Treatment of Human Infertility

Ravi Kumar*¹, Dr. Girendra Kumar Gautam², Sweta Pundir², Shafqat Zaidi², Chhavi Gupta²

¹Bharat Institute of Technology, Meerut, Uttar Pradesh, India.

²Shri Ram College of Pharmacy Muzaffarnagar, Uttar Pradesh, India.

*Corresponding Author E-mail:

ABSTRACT:

The human infertility is a major problem at this time in entire world. Some important factors that responsible for this cause like as Daily routine, Food contents, less physical activity etc. About 40% infertility cases count due to male factors. The spermatogenetic failure is one of the major causes of male infertility while the in female infertility is due to Pelvic inflammatory disease (PID), uterine problems, previous tubal ligation, Endometriosis etc. A number of medicinal plants used in the treatment of this disorder. So in this review, we have summarized most of the data dealing with the positive effects of plant extracts on spermatogenesis.

KEYWORDS: Spermatogenesis, Endometriosis, FSH, LH, fertility.

INTRODUCTION:

The Infertility is the inability to conceive after successful matting/sexual practice without any types of contraceptives medicines. Infertility is the major problem for human society and various many factors that associated with this problems like as- Environmental Factors, Foods, Age, Endometriosis, Hormone imbalance, Abnormal Pap Smears, High body Fat, Sexual transmitted Disease etc.^1,2 Recent updation of WHO, the 15-18% population suffered with this problem and in this ratio, 40% are male factors and instead of these are female factors are responsible. The main symptoms of male infertility are- retarded ejaculation, decreased libido, abnormal sexual intercourse, Erectile Dysfunction etc. and female infertility are associated with- irregular periods, no periods, Hormone Dysfunctions ets.³ Some important factors that associated with human infertility like as- genetic disorders, varicocele, genital duct obstruction, decreased semen quality, decreased sperm production, less ovum production, high thickness of ovum cell etc^.4

Various medicinal herbs are used in the successful treatment of infertility from previous 2 thousand years. These medicines are inducing the production of spermatozoa and these are helpful for healthy ovum production.⁵ These medicines can regulate the blood flow in the uterus and ovaries to improve ovarian reserve in female.⁶ Instead of chemical substances the medicinal herb/ Ayurvedic drugs are mostly used in major problem due to with less adverse and side effect. Some traditional medicines play a major role in regulating the hormones level in women and treating some disorders like as- polycystic ovary syndrome, ovarian hyperstimulation syndrome and hypogonadotropic, hypogonadism, because hormones are responsible for pregnancy.^7,8 The Gonadotropin releasing hormone (GnRH), Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), is perform the main role in women reproduction. These hormones are release from the pituitary gland.⁹

Causes of infertility:

Some important cause that induce infertility in male and female-

1. In Male.: The major cause of male infertility are-¹⁰

· Low semen volume

· Testicular failure

· Obstruction

· Sperm agglutination

· Idiopathic infertility

· Cryptorchidism

· Ejaculatory dysfunction or abnormal viscosity

· High density of sperm

· Environmental causes

· Genetic Factor

· Free Radical

· Age

· Smoking

· Consumption of alcohol

2. In Female- The major cause of female infertility are-¹¹

· Ovarian problems (polycystic ovarian syndrome-PCOS)

· Tubal blockage

· Pelvic inflammatory disease (PID)

· Uterine problems

· Previous tubal ligation

· Endometriosis

· Advance maternal age

· Age related factors

Diagnosis of Infertility:

The healthy and young couple has been trying to conceive for 12 month but they are not succeeded, so consult with physician or woman health nurse practitioner (WHNP) about the earlier and later problem. The physicians may also to able to suggest lifestyle changes to increase the chances of conceiving.¹²

The some diagnostic test of fertility are semen analysis (sperm count over 21 million, Sperm motility, Penetration ability), in female partner analyze the level of Follicle stimulating hormone-serum (FSH), Thyroid stimulating hormone (TSH), Ovum production, if any abnormal so increase the chances of infertility in female partner.¹³ Instead of hormonal examination the infertility examine by-

· Physical Examination- Like as medical history

· Laparoscopy- It’s a surgical procedure that used for the examination of reproductive organ

· Blood test- examine the presence of ovulation hormones

· Ultrasound scans-Examine the fibroids in uterus.¹⁴

Symptoms:

Female infertility: Symptoms that confirm the infertility in women-

· Irregular periods. The number of days in between each period varies each month.

· Painful periods. Back pain, Pelvic pain

· Abnormal periods. Bleeding is heavier or lighter than usual

· Dark hair growth on the lips, chest, and chin

· Loss of hair or thinning hair

· Access weight gain.^15,16

Male Infertility: Some common symptoms of male infertility are¹⁷

· Pain and Swelling in testicle area

· Inability to smell

· Gynecomastia

· Inability to smell

· Lower sperm count no.

Treatments:

In Ayurveda, mostly herb or medicinal plants have a particular medicine that can be used in a specific type of disease. Medicinal herb are used for the treatment of disease from ancient time.¹⁸ Some important medicinal plant that used in human infertility are-

1. Ashwagandha:

The botanical source of Ashwagandha is known as Withanai Somnifera. It belongs to the family of Solanaceaei. It is also known as “Indian ginseng”.¹⁹ This medicine is mostly used as an aphrodisiac and geriatric tonic and it shows the rejuvenating effects. It is a best source of alkaloids, amino acid, neurotransmitter, ergostane steroids.²⁰ The root extract of this plant is also used in the treatment of infertility of man. According to recent study, the normal dose of ashwagandha root extract is 225mg/kg. After the 90 days continuously taking, resulted induce spermatogenesis, sperm count and semen quality and regulated sexual hormone level in oligospermic male.²¹ The ashwagandha herb is active against the oxidative stress through the reducing by lipid peroxidation, and increase the sperm motility.²²

2. Shatavari:

It’s also known as Asparagus racemosus and it belonging to the family of Asparagaceae. It is a powerful male tonic with a bitter taste. It is mostly used for purifying of blood and liver diseases. Due to this cooling property balance it also used to improve sperm count same as onion, and ashwagandha.²³ After the excess secretion of pitta the sperm is depleted by burning, but the shatavari is prevent the depetion process. It produces the better effect with the ashwagandha and vajikaranas. Shatavari is one of best pitta pratyanika herbs which can be used for preparation of several Ayurvedic formulas that balance pitta and vata in mediating male reproductive functions.²⁴

3. Green tea:

The green tea is also obtained from the leaves of Camellia sinensis and belonging to family of Theaceae. It has strong aromatic smell and flavor in leafs/seeds. The green tea is a popular beverage in mostly countries because it has the antioxidants properties. The green tea contain many chemical compounds like as- epicatechin gallate, epicatechin, gallocatechin, gallocatechin gallate, epigallocatechin, theobromine, catechin gallate, and epigallocatechin gallate and vitamins, minerals polyphenols, adenine, flavonols (theaflavins, thearubigens), theophylline, xanthine, gallotannin, small amounts of aminophylline.^25,26 The extract of green tea is significantly enhance the superoxide dismutase (SOD) activity and decreased the lipid peroxidation in testis tissues. Due to antioxidants property they protect the testicular tissue from the oxidative damage and stimulate the spermatogenic cells that can produce the spermatozoa.²⁷

4. Garlic:

The garlic is also obtained from the bulb of Allium sativam and it belonging to the family of Liliaceae. It has been used as a medicine from the ancient time.²⁸ The main chemical constituents of garlic is Diallyl tetrasulphate and it has antioxidants property, along with this it contain a variety of chemical constituents like as- vitamins, flavonoids, fructans etc.²⁹ During a experiment, a 220gm albino rats fed with 10%, 20% or 30% extract of allium sativum with normal diet. Examine after 20 days, results in increase the no. of seminiferous tubules in testis but it show the side effect with decrease the testosterone level.³⁰

5. Fenugreek:

The fenugreek is also known as Trigonella foenum-graecum and it belonging to the family of leguminoceae. The common name of fenugreek is methi in Hindi. It is mostly cultivated in winter season. The ripe seeds of fenugreek is better in taste and it contain various important chemical constituents such as- carbohydrates, proteins, tryptophan, pyridine, choline, gentianine, carpaine, flavonoids apigenin, quercetin, orientin, isovitexin, vitexin, 4- hydroxyisoleucine, histidine, arginine and lysine, calcium and iron, saponins, glycosides, cholesterol and sitosterol, vitamins A, B1, C and nicotinic acid etc.^31,32 The seeds extract of fenugreek is prevent the cytogenic damage and enhance the oxidation process. It increases the activity of COD and CAT by suppressing the oxidative stress and lipid peroxidation.³³ A study showed when we give the seed extract to rabbits in continuously 3 month could significantly decrease male testis weight [~25%] and sperm concentration [~43%], that indicate the toxic effect on seminiferous tubules.³⁴

6. Pumpkin:

It is a Cucurbita pepo Linn. And it’s belonging to the family Cucurbitaceae. In the pumpkin seeds, many chemical compounds are present that effect on reproductive and enhance the fertility human beings.³⁵ The seeds contains proteins, fatty acid, linolenic acid, palmtic acid, stearic acid, small amount of selenium, calcium, copper, iron, potassium, zinc.³⁶The pumpkin seeds increase the sexual desire, semen quality and testosterone level and it inhibit the citral induced hyperplasia of ventral prostate lobe suppressing through protein binding prostate level.³⁷ Other species of pumpkin seeds such as fluted pumpkin seeds are used for the treatment/prevention of infertility because it contains various essential chemical compounds like as linoleic acid, vitamin A, oleic acid, tannins, and alkaloids.³⁸ According to recent study indicates that the pumpkin seeds reduce the side effect of CP by preventing the oxidative stress.³⁹

7. Chasteberry:

It is obtained from the fruits of Vitex Agnus-castus and it belonging to the family of Lamiaceae. It is mostly used for the prevention of oxidation because it contains antioxidant properties. It is mostly used for the treatment of female infertility because it contains phytoestrogen.⁴⁰ The study showed the positive effect on experimental mice, it enhance the fertility power of female mice. When we give the fruit extract to mice for 30 days, after the treatment it can increase the level of FSH and LH hormones.⁴¹

8. Angelica gigas:

It is also known as Korean angelica and it is also found in china, Japan and Korea. It belongs to the Apiaceae family. This only medicine that used in butter. Mostly, the root is used for the treatment of infertility because its ability to enhance the level of ovarian hormones and prevent the osteoporosis.⁴² it increase the LH level and decrease the FSH level in female rats.⁴³

9. Cimicifuga racemosa:

It is also known as Black cohosh and it belongs to the Ranunculaceae family. In this plant, some important chemical constituents are present that show the fertility effect like as phytosterogns and clomiphene. When we given the extract of this plant to infertile woman affected with polycystic ovary syndrome, so they increase the level of estradiol and progesterone.⁴⁴ The both estradiol and progesterone are produce more follicles and induce the endometrium thickness.⁴⁵

CONCLUSION:

The sexual hormone is responsible for the fertility of humans. These hormones are produce a successful fertility in the first half of the menstrual cycle because it increases the estrogen levels and cause the growth and increase of uterine cells. The LH and FSH are responsible for ovum growth. Some Ayurvedic plants like as Ashwagandha, garlic, shatavari, Fenugreek etc, are show the aphrodisiac property and enhance the quality and quantity of semen. These herbs provide the better nourishment to the reproductive tissue.

In this review, we studied the phytomedicines that have showed the positive effects on reproductive system. These natural herbs stimulate the spermatogenesis, sperm motility, semniferous tubule diameters, increasing Leydig cell counts, discard abnormal sperm, improving histopathological recovery, sexual stimulation.

ACKNOWLEDGMENTS:

I would like to thanks all above authors for support and valuable advice.

CONFLICT OF INTEREST:

Conflict of interest declared none.

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Received on 02.01.2021 Modified on 08.02.2021

Asian J. Res. Pharm. Sci. 2021; 11(2):160-164.

DOI: 10.52711/2231-5659.2021-11-2-12