Objective: To evaluate the efficacy and safety of traditional Chinese medicine (TCM) in the treatment of male immune infertility (MII) by meta-analysis.
Methods: We retrieved randomized controlled trial (RCT) on the treatment of male immune infertility with traditional Chinese medicine from the databases of WanFang, Chinese Biomedical Literature, Cochrane Library, Weipu, PubMed and CNKI, and performed methodological quality assessment of the RCTs identified and statistical analysis and evaluation of the publication bias using the RevMan5.4 software.
Results: Totally, 25 RCTs (2 563 cases) were included in this study. Compared with Western medicine alone in the treatment of MII, TCM achieved a significantly higher total effectiveness rate (OR = 6.35, 95% CI: 4.96-8.13, P<0.000 01), negative conversion rate of seminal plasma anti-sperm antibodies (OR = 4.52, 95% CI: 2.72 - 7.51, P<0.000 01), negative rate of serum anti-sperm antibodies (OR = 2.98, 95% CI: 2.23-3.96, P<0.000 01), sperm concentration (MD = 15.56, 95% CI: 11.32-19.79, P<0.000 01), grade a sperm motility (MD = 3.85, 95% CI: 1.91-5.79, P=0.000 01), grade a+b sperm motility (MD = 13.77, 95% CI: 7.06-20.48, P<0.000 1), sperm viability (MD = 10.32, 95% CI: 6.78-13.86, P<0.000 01) and pregnancy rate (OR = 3.53, 95% CI: 2.68-4.63, P<0.000 01), but a lower rate of adverse reactions (OR = 0.06, 95% CI: 0.01-0.23, P<0.000 01). There was no statistically significant difference in the percentage of morphologically abnormal sperm between TCM and Western medicine alone in the treatment of MII (MD = -7.53, 95% CI: -15.50-0.44, P = 0.06).
Conclusion: TCM has a definite effectiveness and high safe in the treatment of male immune infertility.
Keywords: traditional Chinese medicine; male immune infertility; meta-analysis; efficacy; safety.