Trends on pharmacological interventions and survey on knowledge and perception of male infertility in infertile males

Globally, an estimated 15% of couples, totaling 48.5 million couples, experience infertility. Males are identified as the exclusive cause in 20-30% of infertility cases and contribute to 50% of cases overall. The rising prevalence of male infertility is mainly due to lack of information and knowledge about disease prevalence and treatment. The general aim of this thesis was to investigate the available pharmacological and herbal interventions for the treatment of male infertility. A 23-item male infertility questionnaire was developed and validated. A cross-sectional study using 23-items male infertility tool was conducted on 220 patients to assess knowledge and perception of male infertility and its treatment in infertile male population. The results of the network meta-analysis indicate that the intake of supplements is associated with elevated sperm concentration levels (6.26, 95% CI 3.32, 9.21). Conversely, the use of SERMs was linked to an increase in both percentage sperm motility (6.69, 95% CI 2.38, 10.99) and serum FSH levels (3.63, 95% CI 1.48, 5.79). Hormone consumption was found to enhance sperm morphology (3.71, 95% CI 1.34, 6.07). Additionally, supplements were observed to raise total testosterone levels (2.70, 95% CI 1.34, 4.07). The systematic review indicated that Herbal interventions might improve semen parameters in males with infertility. Hochu-ekki-to and W. somnifera have shown the most promising results and should be studied further in a larger sample size. The 23items in the tool were found to be highly consistent internally with the Cronbach’s α value of 0.759.