Role of Withania somnifera (Ashwagandha) in the management of male infertility

Reproductive BioMedicine Online Volume 36, Issue 3, March 2018, Pages 311-326 Reproductive BioMedicine Online Review Author links open overlay panelPallavSenguptaabAshokAgarwalbMariaPogrebetskayabcShubhadeepRoychoudhurybdDamayanthiDurairajanayagameRalfHenkelf a Department of Physiology, Faculty of Medicine, MAHSA University, Jalan SP2, Bandar Saujana Putra, 42610 Jenjarom, Selangor, Malaysia b American Center for Reproductive Medicine, Cleveland Clinic, 10681 Carnegie Avenue, Cleveland, OH 44195, USA c Case Western Reserve University/University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA d Department of Life Science and Bioinformatics, Assam University, Silchar 788011, India e Discipline of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia f Department of Medical Biosciences, University of the Western Cape, Bellville 7535, Cape Town, South Africa Received 6 June 2017, Revised 21 November 2017, Accepted 22 November 2017, Available online 7 December 2017. Declaration: The authors report no financial or commercial conflicts of interest. crossmark-logo https://doi.org/10.1016/j.rbmo.2017.11.007 Get rights and content Abstract To manage male infertility caused by hormonal imbalance, infections and other predicaments, multifarious treatment strategies are emerging worldwide. Contemporary treatments, such as assisted reproductive techniques, are costly with low success rates of only 10–30%; however, herbal remedies are gaining more attention as an alternative or supplementary therapeutic modality for male infertility. The beneficial effects induced by oral intake of the roots of a small evergreen shrub, Withania sominifera (Ashwagandha) on semen quality of infertile men have previously been studied. Oral intake of Ashwagandha roots has been found to inhibit lipid peroxidation, improve sperm count and motility, and regulate reproductive hormone levels. The molecular mechanisms of these effects, however, are yet to be unveiled. In this review, we will discuss the role of herbal medicines in male infertility; provide a detailed analysis of various human and animal studies involving Withania somnifera; describe a proposed direct oxidative mechanism involving mitigation of oxidative stress as well as an indirect mechanism consisting of a gamma-aminobutyric acid-like-mimetic pathway ameliorating hormonal balance through crosstalk among different endocrine glands to improve male fertility; and how Withania somnifera supplementation mitigates risk factor-induced male infertility as well as ameliorates male fertility. Keywords Withania somnifera Ashwagandha Male infertility Semen quality