, were determined by evaluating cell viability, migration, invasion, and apoptosis. Q-RT-PCR and western blotting techniques were carried out to explore the protein levels of signaling pathway markers. A mouse xenograft model was utilized to determine the silibinin efficacy in inhibiting tumor growth. Results After cell treatment with silibinin, cell viability, migration, and invasion were appreciably inhibited in cancer cell lines, but cell apoptosis was promoted. Also, silibinin reversed the epithelial-mesenchymal transition (EMT) mechanism by inducing E-cadherin expression and reducing N-cadherin and vimentin expression, suppressing the levels of regulators related to EMT such as Snail, Slug, and ZEB1 transcription factors, and also decreasing PI3K/AKT, Smad2/3, and β-catenin intermediate molecules in vitro. Silibinin effectively ameliorated tumor growth in vivo. Conclusion silibinin could be considered a potent agent against ovarian cancer based on the results.
... Garlic also has antibiotic properties and prevents the formation of cholesterol. The pharmacological effects of garlic include its antioxidant and protective functions (16). The consumption of garlic extract in patients with high blood cholesterol significantly reduces cholesterol and serum lipids (17). ...
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Background and aims: The abnormal increase in blood cholesterol can cause many problems. Statins have a cholesterol-lowering effect, but they also have adverse effects. Garlic prevents the formation of cholesterol due to its antibiotic properties. This study aimed to investigate the comparative effect of garlic powder and atorvastatin on hypercholesterolemia-induced reproductive failure in female rats. Methods: In the present experimental study, 48 adult female Wistar rats were divided into eight groups (n=6), including control, atorvastatin (10 mg/kg/d; orally), atorvastatin (20 mg/kg/d; orally), garlic powder (100 mg/kg/d; orally), hypercholesterolemia (1.5 mg/kg/d of cholesterol; orally), hypercholesterolemia + atorvastatin (10 mg/kg/d), hypercholesterolemia + atorvastatin (20 mg/kg/d), and hypercholesterolemia + garlic powder. After 30 days, rats were euthanized and blood samples were obtained from their heart for serological assessments. The right ovary was transferred to 10% formalin for histological analyses, and the left ovary was transferred to a −80°C freezer for evaluation of oxidative stress markers. Data were statistically analyzed by ANOVA and Tukey’s test using SPSS version 24.0 (P<0.05). Results: The number of healthy primordial, primary, secondary, and antral follicles, catalase activity, total antioxidant capacity (TAOC) as well as estrogen and progesterone levels were lower in hypercholesterolemic rats compared to controls (P<0.001). Additionally, the number of the atretic primary, secondary, and antral follicles and malondialdehyde (MDA) levels were higher in hypercholesterolemic rats (P<0.001). However, garlic powder and atorvastatin 10 improved alterations in the mentioned parameters (P=0.99). Conclusion: The results showed that hypercholesterolemia could have adverse effects on rat ovaries. However, the garlic powder improves ovarian toxicity in hypercholesterolemia rats better than atorvastatin.
... Since Zn is not widely stored in the body, Zn supplements are needed to maintain steady-state (5). Zinc deficiency in developing countries is one of the major factors to exposing other diseases (6)(7)(8)(9). ...
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... Infertility, as a psychological crisis, imposes a lot of stress on infertile couples and in different ways threatens their mental health. The most emotional and psychological problems of infertile couples are disappointment, frustration, fear and anxiety, and are less associated with anger and aggression (Musavi et al. 2018). ...
... Apoptosis occurs through two intrinsic and extrinsic pathways in response to intracellular stimulants and extracellular signals. The key mediators of the apoptosis pathway include transcription factors (β-catenin, NF-κB), death receptors, anti-apoptosis proteins such as Bak and Bcl-2, pro-apoptosis proteins such as Bax, caspases, and several important signaling pathways including p53, PI3K/AKT, and mitogen-activated protein kinases (MAPKs) (42)(43)(44)(45). In this study, TUNEL assays indicated that silibinin treatment notably induced apoptosis initiation in ovarian cancer A2780s and SKOV-3 cells. ...
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Background Silibinin is a polyphenolic compound that could modulate estrogen receptor activation. Vascular dysfunction is considered a key initiator in atherosclerosis and may occur in the postmenopausal period. This manuscript compares estrogen and silibinin's impacts on factors that change endothelial function in ovariectomized (OVX) rats. Methods 32 female Wistar rats were subdivided into control; OVX; OVX + estrogen (1 mg/kg/day); and OVX + silibinin (50 mg/kg/day) groups. After the experimental period, lipid profile, atherogenic indices, and histopathology of endothelium were monitored. The vascular oxidative stress, adhesion molecules, inflammatory cytokine levels, nitric oxide (NO), angiotensin-II (Ang-II), and endothelin-1 (ET-1) were also analyzed. Results Silibinin treatment, similar to estrogen, significantly normalized the adverse changes of OVX on vascular function, including improved lipid profile and oxidative stress, increased endothelial nitric oxide synthase (eNOS) expression, diminished inflammatory status, and reduced adhesion molecule levels, ET-1 and Ang-II substances. Our findings also revealed that the administration with estrogen or silibinin resulted in a normal endothelium layer in the aorta tissues of OVX rats. Conclusion Estrogen and silibinin have similar effects in improving vascular function. These treatments' protective impacts on vasculature indicate their potential benefits on the cardiovascular system in the postmenopausal period.
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Allicin (diallylthiosulfinate) is a defense molecule produced by cellular contents of garlic (Allium sativum L.). On tissue damage, the non-proteinogenic amino acid alliin (S-allylcysteine sulfoxide) is converted to allicin in an enzyme-mediated process catalysed by alliinase. Allicin is hydrophobic in nature, can efficiently cross the cellular membranes and behaves as a reactive sulfur species (RSS) inside the cells. It is physiologically active molecule with the ability to oxidise the thiol groups of glutathione and between cysteine residues in proteins. Allicin has shown anticancer, antimicrobial, antioxidant properties and also serves as an efficient therapeutic agent against cardiovascular diseases. In this context, the present review describes allicin as an antioxidant, and neuroprotective molecule that can ameliorate the cognitive abilities in case of neurodegenerative and neuropsychological disorders. As an antioxidant, allicin fights the reactive oxygen species (ROS) by downregulation of NOX (NADPH oxidizing) enzymes, it can directly interact to reduce the cellular levels of different types of ROS produced by a variety of peroxidases. Most of the neuroprotective actions of allicin are mediated via redox-dependent pathways. Allicin inhibits neuroinflammation by suppressing the ROS production, inhibition of TLR4/MyD88/NF-κB, P38 and JNK pathways. As an inhibitor of cholinesterase and (AChE) and butyrylcholinesterase (BuChE) it can be applied to manage the Alzheimer’s disease, helps to maintain the balance of neurotransmitters in case of autism spectrum disorder (ASD) and attention deficit hyperactive syndrome (ADHD). In case of acute traumatic spinal cord injury (SCI) allicin protects neuron damage by regulating inflammation, apoptosis and promoting the expression levels of Nrf2 (nuclear factor erythroid 2-related factor 2). Metal induced neurodegeneration can also be attenuated and cognitive abilities of patients suffering from neurological diseases can be ameliorates by allicin administration.
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This experiment was conducted to investigate the effects of dietary supplementation with coated granules (CG) on performance, in vitro digestibility and the gastrointestinal functionality in laying hens. A total of 40 Hisex Brown laying hens (36 weeks of age) were randomly divided into five equal groups; one served as a control and the other four were actual experimental groups supplemented with 0.75, 1.5, 3 or 6 g CG per day. All the hens were fed restrictively with target feed intake of 100 g basal diet/hen per day. There were no differences in egg production or egg weight among the groups, but feed conversion ratio was significantly improved (linearly, p < 0.05) with the dose level of CG in diet. Dietary CG increased the jejunal weight (linear and quadratic terms, p < 0.05) but decreased the ileal weight (linearly, p < 0.05). There was mostly statistical interaction between dietary CG and specific activity of intestinal digestive enzymes with similar patterns for dietary CG treatments (p < 0.05). A positive linear correlation was observed with in vitro protein digestibility by using the crude enzyme extract from dietary CG supplementation. Dietary CG decreased the caecal Escherichia coli population while the Lactobacillus spp.: E. coli ratio increased (quadratic fit, p < 0.05). CG supplementation, on the other hand, significantly altered intestinal morphology by increasing the height of duodenal and ileal villi (linearly, p < 0.05). Also, duodenal antioxidant capacity observed via remaining reducing power improved linearly (p < 0.05). This suggests that CG, unlike garlic oils without encapsulation, may be a good candidate for feed supplementation in commercial egg production. It could be included up to 6 g CG per day without any adverse effects on performance, which may relate to improving nutrient digestibility and better utilization of limited feed intake when using a low amount of diet or other observations in this study.
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The inability to have a child is a baleful event for millions of couples in their life, and a large percentage of them have a personal frustration. The problem of infertility in couples is distributed equitably between the two sexes. Among different methods, medicinal plants have been used in many Nations to treat male infertility problems. These medicinal herbs are used to treat sperm disorders, dysfunctioning of the libido, 2 sexual asthenia and erection. Herbs provide a therapeutic option, which is affordable and available for infertile couples, and herbalism is the main form of treatment in our health system. So in this review, we have summarized most of the data dealing with the positive effects of plant extracts on mammalian reproductive system.
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Background & aim: Infertility is one of the major issues in medical science which various chemical and herbal medicines have been used for its treatment from ancient times. Due to the side effects of chemical drugs and with regard to the cause of infertility in men is a hormonal disorder, thus, the study aimed to investigate the effect of ethanol extracts of parsley leaves performed on serum levels of pituitary - gonadal hormones. Methods: The present experimental study was conducted on fifty adult male rats. The animals were divided into 5 groups of 10 specimens, including controls, and three sets of empirical receiving doses 1000, 1500 and 2000 mg/kg ethanol extract of parsley leaves respectively. Prescriptions were done as gavage for 28 days. At the end of the test, the hearts of the animal and the serum hormones levels of testosterone, FSH and LH were measured. The Data were analyzed with t-test and Duncan and significant differences of data was considered at p = 0.05. Results: The findings revealed that the leaf extract of parsley caused a significant increase in FSH and LH and testosterone significantly increased at minimum and medium doses and decreased significantly in maximum dose. Conclusion: Parsley leaf , having antioxidant compounds, led to the increasing of FSH and LH hormones at three doses and increasing testosterone at minimum and medium doses and decreasing at maximum dose.
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Male factor subfertility has increasingly been considered the cause of infertility in couples. Many men with male infertility have sperm problems such as oligozoospermia, asthenozoospermia, or teratozoospermia. Because abnormal semen parameters are idiopathic to some extent, no standard therapy has been established to date. Herbal medicine has been reported to have beneficial properties in the treatment of subfertility, especially in improving semen quality both in vivo and in human studies. Therefore, we intend to investigate the effectiveness and safety of treatment using Korean medicine (KM) for infertile male patients with poor semen quality. This will be a single-center, prospective, case-only observational pilot study. About 20 male patients with infertility who visit Conmaul Hospital of Korean Medicine will be recruited. We will follow the standard treatment protocol, which has shown good results in the treatment of male infertility. The protocol is composed mainly of a 10-week herbal decoction treatment; acupuncture and/or pharmacopuncture are added when needed. Semen samples, quality of life, and the scrotal temperatures of infertile men will be observed before and after the 10-week treatment with KM. The study has received ethical approval from the Public Institutional Review Board (approval number: P01-201708-21-008). The findings will be disseminated to appropriate audiences via peer-reviewed publication and conference presentations. Trial registration: Korean Clinical Trial Registry (CRIS), Republic of Korea: KCT0002611.
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Background Fertility and infertility problems are among the complex issues in medicine. The use of herbal products in the treatment of fertility has been considered as an alternative to synthetic drugs. Celery containing known compounds can have an impact on the fertility rate. The aim of this study was to do a systematic review on conducted studies in conjunction with the celery and reproduction. Methods Required papers were searched from databases like Science direct, PubMed, Scopus, and Springer. Keywords used in this study were “ Results The notable points were the different results seen by different researchers during different treatment periods or at different doses. Of the 16 studies reviewed in this study, 13 studies have mentioned the positive effect of celery on fertility, while three studies reported the inhibitory effects of this plant. Conclusions Celery can have protective effects against substances such as sodium valproate, propylene glycol, and diethyl phthalate causing damages to the testicular structure and spermatogenesis. In this regard, the doses used and the treatment time while using the plant must be accurately investigated. Since there are compounds such as apigenin, the celery can induce inhibitory effects on fertility in case of chronic use or high concentration.
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Background: Infertility is one of the world's most common problems that affect both males and females. There are a variety of plants used in traditional medicine to increase fertility and determine the gender of the fetus. Objectives: The purpose of this study was to investigate the effect of celery leaf on delivery rate in female rats, weight and gender ratio of infants. Methods: In this experimental study, thirty female rats were divided to three groups (n = 10). The control group received distilled water, while the two experimental groups consumed 100 and 200 mg/kg/BW of the celery extract by daily gavage for five weeks. During the fifth week, each of the two female rats was mated with a male rat. In the end, the number of delivered female rats was identified and recorded. In addition, females received celery extract during the mating period until the end; the infants' weight and gender ratios (male/female) were recorded and compared 30 days after birth. Results: The delivery rate in the experimental groups compared with the control group was not significant (P > 0.05). The mean number of infants in experimental groups 1 and 2 (respectively 8.7±0.5 and 9.12±0.5) compared with the control (6.6±0.3) was significantly increased (P≤0.05). The difference of gender ratio between groups 1 and 2 (respectively 1.25±0.23 and 0.87±0.11), and the control group (0.93±0.1) was not statistically significant. The average weight in experimental groups 1 and 2 (respectively 4.32±0.19 and 4.46±0.22) compared with the control group (5.98±0.20) was significantly reduced (P≤0.05). Conclusions: The results showed that the consumption of celery leaf in females can increase the number of infants, and is associated with weight loss. These changes could be associated with compounds such as phytosterols and flavonoids (such as beta cystosterol and quercetin). © 2016, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences.
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Investigations of the psychological and social aspects of reproductive life events, have, until quite recently, focused predominantly on women. Research has now considered in more detail the psychological aspects of desire for children, avoiding pregnancy when it is not wanted, achieving pregnancy when it is sought, and experiences of infertility among men. The research evidence has been generated predominantly in high- and upper-middle income countries; there is less evidence about these experiences among men living in low- and lower-middle income nations. Men aspire to parenthood as much as women do but they have less knowledge about fertility and the factors that affect it than women do. The gap between ideal biological and ideal social age for parenthood appears to be widening, increasing the risk of involuntary childlessness or having fewer children than planned. Male factors either alone or in combination with female factors contribute to 50% of infertility. Up to 12% of men experience fertility difficulties, with the highest rates being in countries of Africa and Central and Eastern Europe. Male factor infertility remains stigmatized, with pejorative associations with compromised masculinity. Notions that men are unaffected or unperturbed by infertility are false and reflect outdated and unhelpful gender stereotypes. While mental disorders are no more prevalent than in the general community, infertility-specific anxiety is common among men being investigated for fertility difficulties or whose partners are receiving fertility treatment. In general, men prefer to receive psychologically informed care from the infertility treatment team to specialist psychological care. Referral to a mental health professional is recommended for the subgroups of men who have not disclosed infertility to anyone apart from their spouse; appraise being infertile as hopeless or overwhelming or who are considering the use of donor sperm. Preprocedure counseling is also recommended for men considering vasectomy about its permanence and the limited potential for reversal. It is also recommended that infertility counselors are trained in the skills to manage intense psychological distress and interventions to enhance couple communication.
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Adriamycin (ADR), a potent cytotoxic drug, has many adverse effects on different body organs limiting its therapeutic uses. Aged garlic extract (AGE), a garlic preparation, contains many organosulfur compounds with potent antioxidant activity. This investigation was conducted to study the possible protective effects & the underlying the mechanism of AGE on ADR-induced testicular damage. Thirty-six adult male rats were assigned into six groups: a control, AGE-treated (250 mg/kg once oral for 14 days), ADR-treated (10 mg/kg, i.p. once at day 8), AGE (7 days before) + ADR (once at day 8), ADR (once on day 8) + AGE (7 days after), AGE (14 days) + ADR (once at day 8). At day 15; blood samples were collected then the animals were sacrificed and testicular samples were prepared for light and electron microscopic examination. Parenchymal disorganization, cellular degeneration, nuclear apoptosis, mitochondrial degeneration and cytoplasmic vacuolation, decrease count and increase abnormalities of sperms, low testosterone level, high MDA concentration, low GSH level, and decrease GSH-Px, CAT, and SOD activity were recorded in ADR-treated rats. Remarkable histological, biochemical and ultrastructural improvements were observed in the combined AGE plus ADR-treated groups. Thus, AGE can be used as an adjuvant therapy to resume male infertility and weak spermatogenesis induced by cytotoxic drugs or other environmental toxins through its cytoprotective and antioxidant properties.
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Abstract Background &Objective: The present study aims at studying two forms of raw and cooked garlic to identify the effect of this plant on the amount of change in histopatological of spermatogenesis of wistar rat. Materials & Methods: 40 male rats were divided into five equal groups (4 treatment 1 control group) the first and second treatment were received palete food consisted of 5% and 15% of raw garlic every day. The third and fourth reatment were received palete food consisted of 5%and 15% of cooked garlic as a food . The control group received standard palete food every day in a month. Finally,the testis were taken out of stomach and after preparing tissue and coloring, they were gone under microscopic studies. Thence, the data were analyzed using SPSS and Duncan test. Results: The study indicated that the amount of sexual cells in the group having cook garlic for 15% compared with that of controlled group had a significant increase and the amount of sexual cells in the group using raw garlic as a food had asignificant decrease compared with that of the controlled group Conclusion: Prescription of cooked garlic has an influence on Proliferation of sexual cells in testicular tubules and epidydymes and so increased spermatogenesis in this group in caparison with the control group. However, prescribing raw garlic has harmful effects on tissue of testis and process of spermatogenes in empric compared with the control group. Keywords: Spermatogenesis, histomorphometrec,testis, epidydyme, garlic, rat.