Abstract

Objective. This study aimed to investigate the effectiveness and safety of Tribulus Terrestris (TT) in male fertility problems, the studied variables being semen parameters and erectile function. Methods. In this systematic review and meta-analysis, all relevant articles were searched in the relevant databases, including ISI Web of science, Scopus, PubMed, Cochrane, SID, Magiran, IranDoc and Google Scholar, using the keywords which included (Tribulus Terrestris OR Puncture Vine OR Protodioscin) AND (sperm parameters OR Sperm Counts) AND (Oligozo-ospermia OR Azoospermia OR Erectile dysfunction OR Male Sexual Impotence OR Infertility). Risk of bias was assessed using Cochrane Collaboration’s tool. The data were analyzed using STATA software version 11. To examine the heterogeneity, I2 index and Q test were used and the fixed effects model was applied to pool standardized mean differences (SMDs). Results. A total of 10 articles were included in this study, some of which revealed that TT administration improved a number of semen parameters, such as sperm concentration, motility, liquefaction time, and normal acrosome reactions. However, some other studies did not report statistically significant differences in relation to other semen parameters, such as sperm morphology and ejaculate volume. The quantitative analysis showed a statistically significant effect of TT on erectile function (SMD: 0.54; interval confidence 95% CI: 0.30 to 0.78; P < 0.001; heterogeneity: I2 = 0%, p = 0.98, the fixed effects model; 2 trials). Conclusions. The findings of the present study indicated that TT improved some sperm parameters and also had a benefi-cial effect on erectile function. However, these findings should be interpreted with caution, due to the small sample size and some methodological differences among the studies. There-fore, further trials are still required to confirm these findings. © 2020, EDRA S.p.A. All rights reserved.