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      The effectiveness and safety of traditional Chinese herbal medicine for the treatment of male infertility associated with sperm DNA fragmentation : A protocol for systematic review and meta-analysis

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          Abstract

          Background:

          Sperm DNA fragmentation (SDF) may hinder embryonic development and growth, increasing the risk of spontaneous miscarriage, and is considered an important factor affecting male infertility (MI). Traditional Chinese herbal medicine is considered effective in the treatment of MI due to SDF by nourishing kidney essence or promoting blood circulation for removing blood stasis. The objective of this systematic review protocol is to evaluate the effectiveness and safety of traditional Chinese herbal medicine on the treatment of MI associated with SDF.

          Methods:

          We searched the PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP Chinese Science, Technology Journal Database, and Wanfang Database until the end of 2020 for English and Chinese published literature. Randomized controlled trials (RCTs) to evaluate the effectiveness and safety of traditional Chinese herbal medicine for the treatment of MI associated with SDF will be included. Study selection and data extraction were performed independently by 2 reviewers, and the quality evaluation and risk assessment were assessed by the Cochrane collaboration's tool, and use the RevMan 5.3 software for meta-analysis.

          Conclusion:

          This study will evaluate the efficacy and safety of traditional Chinese herbal medicine for the treatment of MI due to SDF, which may provide some help for the clinician's decision.

          Prospero registration number:

          CRD42020221053.

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          Most cited references21

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          The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials

          Flaws in the design, conduct, analysis, and reporting of randomised trials can cause the effect of an intervention to be underestimated or overestimated. The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate
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            World Health Organization reference values for human semen characteristics.

            Semen quality is taken as a surrogate measure of male fecundity in clinical andrology, male fertility, reproductive toxicology, epidemiology and pregnancy risk assessments. Reference intervals for values of semen parameters from a fertile population could provide data from which prognosis of fertility or diagnosis of infertility can be extrapolated. Semen samples from over 4500 men in 14 countries on four continents were obtained from retrospective and prospective analyses on fertile men, men of unknown fertility status and men selected as normozoospermic. Men whose partners had a time-to-pregnancy (TTP) of < or =12 months were chosen as individuals to provide reference distributions for semen parameters. Distributions were also generated for a population assumed to represent the general population. The following one-sided lower reference limits, the fifth centiles (with 95th percent confidence intervals), were generated from men whose partners had TTP < or = 12 months: semen volume, 1.5 ml (1.4-1.7); total sperm number, 39 million per ejaculate (33-46); sperm concentration, 15 million per ml (12-16); vitality, 58% live (55-63); progressive motility, 32% (31-34); total (progressive + non-progressive) motility, 40% (38-42); morphologically normal forms, 4.0% (3.0-4.0). Semen quality of the reference population was superior to that of the men from the general population and normozoospermic men. The data represent sound reference distributions of semen characteristics of fertile men in a number of countries. They provide an appropriate tool in conjunction with clinical data to evaluate a patient's semen quality and prospects for fertility.
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              Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century.

              Infertility is estimated to affect as many as 186 million people worldwide. Although male infertility contributes to more than half of all cases of global childlessness, infertility remains a woman's social burden. Unfortunately, areas of the world with the highest rates of infertility are often those with poor access to assisted reproductive techniques (ARTs). In such settings, women may be abandoned to their childless destinies. However, emerging data suggest that making ART accessible and affordable is an important gender intervention. To that end, this article presents an overview of what we know about global infertility, ART and changing gender relations, posing five key questions: (i) why is infertility an ongoing global reproductive health problem? (ii) What are the gender effects of infertility, and are they changing over time? (iii) What do we know about the globalization of ART to resource-poor settings? (iv) How are new global initiatives attempting to improve access to IVF? (v) Finally, what can be done to overcome infertility, help the infertile and enhance low-cost IVF (LCIVF) activism?
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Lippincott Williams & Wilkins (Hagerstown, MD )
                0025-7974
                1536-5964
                05 March 2021
                05 March 2021
                : 100
                : 9
                : e24918
                Affiliations
                [a ]Beijing University of Chinese Medicine, Beijing
                [b ]Yunnan University of Traditional Chinese Medicine
                [c ]Hospital of Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan, China.
                Author notes
                []Correspondence: Guozheng Qin, Hospital of Yunnan University of Traditional Chinese Medicine, Kunming 650021, China (e-mail: guozhengqin@ 123456163.com ).
                Article
                MD-D-21-00883 24918
                10.1097/MD.0000000000024918
                7939154
                33655953
                fd345854-acfc-4ceb-8c56-b8c1fac56023
                Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 3 March 2020
                : 25 November 2020
                : 18 January 2021
                Funding
                Funded by: National Natural Science Foundation of China
                Award ID: 81760872
                Award Recipient : Guozheng Qin
                Funded by: National Natural Science Foundation of China
                Award ID: 82003972
                Award Recipient : Chao Zhang
                Funded by: Postdoctoral Research Foundation of China
                Award ID: 2019M650599
                Award Recipient : Chao Zhang
                Funded by: Fundamental Research Funds for the Central Universities
                Award ID: 2020-JYB-XJSJJ-011
                Award Recipient : Chao Zhang
                Categories
                3700
                Research Article
                Study Protocol Systematic Review
                Custom metadata
                TRUE

                male infertility,protocol,sperm dna fragmentation,systematic review,traditional chinese medicine

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