Efficacy and safety of nonpharmacological strategies for the treatment of oligoasthenospermia: a systematic review and Bayesian network meta-analysis
Abstract Background Oligoasthenospermia (OAT) is the most common cause of male infertility, and the annual incidence of the disease continues to increase due to changing lifestyle habits, increased work pressure and increased environmental pollution. A variety of nonpharmacological therapies have be...
| Principais autores: | , , , , , , , , , , |
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| Formato: | Artigo |
| Idioma: | English |
| Publicado em: |
BMC
2023-01-01
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| coleção: | European Journal of Medical Research |
| Assuntos: | |
| Acesso em linha: | https://doi.org/10.1186/s40001-022-00968-6 |
| _version_ | 1828069701433950208 |
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| author | Zhen Wang Ziyang Zhou Lijuan Zhang Xujie Li Miaoxiu Li Yankun Pan Tiyong Jiao Xiaoyun Shi Qing Liu Congan Wang Yongquan Wang |
| author_facet | Zhen Wang Ziyang Zhou Lijuan Zhang Xujie Li Miaoxiu Li Yankun Pan Tiyong Jiao Xiaoyun Shi Qing Liu Congan Wang Yongquan Wang |
| author_sort | Zhen Wang |
| collection | DOAJ |
| description | Abstract Background Oligoasthenospermia (OAT) is the most common cause of male infertility, and the annual incidence of the disease continues to increase due to changing lifestyle habits, increased work pressure and increased environmental pollution. A variety of nonpharmacological therapies have been reported to be effective for treating OAT; however, there is a lack of direct evidence comparing these different nonpharmacological therapies. Therefore, the optimal strategy has yet to be identified. Objectives A network meta-analysis was performed to evaluate the efficacy and safety of nonpharmacological treatments for OAT, thus providing an evidence-based medical reference for the clinical treatment of oligoasthenospermia. Methods The Web of Science, Cochrane Library, Embase, PubMed, Weipu (VIP), Wan Fang Data, China National Knowledge Infrastructure (CNKI), and China Biomedical Literature (CBM) databases were searched from inception to April 2022 to identify randomized controlled trials (RCTs) that examined nonpharmacological treatments for oligozoospermia. Grey literature was also searched. Studies that met the quality criteria were analysed using Stata 16.0 and Review Manager 5.4 software. Results A total of 4629 publications were initially retrieved; ultimately, 38 RCTs were analysed, including 8 nonpharmacological therapies and 3080 patients. Each intervention outperformed the sham intervention and no treatment approaches in terms of improved efficacy. In terms of improved total effective rate and sperm concentration, warming acupuncture may be the most effective treatment (SUCRA = 80.1% and 93.4%, respectively). Electroacupuncture perhaps resulted in the best improvement in sperm motility a% and a + b% (SUCRA = 96.6% and 82.0%, respectively). In terms of the incidence of adverse reactions, the three safest interventions probably were no treatment, warming acupuncture, and sham intervention (SUCRA = 88.0%, 68.8% and 62.9%, respectively). In terms of improving the reproductive hormones FSH, LH, and T, the best interventions perhaps were hyperbaric oxygen, 2 Hz TEAS, and electroacupuncture (SUCRA = 85.1%, 96.8% and 99.4%, respectively). Conclusions Nonpharmacological treatments for oligoasthenospermia have good clinical efficacy. Warm acupuncture and electroacupuncture have better overall efficacy and safety. These treatment approaches can be recommended based on the actual situation. If a patient is complicated with varicoceles, they should be removed before symptomatic treatment. Due to the limitations of the quality of the included studies, the findings need to be further validated. |
| first_indexed | 2024-04-11T00:24:23Z |
| format | Article |
| id | doaj.art-be4e4c79212d40ad986585023c0b51b9 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-04-11T00:24:23Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-be4e4c79212d40ad986585023c0b51b92023-01-08T12:07:46ZengBMCEuropean Journal of Medical Research2047-783X2023-01-0128111610.1186/s40001-022-00968-6Efficacy and safety of nonpharmacological strategies for the treatment of oligoasthenospermia: a systematic review and Bayesian network meta-analysisZhen Wang0Ziyang Zhou1Lijuan Zhang2Xujie Li3Miaoxiu Li4Yankun Pan5Tiyong Jiao6Xiaoyun Shi7Qing Liu8Congan Wang9Yongquan Wang10Shandong University of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineNeck, Shoulder, Waist and Leg Pain Hospital Affiliated to Shandong First Medical UniversityAffiliated Hospital of Shandong University of Traditional Chinese MedicineAbstract Background Oligoasthenospermia (OAT) is the most common cause of male infertility, and the annual incidence of the disease continues to increase due to changing lifestyle habits, increased work pressure and increased environmental pollution. A variety of nonpharmacological therapies have been reported to be effective for treating OAT; however, there is a lack of direct evidence comparing these different nonpharmacological therapies. Therefore, the optimal strategy has yet to be identified. Objectives A network meta-analysis was performed to evaluate the efficacy and safety of nonpharmacological treatments for OAT, thus providing an evidence-based medical reference for the clinical treatment of oligoasthenospermia. Methods The Web of Science, Cochrane Library, Embase, PubMed, Weipu (VIP), Wan Fang Data, China National Knowledge Infrastructure (CNKI), and China Biomedical Literature (CBM) databases were searched from inception to April 2022 to identify randomized controlled trials (RCTs) that examined nonpharmacological treatments for oligozoospermia. Grey literature was also searched. Studies that met the quality criteria were analysed using Stata 16.0 and Review Manager 5.4 software. Results A total of 4629 publications were initially retrieved; ultimately, 38 RCTs were analysed, including 8 nonpharmacological therapies and 3080 patients. Each intervention outperformed the sham intervention and no treatment approaches in terms of improved efficacy. In terms of improved total effective rate and sperm concentration, warming acupuncture may be the most effective treatment (SUCRA = 80.1% and 93.4%, respectively). Electroacupuncture perhaps resulted in the best improvement in sperm motility a% and a + b% (SUCRA = 96.6% and 82.0%, respectively). In terms of the incidence of adverse reactions, the three safest interventions probably were no treatment, warming acupuncture, and sham intervention (SUCRA = 88.0%, 68.8% and 62.9%, respectively). In terms of improving the reproductive hormones FSH, LH, and T, the best interventions perhaps were hyperbaric oxygen, 2 Hz TEAS, and electroacupuncture (SUCRA = 85.1%, 96.8% and 99.4%, respectively). Conclusions Nonpharmacological treatments for oligoasthenospermia have good clinical efficacy. Warm acupuncture and electroacupuncture have better overall efficacy and safety. These treatment approaches can be recommended based on the actual situation. If a patient is complicated with varicoceles, they should be removed before symptomatic treatment. Due to the limitations of the quality of the included studies, the findings need to be further validated.https://doi.org/10.1186/s40001-022-00968-6OligoasthenospermiaNonpharmacological strategiesNetwork meta-analysisRandomized controlled trials |
| spellingShingle | Zhen Wang Ziyang Zhou Lijuan Zhang Xujie Li Miaoxiu Li Yankun Pan Tiyong Jiao Xiaoyun Shi Qing Liu Congan Wang Yongquan Wang Efficacy and safety of nonpharmacological strategies for the treatment of oligoasthenospermia: a systematic review and Bayesian network meta-analysis European Journal of Medical Research Oligoasthenospermia Nonpharmacological strategies Network meta-analysis Randomized controlled trials |
| title | Efficacy and safety of nonpharmacological strategies for the treatment of oligoasthenospermia: a systematic review and Bayesian network meta-analysis |
| title_full | Efficacy and safety of nonpharmacological strategies for the treatment of oligoasthenospermia: a systematic review and Bayesian network meta-analysis |
| title_fullStr | Efficacy and safety of nonpharmacological strategies for the treatment of oligoasthenospermia: a systematic review and Bayesian network meta-analysis |
| title_full_unstemmed | Efficacy and safety of nonpharmacological strategies for the treatment of oligoasthenospermia: a systematic review and Bayesian network meta-analysis |
| title_short | Efficacy and safety of nonpharmacological strategies for the treatment of oligoasthenospermia: a systematic review and Bayesian network meta-analysis |
| title_sort | efficacy and safety of nonpharmacological strategies for the treatment of oligoasthenospermia a systematic review and bayesian network meta analysis |
| topic | Oligoasthenospermia Nonpharmacological strategies Network meta-analysis Randomized controlled trials |
| url | https://doi.org/10.1186/s40001-022-00968-6 |
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