title: 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.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01357044.
authors.affiliation: Laboratory of Reproductive Biology, Scientific Unit, Regional Hospital of Horsens, Horsens, Denmark.
authors.forename: Maja D K
authors.initials: MD
authors.lastname: Fedder
authors.affiliation: Nerthus ApS, Lejre, Denmark.
authors.forename: Henrik B
authors.initials: HB
authors.lastname: Jakobsen
authors.affiliation: Nerthus ApS, Lejre, Denmark.
authors.forename: Ina
authors.initials: I
authors.lastname: Giversen
authors.affiliation: Department of Chemical Engineering, Biotechnology and Environmental Technology, Faculty of Engineering, University of Southern Denmark, Odense, Denmark.
authors.forename: Lars P
authors.initials: LP
authors.lastname: Christensen
authors.affiliation: Department of Public Health, Section for Biostatistics, University of Aarhus, Aarhus, Denmark.
authors.forename: Erik T
authors.initials: ET
authors.lastname: Parner
authors.affiliation: Laboratory of Reproductive Biology, Scientific Unit, Regional Hospital of Horsens, Horsens, Denmark; Centre of Andrology, Fertility Clinic, Department D, Odense University Hospital, Odense, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Fedder
mesh_terms: D000328:Adult; D032429:Alpinia / Q000737:chemistry*; D015415:Biomarkers / Q000378:metabolism; D003710:Demography; D004311:Double-Blind Method; D005638:Fruit / Q000737:chemistry*; D006801:Humans; D008019:Life Style; D029561:Lythraceae / Q000737:chemistry*; D008297:Male; D010349:Patient Compliance; D010936:Plant Extracts / Q000009:adverse effects / Q000494:pharmacology*; D011446:Prospective Studies; D027343:Rhizome / Q000737:chemistry*; D013076:Sperm Count; D013081:Sperm Motility / Q000187:drug effects*; D013094:Spermatozoa / Q000166:cytology / Q000187:drug effects
chemical_list: D015415:Biomarkers; D010936:Plant Extracts