1- Department of Persian Medicine, Clinical Research Development Unit [CRDU], Sayad Shirazi Hospital, School of Persian Medicine, Golestan University of Medical Sciences, Gorgan, Iran
2- Counseling and Reproductive Health Research Center, Department of Persian Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran ,dr.kolaangi@gmail.com
2- Counseling and Reproductive Health Research Center, Department of Persian Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran ,
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For 3 months, the patient took two 500 mg capsules of dried Daucus carota L. seed extract powder twice daily. The subject has given their written consent. The treatment was not associated with any side effects. The patient’s sperm parameters greatly improved 3 months after the start of the treatment. In the 8th week of treatment, the pregnancy occurred spontaneously without the use of reproductive technologies, such as in vitro fertilization (IVF).
Discussion
There is no established therapy to enhance sperm characteristics in idiopathic infertility (14). However, the use of empirical medical treatments, such as hormone therapy and antioxidant therapy (15), plays a significant role in the management of idiopathic male infertility (16). Treatment with the herbs and conventional treatments (e.g., vitamins E/C, L-carnitine, zinc, and selenium) (17) was shown to significantly improve the sperm quality of infertile patients in spermogram in certain studies (18,19). Additionally, some herbal remedies, including Sesamum indicum (20), Crocus sativus (18), Withania somnifera (1), Alpinia officinarum (21), and Medicago sativa (22), have been said to be efficient in sperm parameters, especially their antioxidant actions.
In traditional Persian medicine, herbal treatments, such as Daucus carota L., were used as aphrodisiacs and infertility cures (9,23,24). In the present case, a male patient with unexplained infertility was treated using dried Daucus carota L. seed extract powder. The patient’s sperm motility, count, and morphology were also improved, and the patient’s wife became pregnant without the need for assisted reproductive procedures, such as IVF.
For healthy sperm function and fertilizing ability, a specific amount of ROS is necessary. Increased ROS in seminal fluid might be one of the primary causes of damage in spermatogenesis and the male reproductive system (25), which can lead to male infertility and be considered the failure of ART (26). Daucus carota L. seed contains terpene compounds, such as granyl acetate, cedarone, and azarone, which are present in its volatile oil as oxygenated monoterpenes and sesquiterpenes (11). In addition to alkaloids and a variety of steroids, it includes flavonoids, coumarins, and other polyphenolic molecules, all of which have antioxidant properties (12).
Recent research has demonstrated that the polyphenolic substances found in Daucus carota L. seed, such as flavonoids, hydroxycinnamic acid, and anthocyanin, are helpful in addressing infertility (27,28). The retention time of standard quercetin, as determined by high-performance liquid chromatography (HPLC) chromatogram, was 25.21 minutes; however, it was reported as 25.22 minutes at 270 and 360 nm. According to the present study, the concentration of quercetin was 8.2 mg per gram of dried carrot seed dry extract. Therefore, the improvement in semen parameters brought about by dried Daucus carota L. seed extract powder might be due to its ability to scavenge the ROS that harm the lipid and protein composition of sperm (29). In future studies, the ROS content of the semen should be measured both before and after the treatment, since it was impossible to determine it for this case.
Conclusion
In this study, the semen parameters of a male patient, particularly sperm count, motility, and morphology, improved following the treatment with Daucus carota L., and pregnancy occurred in the case’s spouse. In studies aimed at finding effective treatments and achieving better outcomes in managing idiopathic male infertility, the use of herbal and traditional medicine alongside modern medical treatments can increase the chances of therapeutic success.
Acknowledgement
The authors of this article would like to express their gratitude to the patient who agreed to participate in this study.
Funding sources
None.
Ethical statement
The code of ethics for this study was approved by Golestan University of Medical Sciences (IR.GOUMS.REC.1400.319) and subsequently registered under Clinical Trial Registration Number: IRCT20210911052430N1 in Iran's clinical trials registry.
Conflicts of interest
None declared.
Author contributions
Abolhasan MousaviKhorshidi: The provision of study patients; Conduction of the study; Writing, Review, and Editing. Fatemeh Kolangi: Project administration, Supervision, and Editing of the original draft.
Data availability statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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Introduction
Infertility is defined as the inability to become pregnant after 12 months or more of unprotected sex, affecting 50-80 million couples globally (1). Infertility can cause psychosocial and economic impacts in couples (2). Male factors contribute to 40-50% of cases, with idiopathic etiology accounting for > 50% (3). Despite advances, standardized treatments remain elusive (4). Due to the unknown and non-homogeneous causes of male factor infertility, its management is still unclear, expensive, difficult, and sometimes impossible in many cases (5).
Assisted reproductive technology (ART) and drug treatments, such as hormone therapy and antioxidant combinations (Including nutritional supplements), are the two main treatment approaches for male factor infertility that are widely used today (6). However, it should be noted that ART is an invasive and expensive process with a low success rate (7). Therefore, both patients and therapists prefer drug treatments more (8).
One of the drugs used in Persian medicine as an aphrodisiac improving the condition of semen is Zardek (Daucus carota L. var. carota) or Persian carrot (9,10). Zardek belongs to the Umbellifers (Apiaceae) family (10). Daucus carota seed contains terpene compounds, monoterpenes, sesquiterpenes (11), and polyphenols with antioxidant and anti-inflammatory effects (12). Antioxidants can lead to the improvement of sperm activity and safety (5). Various oxidants can reduce sperm production, motility, and morphology, cause an imbalance between the production of reactive oxygen species (ROS) and antioxidant capacity, and lead to infertility (13). This case study reports the efficacy of Daucus carota L. seed extract in improving semen parameters in idiopathic infertility. The patient’s spouse achieved a natural pregnancy within 8 weeks.
Case presentation
A 36-year-old non-smoking male (Body mass index [BMI]: 28), with a 6-year history of marriage and 3 years of conventional infertility treatments, presented with primary infertility. According to Persian medicine, the diagnosis was based on a cold and wet (Sard-o-tar) temperament imbalance in his body. The patient worked as a driver and had a sedentary lifestyle with minimal physical activity. There was no history of exposure to radiation, toxins, or excessive computer use.
The couple had been trying to conceive for 3 years, during which he took supplements, including vitamins E and C, L-carnitine, omega-3, and zinc, during the first 3 years, but without any effect. His medical history revealed no childhood mumps and no history of smoking, alcohol consumption, drug abuse, or surgical interventions in any organ. Apart from infertility, his medical background was unremarkable. Liver function tests were within normal limits, and his diet remained unchanged during the course of treatment.
The patient’s wife was evaluated by a gynecologist and showed no abnormalities. After an initial urological examination and relevant workup, the patient was diagnosed with idiopathic infertility and underwent a 3-month treatment course with Daucus carota L. Seed Extract according to traditional recommendations. Before and after 3 months of treatment, semen analysis was conducted in the same laboratory with the same method and technicians (Table 1). Semen analysis was performed in the same lab with the same methodology and technicians before and after 3 months of treatment (Table 1). The criteria were used to evaluate the semen parameters.
Infertility is defined as the inability to become pregnant after 12 months or more of unprotected sex, affecting 50-80 million couples globally (1). Infertility can cause psychosocial and economic impacts in couples (2). Male factors contribute to 40-50% of cases, with idiopathic etiology accounting for > 50% (3). Despite advances, standardized treatments remain elusive (4). Due to the unknown and non-homogeneous causes of male factor infertility, its management is still unclear, expensive, difficult, and sometimes impossible in many cases (5).
Assisted reproductive technology (ART) and drug treatments, such as hormone therapy and antioxidant combinations (Including nutritional supplements), are the two main treatment approaches for male factor infertility that are widely used today (6). However, it should be noted that ART is an invasive and expensive process with a low success rate (7). Therefore, both patients and therapists prefer drug treatments more (8).
One of the drugs used in Persian medicine as an aphrodisiac improving the condition of semen is Zardek (Daucus carota L. var. carota) or Persian carrot (9,10). Zardek belongs to the Umbellifers (Apiaceae) family (10). Daucus carota seed contains terpene compounds, monoterpenes, sesquiterpenes (11), and polyphenols with antioxidant and anti-inflammatory effects (12). Antioxidants can lead to the improvement of sperm activity and safety (5). Various oxidants can reduce sperm production, motility, and morphology, cause an imbalance between the production of reactive oxygen species (ROS) and antioxidant capacity, and lead to infertility (13). This case study reports the efficacy of Daucus carota L. seed extract in improving semen parameters in idiopathic infertility. The patient’s spouse achieved a natural pregnancy within 8 weeks.
Case presentation
A 36-year-old non-smoking male (Body mass index [BMI]: 28), with a 6-year history of marriage and 3 years of conventional infertility treatments, presented with primary infertility. According to Persian medicine, the diagnosis was based on a cold and wet (Sard-o-tar) temperament imbalance in his body. The patient worked as a driver and had a sedentary lifestyle with minimal physical activity. There was no history of exposure to radiation, toxins, or excessive computer use.
The couple had been trying to conceive for 3 years, during which he took supplements, including vitamins E and C, L-carnitine, omega-3, and zinc, during the first 3 years, but without any effect. His medical history revealed no childhood mumps and no history of smoking, alcohol consumption, drug abuse, or surgical interventions in any organ. Apart from infertility, his medical background was unremarkable. Liver function tests were within normal limits, and his diet remained unchanged during the course of treatment.
The patient’s wife was evaluated by a gynecologist and showed no abnormalities. After an initial urological examination and relevant workup, the patient was diagnosed with idiopathic infertility and underwent a 3-month treatment course with Daucus carota L. Seed Extract according to traditional recommendations. Before and after 3 months of treatment, semen analysis was conducted in the same laboratory with the same method and technicians (Table 1). Semen analysis was performed in the same lab with the same methodology and technicians before and after 3 months of treatment (Table 1). The criteria were used to evaluate the semen parameters.
|
Table 1. Semen parameters before and after intervention
.PNG) |
|
Table 2. Hormones before intervention
.PNG) Abbreviations: TSH: Thyroid-Stimulating Hormone; LH: Luteinizing Hormone; FSH: Follicle-Stimulating Hormone |
For 3 months, the patient took two 500 mg capsules of dried Daucus carota L. seed extract powder twice daily. The subject has given their written consent. The treatment was not associated with any side effects. The patient’s sperm parameters greatly improved 3 months after the start of the treatment. In the 8th week of treatment, the pregnancy occurred spontaneously without the use of reproductive technologies, such as in vitro fertilization (IVF).
Discussion
There is no established therapy to enhance sperm characteristics in idiopathic infertility (14). However, the use of empirical medical treatments, such as hormone therapy and antioxidant therapy (15), plays a significant role in the management of idiopathic male infertility (16). Treatment with the herbs and conventional treatments (e.g., vitamins E/C, L-carnitine, zinc, and selenium) (17) was shown to significantly improve the sperm quality of infertile patients in spermogram in certain studies (18,19). Additionally, some herbal remedies, including Sesamum indicum (20), Crocus sativus (18), Withania somnifera (1), Alpinia officinarum (21), and Medicago sativa (22), have been said to be efficient in sperm parameters, especially their antioxidant actions.
In traditional Persian medicine, herbal treatments, such as Daucus carota L., were used as aphrodisiacs and infertility cures (9,23,24). In the present case, a male patient with unexplained infertility was treated using dried Daucus carota L. seed extract powder. The patient’s sperm motility, count, and morphology were also improved, and the patient’s wife became pregnant without the need for assisted reproductive procedures, such as IVF.
For healthy sperm function and fertilizing ability, a specific amount of ROS is necessary. Increased ROS in seminal fluid might be one of the primary causes of damage in spermatogenesis and the male reproductive system (25), which can lead to male infertility and be considered the failure of ART (26). Daucus carota L. seed contains terpene compounds, such as granyl acetate, cedarone, and azarone, which are present in its volatile oil as oxygenated monoterpenes and sesquiterpenes (11). In addition to alkaloids and a variety of steroids, it includes flavonoids, coumarins, and other polyphenolic molecules, all of which have antioxidant properties (12).
Recent research has demonstrated that the polyphenolic substances found in Daucus carota L. seed, such as flavonoids, hydroxycinnamic acid, and anthocyanin, are helpful in addressing infertility (27,28). The retention time of standard quercetin, as determined by high-performance liquid chromatography (HPLC) chromatogram, was 25.21 minutes; however, it was reported as 25.22 minutes at 270 and 360 nm. According to the present study, the concentration of quercetin was 8.2 mg per gram of dried carrot seed dry extract. Therefore, the improvement in semen parameters brought about by dried Daucus carota L. seed extract powder might be due to its ability to scavenge the ROS that harm the lipid and protein composition of sperm (29). In future studies, the ROS content of the semen should be measured both before and after the treatment, since it was impossible to determine it for this case.
Conclusion
In this study, the semen parameters of a male patient, particularly sperm count, motility, and morphology, improved following the treatment with Daucus carota L., and pregnancy occurred in the case’s spouse. In studies aimed at finding effective treatments and achieving better outcomes in managing idiopathic male infertility, the use of herbal and traditional medicine alongside modern medical treatments can increase the chances of therapeutic success.
Acknowledgement
The authors of this article would like to express their gratitude to the patient who agreed to participate in this study.
Funding sources
None.
Ethical statement
The code of ethics for this study was approved by Golestan University of Medical Sciences (IR.GOUMS.REC.1400.319) and subsequently registered under Clinical Trial Registration Number: IRCT20210911052430N1 in Iran's clinical trials registry.
Conflicts of interest
None declared.
Author contributions
Abolhasan MousaviKhorshidi: The provision of study patients; Conduction of the study; Writing, Review, and Editing. Fatemeh Kolangi: Project administration, Supervision, and Editing of the original draft.
Data availability statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Article Type: Case report |
Subject:
Medicine
References
1. Nasimi Doost Azgomi R, Nazemiyeh H, Sadeghi Bazargani H, Fazljou S, Nejatbakhsh F, Moini Jazani A, et al. Comparative evaluation of the effects of Withania somnifera with pentoxifylline on the sperm parameters in idiopathic male infertility: A triple‐blind randomised clinical trial. Andrologia. 2018;50(7):e13041. [View at Publisher] [DOI] [PMID] [Google Scholar]
2. Aitken R, Finnie J, Muscio L, Whiting S, Connaughton H, Kuczera L, et al. Potential importance of transition metals in the induction of DNA damage by sperm preparation media. Hum Reprod. 2014;29(10):2136-47. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Kolangi F, Shafi H, Memariani Z, Kamalinejad M, Naeimi M, Mozaffarpur SA. Improvement in semen quality and occurrence of pregnancy treated with an herbal medication: a case report. JTIM. 2019. [View at Publisher] [DOI] [Google Scholar]
4. Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility. 7th ed. Philadelphia: Lippincott. Williams & wilkins; 2005. [View at Publisher] [Google Scholar]
5. Ahmad MK, Mahdi AA, Shukla KK, Islam N, Rajender S, Madhukar D, et al. Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males. Fertil Steril. 2010;94(3):989-96. [View at Publisher] [DOI] [PMID] [Google Scholar]
6. Tahvilzadeh M, Hajimahmoodi M, Toliyat T, Karimi M, Rahimi R. An evidence‐based approach to medicinal plants for the treatment of sperm abnormalities in traditional P ersian medicine. Andrologia. 2016;48(8):860-79. [View at Publisher] [DOI] [PMID] [Google Scholar]
7. Bioos S, Nazem E, Keshavarz M, Siahpoosh MB, Sohrabvand F, Sohanaki H, et al. A traditional Iranian medicine (Majoon-e Loboob) for idiopathic male infertility: a case series. JTIM. 2016;1(1):47-51. [View at Publisher] [Google Scholar]
8. Safarinejad MR. Effect of pentoxifylline on semen parameters, reproductive hormones, and seminal plasma antioxidant capacity in men with idiopathic infertility: a randomized double-blind placebo-controlled study. Int Urol Nephrol. 2011;43(2):315-28. [View at Publisher] [DOI] [PMID] [Google Scholar]
9. Aghili Alavi Khorasani Shirazi, M.H. (2008) Makhzan-ol-Adviyeh [Source of plants]. Tehran: Institute of Historical Studies, Islamic and Complementary Medicine, Medical University ofIran Press; 2008. [View at Publisher] [Google Scholar]
10. Medical Economics Company. PDR for Herbal Medicines. Montvale, N.J: Medical Economics Co., 1998. [View at Publisher]
11. Ksouri A, Dob T, Belkebir A, Krimat S, Chelghoum C. Chemical composition and antioxidant activity of the essential oil and the methanol extract of Algerian wild carrot Daucus carota L. ssp. carota.(L.) Thell. J Mater Environ Sci. 2015;6(3):784-91. [View at Publisher] [Google Scholar]
12. Tijjani H, Mohammed A, Adegunloye AP, editors. Phytochemicals and in vitro antioxidant studies of Daucus carota L. seed extracts. 5th International Electronic Conference on Medicinal Chemistry. 2019. [View at Publisher] [DOI] [Google Scholar]
13. Nouri M, Khaki A, Fathiazar F, RASHIDI MR. The protective effects of carrot seed extract on spermatogenesis and cauda epididymal sperm reserves in gentamicin treated rats. Cell J. 2009;11(3):327-33. [View at Publisher] [Google Scholar]
14. Fritz MA, Speroff L. Clinical gynecologic endocrinology and infertility. Philadelphia: lippincott Williams & wilkins; 2011. [View at Publisher] [Google Scholar]
15. Tadros NN, Sabanegh ES. Empiric medical therapy with hormonal agents for idiopathic male infertility. Indian J Urol. 2017;33(3):194-8. [View at Publisher] [DOI] [PMID] [Google Scholar]
16. Türk S, Mändar R, Mahlapuu R, Viitak A, Punab M, Kullisaar T. Male infertility: Decreased levels of selenium, zinc and antioxidants. J Trace Elem Med Biol. 2014;28(2):179-85. [View at Publisher] [DOI] [PMID] [Google Scholar]
17. Wirleitner B, Vanderzwalmen P, Stecher A, Spitzer D, Schuff M, Schwerda D, et al. Dietary supplementation of antioxidants improves semen quality of IVF patients in terms of motility, sperm count, and nuclear vacuolization. Int J Vitam Nutr Res. 2012;82(6):391-8. [View at Publisher] [DOI] [PMID] [Google Scholar]
18. Safarinejad MR, Shafiei N, Safarinejad S. A prospective double‐blind randomized placebo‐controlled study of the effect of saffron (Crocus sativus Linn.) on semen parameters and seminal plasma antioxidant capacity in infertile men with idiopathic oligoasthenoteratozoospermia. Phytother Res. 2011;25(4):508-16. [View at Publisher] [DOI] [PMID] [Google Scholar]
19. Haghighian HK, Haidari F, Mohammadi-Asl J, Dadfar M. Randomized, triple-blind, placebo-controlled clinical trial examining the effects of alpha-lipoic acid supplement on the spermatogram and seminal oxidative stress in infertile men. Fertil Steril. 2015;104(2):318-24. [View at Publisher] [DOI] [PMID] [Google Scholar]
20. Khani B, Bidgoli SR, Moattar F, Hassani H. Effect of sesame on sperm quality of infertile men. J Res Med Sci. 2013;18(3):184-7. [View at Publisher] [PMID] [Google Scholar]
21. Kolangi F, Shafi H, Memariani Z, Kamalinejad M, Bioos S, Jorsaraei SGA, et al. Effect of Alpinia officinarum Hance rhizome extract on spermatogram factors in men with idiopathic infertility: A prospective double‐blinded randomised clinical trial. Andrologia. 2019;51(1):e13172. [View at Publisher] [DOI] [PMID] [Google Scholar]
22. Shahmirzadi AS, Shafi H, Shirafkan H, Memariani Z, Gorji N, Moeini R. Effect of Medicago sativa seed powder (Plus vitamin E vs. vitamin E alone) on semen analysis in men with idiopathic infertility: A double blind randomized clinical trial. J Ethnopharmacol.2024:322:117606. [View at Publisher] [DOI] [Google Scholar]
23. Tohfat-ol-Momeni. Ehyaye Tebbe Tabiyi (Tohfeh-ol-Momenin). 2nd ed. Tehran: Moasseseh Ehya-ye Tebb-e Tabi’i; 2011. [View at Publisher]
24. Kolangi F, MousaviKhorshidi A. Daucus carota L.: Can it be offered as an alternative treatment for improving semen quality. JCBR. 2023;7(1):30-1. [View at Publisher] [DOI] [Google Scholar]
25. Adewoyin M, Ibrahim M, Roszaman R, Md Isa ML, Mat Alewi NA, Abdul Rafa AA, et al. Male infertility: the effect of natural antioxidants and phytocompounds on seminal oxidative stress. Diseases. 2017;5(1):9. [View at Publisher] [DOI] [PMID] [Google Scholar]
26. KHOSRO BA, ZARGHAMI N, Deldar Y. Correlation between sperm quality parameters and seminal plasma antioxidants status. Iran. J Reprod Med. 2004;2(2):58-64. [View at Publisher] [Google Scholar]
27. Ahmad T, Cawood M, Iqbal Q, Ariño A, Batool A, Tariq RMS, et al. Phytochemicals in Daucus carota and their health benefits-Review Article. Foods. 2019;8(9):424. [View at Publisher] [DOI] [PMID] [Google Scholar]
28. Ganguly M, Hazarika J, Sarma S, Bhuyan P, Mahanta R. Estrogen receptor modulation of some polyphenols extracted from Daucus carota as a probable mechanism for antifertility effect: an in silico study. JTCC. 2020;19(6):2041004. [View at Publisher] [DOI] [Google Scholar]
29. Mahfouz R, Sharma R, Lackner J, Aziz N, Agarwal A. Evaluation of chemiluminescence and flow cytometry as tools in assessing production of hydrogen peroxide and superoxide anion in human spermatozoa. Fertil Steril. 2009;92(2):819-27. [View at Publisher] [DOI] [PMID] [Google Scholar]
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