Protective effects of herbal medicines on murine spermatogenesis under heat stress and other injury models: Evidence from meta-analyses

Tung Nguyen-Thanh; Phuc Dang-Ngoc; Manh-Hung Bui

Keywords:

Herbal medicines

male murine

sexual dysfunction

fertility impairments

male reproductive system

spermatogenesis

Abstract

Male infertility has increased dramatically in recent decades, with herbal medicine being a potential complementary treatment. Animal studies are essential to gain insights into the mechanisms involved and to refine the development of herbal medicine in human trials. This study aimed to systematically review the protective effects of herbal medicines on murine spermatogenesis. The literature search was conducted using databases such as EMBASE, PubMed, and Google Scholar, as well as scientific journals indexed in the Web of Science, until October 21, 2024. The studies included in the analysis focused on the impact of herbal medicines on murine models, specifically examining physical and organ weights, reproductive parameters, metabolic and biochemical markers, and oxidative stress and antioxidant markers. The analysis included 48 studies from 44 articles involving 1597 murine subjects, 27 plant species, and seven formulations. Herbal medicine significantly increased male murine reproductive organ weights, including body weight (SMD = 1.83; 95% CI: 1.24, 2.42), testis weight (SMD = 1.94; 95% CI: 1.42, 2.46), relative testis weight (SMD = 2.01; 95% CI: 1.27, 2.75), epididymis weight (SMD = 1.22; 95% CI: 0.79, 1.65), relative epididymal weight (SMD = 1.93; 95% CI: 0.93, 2.93), seminal vesicle weight (SMD = 1.25; 95% CI: 0.75, 1.75), and relative seminal vesicle weight (SMD = 1.67; 95% CI: 0.81, 2.54). Additionally, treatment increased the seminiferous tubule diameter (SMD = 9.10; 95% CI: 4.93, 13.28) and Johnson's score (SMD = 6.40; 95% CI: 3.73, 9.06). In the injury models, the semen parameters, including the sperm count (SMD = 3.47; 95% CI: 2.72, 4.21), motility (SMD = 3.57; 95% CI: 2.70, 4.44), viability (SMD = 2.04; 95% CI: 1.21, 2.87), and reduced abnormal sperm morphology (SMD = -2.28; 95% CI: -3.65, -1.72), improved. While no significant changes were observed in the FSH and LH levels, the serum testosterone levels increased favorably. Moreover, blood serum biochemical parameters and oxidative stress markers in injury model mice improved following herbal treatment. Herbal medicine has been shown to enhance spermatogenesis in murine models. These in-depth findings provide a foundation for optimizing future human studies.
References
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2. Ambulkar PS, Sigh R, Reddy M, Varma PS, Gupta DO, Shende MR, Pal AK. 2014. Genetic Risk of Azoospermia Factor (AZF) Microdeletions in Idiopathic Cases of Azoospermia and Oligozoospermia in Central Indian Population. J Clin Diagn Res 8: 88-91.
3. Aslan E, Kumalar K, Güzel H, DemİRel H, Celik S, PektaŞ M. 2021. Effects of Panax ginseng on cisplatin-induced testicular damage of rats. Anatolian Journal of Botany 5.
4. Bahmanpour S, Vojdani Z, Panjehshahin MR, Hoballah H, Kassas H. 2012. Effects of Carthamus tinctorius on Semen Quality and Gonadal Hormone Levels in Partially Sterile Male Rats. Korean J Urol 53: 705-710.
5. Balawender K, Orkisz S. 2020. The impact of selected modifiable lifestyle factors on male fertility in the modern world. Cent European J Urol 73: 563-568.
6. Barratt CLR, et al. 2017. The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance-challenges and future research opportunities. Hum Reprod Update 23: 660-680.
7. Bayatli F, Akkuş D, Kilic E, Saraymen R, Sönmez MF. 2013. The protective effects of grape seed extract on MDA, AOPP, apoptosis and eNOS expression in testicular torsion: an experimental study. World J Urol 31: 615-622.
8. Behdarvand-Margha Z, Ahangarpour A. 2021. The effects of gallic acid and metformin on male reproductive dysfunction in diabetic mice induced by methylglyoxal: An experimental study. 19: 715-724.
9. Besong EB, Ateufack G. 2018. Leaf-Methanolic Extract of Pseudopanax arboreus (Araliaceae) (L. F. Phillipson) Reverses Amitriptyline-Induced Sexual Dysfunction in Male Rats. 2018: 2869727.
10. Boeri L, et al. 2021. Testicular volume in infertile versus fertile white-European men: a case-control investigation in the real-life setting. Asian J Androl 23: 501-509.
11. Boudou F, Abdelkrim B, Bendahmane M, Baderdine K, adli D, Tou N. 2013. Ameliorative Effects of Syzygium aromaticum Essential Oil on Fertility in Male Rats Exposed to Manganese. Advances in Sexual Medicine 03: 85-91.
12. Bui-Le TN, Hoang-Tan Q. 2023. Protective Effect of Curculigo orchioides Gaertn. Extract on Heat Stress-Induced Spermatogenesis Complications in Murine Model. 45: 3255-3267.
13. Bustani G, Kareem M, Al-Baghdady Ha, Al-Dhalimy A. 2022. Protective effects of curcumin on testicular and sperm parameters abnormalities induced by nicotine in male rats.
14. Cele ND, Sangweni NF, Mosa RA. 2017. Testicular Dysfunction Ameliorative Effect of the Methanolic Roots Extracts of Maytenus procumbens and Ozoroa paniculosa. 2017: 8204816.
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19. Fungfuang W, Lert-Amornpat T, Maketon C. 2016. Effects of Black ginger (Kaempferia parviflora) on the testicular function in streptozotocin-induced diabetic male rats. Veterinary Integrative Sciences 14: 95-107.
20. Hady A, et al. 2023. Protective Effects of Curcumin and Selenium on Testicular Toxicity Induced by Lead Acetate in Adult Male Albino Rats [Structural and Biochemical Study]. International Journal of Medical Arts 5: 3045-3053.
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24. Hozayen W. 2013. The chemopreventive effects of ginger aqueous and methanolic extracts against alcohol-induced sexual dysfunction in rats. Medical Research Journal 12: 108-114.
25. Huang B, Wang Z, Kong Y, Jin M, Ma L. 2023. Global, regional and national burden of male infertility in 204 countries and territories between 1990 and 2019: an analysis of global burden of disease study. BMC Public Health 23: 2195.
26. Huang H, Zhou G, Liu H, Zhou Z. 2017. Effect of total terpenes of Cornus officinalis Sieb. On hypogonadism in streptozotocin (STZ)-induced diabetic rats. International Journal of Clinical and Experimental Medicine 10: 6926-6933.
27. Hwang DS, Kim HG, Park S, Hong ND, Ryu JH, Oh MS. 2015. Effect of a Traditional Herbal Prescription, Kyung-Ok-Ko, on Male Mouse Spermatogenic Ability after Heat-Induced Damage. Evid Based Complement Alternat Med 2015: 950829.
28. Jang M, Min JW, In JG, Yang DC. 2011. Effects of red ginseng extract on the epididymal sperm motility of mice exposed to ethanol. Int J Toxicol 30: 435-442.
29. Ji HJ, Wang DM, Wu YP, Niu YY, Jia LL, Liu BW, Feng QJ, Feng ML. 2016. Wuzi Yanzong pill, a Chinese polyherbal formula, alleviates testicular damage in mice induced by ionizing radiation. BMC Complement Altern Med 16: 509.
30. Karimi S, Khorsandi L, Nejaddehbashi F. 2019. Protective effects of Curcumin on testicular toxicity induced by titanium dioxide nanoparticles in mice. JBRA Assist Reprod 23: 344-351.
31. Kim MK, Cha KM, Hwang SY, Park UK, Seo SK, Lee SH, Jeong MS, Cho S, Kopalli SR, Kim SK. 2017. Pectinase-treated Panax ginseng protects heat stress-induced testicular damage in rats. Reproduction 153: 737-747.
32. Kim YH, Kim GH, Shin JH, Kim KS, Lim JS. 2010. Effect of korean red ginseng on testicular tissue injury after torsion and detorsion. Korean J Urol 51: 794-799.
33. Kopalli SR, Cha KM, Hwang SY, Jeong MS, Kim SK. 2019. Korean Red Ginseng (Panax ginseng Meyer) with enriched Rg3 ameliorates chronic intermittent heat stress-induced testicular damage in rats via multifunctional approach. J Ginseng Res 43: 135-142.
34. Kumar Roy V, Marak TR, Gurusubramanian G. 2016. Alleviating effect of Mallotus roxburghianus in heat-induced testicular dysfunction in Wistar rats. Pharm Biol 54: 905-918.
35. Lamondo D, Soegianto A, Abadi A, Keman S. 2014. Antioxidant Effects of Sarang Semut (Myrmecodia pendans) on the Apoptosis of Spermatogenic Cells of Rats Exposed to Plumbum. Research Journal of Pharmaceutical, Biological and Chemical Sciences 5.
36. Lin C, Shin DG, Park SG, Chu SB, Gwon LW, Lee JG, Yon JM, Baek IJ, Nam SY. 2015. Curcumin dose-dependently improves spermatogenic disorders induced by scrotal heat stress in mice. Food Funct 6: 3770-3777.
37. López-Botella A, Velasco I. 2021. Impact of Heavy Metals on Human Male Fertility-An Overview. 10.
38. Mallick C, Mandal S, Barik B, Bhattacharya A, Ghosh D. 2007. Protection of testicular dysfunctions by MTEC, a formulated herbal drug, in streptozotocin induced diabetic rat. Biol Pharm Bull 30: 84-90.
39. Mohajeri D, Kaffashi Elahi R. 2015. Effects of Nigella sativa on heat-induced testis damage in mouse. Bratisl Lek Listy 116: 264-269.
40. Mt M, Sk M, T Z, S A, Ka M, M A, Rj H. 2018. The Effect of Alcoholic Extract of Ginger on Apoptosis and Inflammation of Germ Cells in Streptozotocin-Induced Diabetic Rats. Asian Journal of Biomedical and Pharmaceutical Sciences 8.
41. Nouri M, Khaki A, Azar F, Rashidi M-R. 2009. The Protective Effects of Carrot Seed Extract on Spermatogenesis and Cauda Epididymal Sperm Reserves in Gentamicin Treated Rats. Yakhte Med J 11.
42. Nguyen-Thanh T, Dang-Ngoc P, Bui M-H, Le-Minh T, Nguyen-Vu Q-H. 2024. Effectiveness of Herbal medicines on male reproductive system: Evidence from meta-analysis. Pharmacological Research - Modern Chinese Medicine 12: 100462.
43. Offor SJ, Mbagwu HO, Orisakwe OE. 2019. Improvement of Lead Acetate-Induced Testicular Injury and Sperm Quality Deterioration by Solanum Anomalum Thonn. Ex. Schumach Fruit Extracts in Albino Rats. J Family Reprod Health 13: 98-108.
44. Panpan Z, Alifu N, Sataer M, Yiming A, Amuti S, Wenjing M, Binghua W. 2023. Effects of phytoestrogens combined with cold stress on sperm parameters and testicular proteomics in rats. Open Life Sci 18: 20220531.
45. Park HJ, Koo YK. 2017. Restoration of Spermatogenesis Using a New Combined Herbal Formula of Epimedium koreanum Nakai and Angelica gigas Nakai in an Luteinizing Hormone-Releasing Hormone Agonist-Induced Rat Model of Male Infertility. 35: 170-177.
46. Park JS, Hwang SY, Lee WS, Yu KW, Paek KY, Hwang BY, Han K. 2006. The therapeutic effect of tissue cultured root of wild Panax ginseng C.A. Mayer on spermatogenetic disorder. Arch Pharm Res 29: 800-807.
47. Pomjunya A, Ratthanophart J, Fungfuang W. 2017. Effects of Vernonia cinerea on reproductive performance in streptozotocin-induced diabetic rats. J Vet Med Sci 79: 572-578.
48. Sengupta P, Borges E, Jr., Dutta S, Krajewska-Kulak E. 2018. Decline in sperm count in European men during the past 50 years. Hum Exp Toxicol 37: 247-255.
49. Shahraki M, Dehvari J, Shahrakipoor M, Shahreki E, Sharaki A, Dashipour A. 2019. The Effects of Anacyclus pyrethrum Alcoholic Root Extract on FSH, LH, Testosterone and Sperm Count in Diabetic Male Rats. Zahedan Journal of Research in Medical Sciences In Press.
50. Sharma V, Chauhan N, Patil U, Dixit V. 2021. Protective Effect of Rasayana Herbs on Lead Acetate-induced Testicular Toxicity in Wistar Rats. Indian Journal of Natural Products 35: 9-15.
51. Shi GJ, Zheng J, Wu J, Qiao HQ, Chang Q, Niu Y, Sun T, Li YX, Yu JQ. 2017. Protective effects of Lycium barbarum polysaccharide on male sexual dysfunction and fertility impairments by activating hypothalamic pituitary gonadal axis in streptozotocin-induced type-1 diabetic male mice. Endocr J 64: 907-922.
52. Sudjarwo SA, Sudjarwo GW, Koerniasari. 2017. Protective effect of curcumin on lead acetate-induced testicular toxicity in Wistar rats. Res Pharm Sci 12: 381-390.
53. Udefa AL, Amama EA, Archibong EA, Nwangwa JN, Adama S, Inyang VU, Inyaka GU, Aju GJ, Okpa S, Inah IO. 2020. Antioxidant, anti-inflammatory and anti-apoptotic effects of hydro-ethanolic extract of Cyperus esculentus L. (tigernut) on lead acetate-induced testicular dysfunction in Wistar rats. Biomed Pharmacother 129: 110491.
54. Wal A, Wal P, Pandey A, Vig H, Karunakaran R, Dash B. 2022. Conventional treatment options and herbal remedies for male infertility: An overview. Asian Pacific Journal of Reproduction 11.
55. Yang W-S, Kim I, Seu Y-B, Jeong Y, Han H, Ryu K, Kang S. 2016. Ethanolic Extract of Radish Sprout ( Raphanus Sativus L.) Prevents Bisphenol A-Induced Testicular Dysfunction in Male Rats. Journal of Food Biochemistry 40: n/a-n/a.
56. Yuan D, Wang H, He H, Jia L, He Y, Wang T, Zeng X, Li Y, Li S, Zhang C. 2014. Protective effects of total flavonoids from Epimedium on the male mouse reproductive system against cyclophosphamide-induced oxidative injury by up-regulating the expressions of SOD3 and GPX1. Phytother Res 28: 88-97.
57. Zhang K, et al. 2020. Effects of Qilin pills on spermatogenesis, reproductive hormones, oxidative stress, and the TSSK2 gene in a rat model of oligoasthenospermia. 20: 42.
58. Zirkin BR, Santulli R, Awoniyi CA, Ewing LL. 1989. Maintenance of advanced spermatogenic cells in the adult rat testis: quantitative relationship to testosterone concentration within the testis. Endocrinology 124: 3043-3049.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to cite

Nguyen-Thanh, T., Dang-Ngoc, P., & Bui, M.-H. (2025). Protective effects of herbal medicines on murine spermatogenesis under heat stress and other injury models: Evidence from meta-analyses. Journal of Animal Behaviour and Biometeorology, (| Accepted Articles). Retrieved from https://malque.pub/ojs/index.php/jabb/article/view/8669

[1] Alkhedaide A, Alshehri ZS, Sabry A, Abdel-Ghaffar T, Soliman MM, Attia H. 2016. Protective effects of grape seed extract against cadmium-induced testicular dysfunction. Mol Med Rep 13: 3101-3109.

[2] Ambulkar PS, Sigh R, Reddy M, Varma PS, Gupta DO, Shende MR, Pal AK. 2014. Genetic Risk of Azoospermia Factor (AZF) Microdeletions in Idiopathic Cases of Azoospermia and Oligozoospermia in Central Indian Population. J Clin Diagn Res 8: 88-91.

[3] Aslan E, Kumalar K, Güzel H, DemİRel H, Celik S, PektaŞ M. 2021. Effects of Panax ginseng on cisplatin-induced testicular damage of rats. Anatolian Journal of Botany 5.

[4] Bahmanpour S, Vojdani Z, Panjehshahin MR, Hoballah H, Kassas H. 2012. Effects of Carthamus tinctorius on Semen Quality and Gonadal Hormone Levels in Partially Sterile Male Rats. Korean J Urol 53: 705-710.

[5] Balawender K, Orkisz S. 2020. The impact of selected modifiable lifestyle factors on male fertility in the modern world. Cent European J Urol 73: 563-568.

[6] Barratt CLR, et al. 2017. The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance-challenges and future research opportunities. Hum Reprod Update 23: 660-680.

[7] Bayatli F, Akkuş D, Kilic E, Saraymen R, Sönmez MF. 2013. The protective effects of grape seed extract on MDA, AOPP, apoptosis and eNOS expression in testicular torsion: an experimental study. World J Urol 31: 615-622.

[8] Behdarvand-Margha Z, Ahangarpour A. 2021. The effects of gallic acid and metformin on male reproductive dysfunction in diabetic mice induced by methylglyoxal: An experimental study. 19: 715-724.

[9] Besong EB, Ateufack G. 2018. Leaf-Methanolic Extract of Pseudopanax arboreus (Araliaceae) (L. F. Phillipson) Reverses Amitriptyline-Induced Sexual Dysfunction in Male Rats. 2018: 2869727.

[10] Boeri L, et al. 2021. Testicular volume in infertile versus fertile white-European men: a case-control investigation in the real-life setting. Asian J Androl 23: 501-509.

[11] Boudou F, Abdelkrim B, Bendahmane M, Baderdine K, adli D, Tou N. 2013. Ameliorative Effects of Syzygium aromaticum Essential Oil on Fertility in Male Rats Exposed to Manganese. Advances in Sexual Medicine 03: 85-91.

[12] Bui-Le TN, Hoang-Tan Q. 2023. Protective Effect of Curculigo orchioides Gaertn. Extract on Heat Stress-Induced Spermatogenesis Complications in Murine Model. 45: 3255-3267.

[13] Bustani G, Kareem M, Al-Baghdady Ha, Al-Dhalimy A. 2022. Protective effects of curcumin on testicular and sperm parameters abnormalities induced by nicotine in male rats.

[14] Cele ND, Sangweni NF, Mosa RA. 2017. Testicular Dysfunction Ameliorative Effect of the Methanolic Roots Extracts of Maytenus procumbens and Ozoroa paniculosa. 2017: 8204816.

[15] Cunha GR, Sinclair A, Ricke WA, Robboy SJ, Cao M, Baskin LS. 2019. Reproductive tract biology: Of mice and men. Differentiation 110: 49-63.

[16] Ding GL, Liu Y, Liu ME, Pan JX, Guo MX, Sheng JZ, Huang HF. 2015. The effects of diabetes on male fertility and epigenetic regulation during spermatogenesis. Asian J Androl 17: 948-953.

[17] Eisenberg ML, Esteves SC. 2023. Male infertility. 9: 49.

[18] El-Ashmawy IM, Saleh A, Salama OM. 2007. Effects of marjoram volatile oil and grape seed extract on ethanol toxicity in male rats. Basic Clin Pharmacol Toxicol 101: 320-327.

[19] Fungfuang W, Lert-Amornpat T, Maketon C. 2016. Effects of Black ginger (Kaempferia parviflora) on the testicular function in streptozotocin-induced diabetic male rats. Veterinary Integrative Sciences 14: 95-107.

[20] Hady A, et al. 2023. Protective Effects of Curcumin and Selenium on Testicular Toxicity Induced by Lead Acetate in Adult Male Albino Rats [Structural and Biochemical Study]. International Journal of Medical Arts 5: 3045-3053.

[21] Hala A, Khattab, Inas Z, Abdallah I, Gehan M, Kamel, Khattab H, Abdallah G, Kamel M. 2010. Grape seed extract alleviate reproductive toxicity caused by aluminium chloride in male rats. Journal of American Science 6.

[22] Hoang-Thi AP, Dang-Thi AT, Phan-Van S, Nguyen-Ba T, Truong-Thi PL, Le-Minh T, Nguyen-Vu QH, Nguyen-Thanh T. 2022. The Impact of High Ambient Temperature on Human Sperm Parameters: A Meta-Analysis. Iran J Public Health 51: 710-723.

[23] Hou Y, Yuan P, Fu Y, Zhang Q, Wei Y, Gao L, Liu L, Wang X, Zheng X. 2020. Duzhong Butiansu Prescription Improves Heat Stress-Induced Spermatogenic Dysfunction by Regulating Sperm Formation and Heat Stress Pathway. 2020: 6723204.

[24] Hozayen W. 2013. The chemopreventive effects of ginger aqueous and methanolic extracts against alcohol-induced sexual dysfunction in rats. Medical Research Journal 12: 108-114.

[25] Huang B, Wang Z, Kong Y, Jin M, Ma L. 2023. Global, regional and national burden of male infertility in 204 countries and territories between 1990 and 2019: an analysis of global burden of disease study. BMC Public Health 23: 2195.

[26] Huang H, Zhou G, Liu H, Zhou Z. 2017. Effect of total terpenes of Cornus officinalis Sieb. On hypogonadism in streptozotocin (STZ)-induced diabetic rats. International Journal of Clinical and Experimental Medicine 10: 6926-6933.

[27] Hwang DS, Kim HG, Park S, Hong ND, Ryu JH, Oh MS. 2015. Effect of a Traditional Herbal Prescription, Kyung-Ok-Ko, on Male Mouse Spermatogenic Ability after Heat-Induced Damage. Evid Based Complement Alternat Med 2015: 950829.

[28] Jang M, Min JW, In JG, Yang DC. 2011. Effects of red ginseng extract on the epididymal sperm motility of mice exposed to ethanol. Int J Toxicol 30: 435-442.

[29] Ji HJ, Wang DM, Wu YP, Niu YY, Jia LL, Liu BW, Feng QJ, Feng ML. 2016. Wuzi Yanzong pill, a Chinese polyherbal formula, alleviates testicular damage in mice induced by ionizing radiation. BMC Complement Altern Med 16: 509.

[30] Karimi S, Khorsandi L, Nejaddehbashi F. 2019. Protective effects of Curcumin on testicular toxicity induced by titanium dioxide nanoparticles in mice. JBRA Assist Reprod 23: 344-351.

[31] Kim MK, Cha KM, Hwang SY, Park UK, Seo SK, Lee SH, Jeong MS, Cho S, Kopalli SR, Kim SK. 2017. Pectinase-treated Panax ginseng protects heat stress-induced testicular damage in rats. Reproduction 153: 737-747.

[32] Kim YH, Kim GH, Shin JH, Kim KS, Lim JS. 2010. Effect of korean red ginseng on testicular tissue injury after torsion and detorsion. Korean J Urol 51: 794-799.

[33] Kopalli SR, Cha KM, Hwang SY, Jeong MS, Kim SK. 2019. Korean Red Ginseng (Panax ginseng Meyer) with enriched Rg3 ameliorates chronic intermittent heat stress-induced testicular damage in rats via multifunctional approach. J Ginseng Res 43: 135-142.

[34] Kumar Roy V, Marak TR, Gurusubramanian G. 2016. Alleviating effect of Mallotus roxburghianus in heat-induced testicular dysfunction in Wistar rats. Pharm Biol 54: 905-918.

[35] Lamondo D, Soegianto A, Abadi A, Keman S. 2014. Antioxidant Effects of Sarang Semut (Myrmecodia pendans) on the Apoptosis of Spermatogenic Cells of Rats Exposed to Plumbum. Research Journal of Pharmaceutical, Biological and Chemical Sciences 5.

[36] Lin C, Shin DG, Park SG, Chu SB, Gwon LW, Lee JG, Yon JM, Baek IJ, Nam SY. 2015. Curcumin dose-dependently improves spermatogenic disorders induced by scrotal heat stress in mice. Food Funct 6: 3770-3777.

[37] López-Botella A, Velasco I. 2021. Impact of Heavy Metals on Human Male Fertility-An Overview. 10.

[38] Mallick C, Mandal S, Barik B, Bhattacharya A, Ghosh D. 2007. Protection of testicular dysfunctions by MTEC, a formulated herbal drug, in streptozotocin induced diabetic rat. Biol Pharm Bull 30: 84-90.

[39] Mohajeri D, Kaffashi Elahi R. 2015. Effects of Nigella sativa on heat-induced testis damage in mouse. Bratisl Lek Listy 116: 264-269.

[40] Mt M, Sk M, T Z, S A, Ka M, M A, Rj H. 2018. The Effect of Alcoholic Extract of Ginger on Apoptosis and Inflammation of Germ Cells in Streptozotocin-Induced Diabetic Rats. Asian Journal of Biomedical and Pharmaceutical Sciences 8.

[41] Nouri M, Khaki A, Azar F, Rashidi M-R. 2009. The Protective Effects of Carrot Seed Extract on Spermatogenesis and Cauda Epididymal Sperm Reserves in Gentamicin Treated Rats. Yakhte Med J 11.

[42] Nguyen-Thanh T, Dang-Ngoc P, Bui M-H, Le-Minh T, Nguyen-Vu Q-H. 2024. Effectiveness of Herbal medicines on male reproductive system: Evidence from meta-analysis. Pharmacological Research - Modern Chinese Medicine 12: 100462.

[43] Offor SJ, Mbagwu HO, Orisakwe OE. 2019. Improvement of Lead Acetate-Induced Testicular Injury and Sperm Quality Deterioration by Solanum Anomalum Thonn. Ex. Schumach Fruit Extracts in Albino Rats. J Family Reprod Health 13: 98-108.

[44] Panpan Z, Alifu N, Sataer M, Yiming A, Amuti S, Wenjing M, Binghua W. 2023. Effects of phytoestrogens combined with cold stress on sperm parameters and testicular proteomics in rats. Open Life Sci 18: 20220531.

[45] Park HJ, Koo YK. 2017. Restoration of Spermatogenesis Using a New Combined Herbal Formula of Epimedium koreanum Nakai and Angelica gigas Nakai in an Luteinizing Hormone-Releasing Hormone Agonist-Induced Rat Model of Male Infertility. 35: 170-177.

[46] Park JS, Hwang SY, Lee WS, Yu KW, Paek KY, Hwang BY, Han K. 2006. The therapeutic effect of tissue cultured root of wild Panax ginseng C.A. Mayer on spermatogenetic disorder. Arch Pharm Res 29: 800-807.

[47] Pomjunya A, Ratthanophart J, Fungfuang W. 2017. Effects of Vernonia cinerea on reproductive performance in streptozotocin-induced diabetic rats. J Vet Med Sci 79: 572-578.

[48] Sengupta P, Borges E, Jr., Dutta S, Krajewska-Kulak E. 2018. Decline in sperm count in European men during the past 50 years. Hum Exp Toxicol 37: 247-255.

[49] Shahraki M, Dehvari J, Shahrakipoor M, Shahreki E, Sharaki A, Dashipour A. 2019. The Effects of Anacyclus pyrethrum Alcoholic Root Extract on FSH, LH, Testosterone and Sperm Count in Diabetic Male Rats. Zahedan Journal of Research in Medical Sciences In Press.

[50] Sharma V, Chauhan N, Patil U, Dixit V. 2021. Protective Effect of Rasayana Herbs on Lead Acetate-induced Testicular Toxicity in Wistar Rats. Indian Journal of Natural Products 35: 9-15.

[51] Shi GJ, Zheng J, Wu J, Qiao HQ, Chang Q, Niu Y, Sun T, Li YX, Yu JQ. 2017. Protective effects of Lycium barbarum polysaccharide on male sexual dysfunction and fertility impairments by activating hypothalamic pituitary gonadal axis in streptozotocin-induced type-1 diabetic male mice. Endocr J 64: 907-922.

[52] Sudjarwo SA, Sudjarwo GW, Koerniasari. 2017. Protective effect of curcumin on lead acetate-induced testicular toxicity in Wistar rats. Res Pharm Sci 12: 381-390.

[53] Udefa AL, Amama EA, Archibong EA, Nwangwa JN, Adama S, Inyang VU, Inyaka GU, Aju GJ, Okpa S, Inah IO. 2020. Antioxidant, anti-inflammatory and anti-apoptotic effects of hydro-ethanolic extract of Cyperus esculentus L. (tigernut) on lead acetate-induced testicular dysfunction in Wistar rats. Biomed Pharmacother 129: 110491.

[54] Wal A, Wal P, Pandey A, Vig H, Karunakaran R, Dash B. 2022. Conventional treatment options and herbal remedies for male infertility: An overview. Asian Pacific Journal of Reproduction 11.

[55] Yang W-S, Kim I, Seu Y-B, Jeong Y, Han H, Ryu K, Kang S. 2016. Ethanolic Extract of Radish Sprout ( Raphanus Sativus L.) Prevents Bisphenol A-Induced Testicular Dysfunction in Male Rats. Journal of Food Biochemistry 40: n/a-n/a.

[56] Yuan D, Wang H, He H, Jia L, He Y, Wang T, Zeng X, Li Y, Li S, Zhang C. 2014. Protective effects of total flavonoids from Epimedium on the male mouse reproductive system against cyclophosphamide-induced oxidative injury by up-regulating the expressions of SOD3 and GPX1. Phytother Res 28: 88-97.

[57] Zhang K, et al. 2020. Effects of Qilin pills on spermatogenesis, reproductive hormones, oxidative stress, and the TSSK2 gene in a rat model of oligoasthenospermia. 20: 42.

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