An Extract of Pomegranate Fruit and Galangal Rhizome Increases the Numbers of Motile Sperm: A Prospective, Randomised, Controlled, Double-Blinded Trial

Abstract

Pomegranate fruit (Punica granatum) and galangal (Alpinia galanga) have separately been shown to stimulate spermatogenesis and to increase sperm counts and motility in rodents. Within traditional medicine, pomegranate fruit has long been used to increase fertility, however studies on the effect on spermatogenesis in humans have never been published. With this study we investigated whether oral intake of tablets containing standardised amounts of extract of pomegranate fruit and powder of greater galangal rhizome (Punalpin) would increase the total number of motile spermatozoa. The study was designed as a prospective, randomized, controlled, double-blinded trial. Enrolment was based on the mean total number of motile spermatozoa of two ejaculates. The participants delivered an ejaculate after 4–8 days of tablet intake and two ejaculates just before they stopped taking the tablets. Seventy adult men with a semen quality not meeting the standards for commercial application at Nordic Cryobank, but without azoospermia, were included in the study. Participants were randomized to take tablets containing extract of pomegranate fruit (standardised with respect to punicalagin A+B, punicalin and ellagic acid) and freeze-dried rhizome of greater galangal (standardised with respect to 1′S-1′-acetoxychavicol acetate) or placebo on a daily basis for three months. Sixty-six participants completed the intervention (active treatment: n = 34; placebo: n = 32). After the intervention the total number of motile spermatozoa was increased in participants treated with plant extracts compared with the placebo group (p = 0.026). After three months of active treatment, the average total number of motile sperm increased by 62% (from 23.4 to 37.8 millions), while for the placebo group, the number of motile sperm increased by 20%. Sperm morphology was not affected by the treatment. Our findings may help subfertile men to gain an improved amount of motile ejaculated sperm by taking tablets containing preparations of pomegranate fruit extract and rhizome of greater galangal.Trial Registration ClinicalTrials.gov NCT01357044

Plants in the management of male infertility

“…For example, in rats, the formulation of hydro‐alcoholic extracts of L. meyenii and F. tessmannii could increase spermatogenesis and testosterone level much more when administered together (Lembe et al, ). Similarly, men with poor semen quality who had received standardised extracts of the combination of Punica granatum and Alpinia galanga showed increased total number of motile spermatozoa after three months of daily treatment (Fedder et al, ). All these interesting findings are expected to drive the development of new botanical medicines for the treatment of male infertility.…”

The Effect of Lyophilized Pomegranate Extract on Epididymal Sperm Quality, Oxidative Stress and Spermatogenic Cell Density in Rabbits

“…In a rabbit study of Fayed et al (2012), it was reported that a supplementary diet with pomegranate peel in different concentrations (0.5%, 1.0% and 1.5%) for eight weeks raised semen volume, motility and total number of spermatozoa, while the morphological abnormal and dead/live sperm ratio were decreased. On the other hand, in human the daily consumption of tablets of P. granatum extract for 3 months resulted in a significant increase of the sperm motility and volume (Fedder et al, 2014). According to Leiva et al (2011), daily administration of 500 mg/kg pomegranate extract to rats exposed to lead poisoning for A: Control group and 1 ml % 0.5 carboxymethyl cellulose (CMC) B: animals treated with 25 mg/kg/day pomegranate extract + 1 ml % 0.5 carboxymethyl cellulose (CMC) C: animals treated with 50 mg/kg/day pomegranate extract + 1 ml % 0.5 CMC D: animals treated with 100 mg/kg/day pomegranate extract + 1 ml % 0.5 CMC.…”

Effect ofAlpinia officinarumHance rhizome extract on spermatogram factors in men with idiopathic infertility: A prospective double-blinded randomised clinical trial

“…galangal in male infertility. The treatment with the tablets contained the extracts of greater galangal rhizome ( A. galangal ) and pomegranate fruit in a clinical study and increased the total number of motile spermatozoa by 62% compared with the placebo (Fedder et al, ). Also, oral administration of A. galangal extract (100 mg kg ‐1 day ‐1 , for 90 days) has been reported to increase the sperm motility and sperm counts in male mice without any spermatotoxic effect (Ravichandran, ).…”

“…At the end of 3 months, semen analysis was done for each patient again. Semen samples were kept at or above room temperature (max 30◦C) (Fedder et al, ) and were analysed within 1 hr of sample collection.…”

“…In several reports, a decrease in semen quality during the last 40 years has been indicated. Only 23% of Danish men have suitable sperm quality, and 15% are at high risk of requiring fertility treatment in order to increase the chance for pregnancy (Fedder et al, ).…”