Exploring the efficacy of herbal therapies in treating male infertility: a narrative review

Infertility, defined as the inability to conceive after one year of unprotected intercourse, affects millions worldwide, with male factors contributing to nearly 40% of cases. Lifestyle habits, psychological stress, genetic abnormalities, and environmental exposures are key contributors. In low and middle-income countries, herbal medicines are increasingly used as affordable, accessible alternatives to conventional therapies due to their favorable safety profile. This review synthesizes evidence from in vitro, in vivo, and clinical studies on medicinal plants such as Eurycoma longifolia, Tribulus terrestris, Mucuna pruriens, and Withania somnifera, which have demonstrated potential to promote spermatogenesis, regulate hormones, strengthen antioxidant defenses, and improve sperm quality. Although long employed in traditional systems like Ayurveda, Siddha, and Unani these therapies remain underutilized in modern practice. This review emphasizes the integration of traditional knowledge with contemporary medicine and highlights the need for standardized clinical trials and regulatory frameworks to ensure safety and efficacy. Herbal medicine may serve as a valuable adjunct in improving male reproductive outcomes, bridging historical practice with scientific advances.