Hari Prasad Sharma (name changed) is ecstatic. His wife has finally conceived after nearly four years of marriage. The couple from Lucknow had seen many doctors but all declared that there was no reason for them to not conceive.

What made their dearest wish come true was their decision to enroll in a study that medical scientists from Lucknow were planning to undertake. A team of researchers from the Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) and King George’s Medical University (KGMU) was setting out to explore the potential of the Indian herb ashwagandha (Withania somnifera) in treating male infertility.

“It is known to inhibit the ageing process, fight stress and enhance endurance. As a result, Indian systems of medicine prescribe it as a geriatric tonic as well as sex stimulant. But nobody carried out any detailed scientific study on its ability to cure male infertility,” says Ashish Gupta, a biochemist at SGPGIMS.

Gupta, who started studying the herb also known as Indian ginseng in the mid-2000s as a doctoral student, and his collaborators from the SGPGIMS and KGMU have shown that ashwagandha is capable of rebooting sperm production in men who suffer from infertility to “near normal levels”, making it possible for them to have children.

More importantly, the scientists have been able to understand the underlying mechanisms that help ashwagandha improve semen quality. The powerful nuclear magnetic resonance spectrometry recorded how the administration of the herb improved the levels of certain proteins and enzymes that are required for sustainable production of quality sperm and curbed those that have an adverse effect.

For the study, reported in the Journal of Ethnonopharmacology online last week, the researchers randomly recruited 180 male patients from those undergoing treatment for different forms of infertility at KGMU. Their semen and blood samples were analysed and matched with that of 50 healthy volunteers who came in as control.

While a third of these patients remained infertile despite having normal sperm volume and motility, another set had such low levels of sperm production that pregnancy was impossible. In the third category, both the volume as well as the number of motile sperm was extremely low.

All patients were asked to take a dry powder of the ashwagandha root continuously for three months. Their blood and sperm samples were subsequently tested. “All patients exhibited remarkable improvement following treatment. Nearly 15 per cent of the couples went on to conceive naturally within months after the treatment,” says Gupta. Similarly, the measured parameters were found to have been improved significantly in others as well.

“We have been studying ashwagandha’s capability to improve endurance against stress (one of the important factors for infertility in men as well as women) and confer male sexual health in disorders such as psychogenic impotence and unexplained infertility for a while now,” says Abbas Ali Mahdi, head of biochemistry at KGMU, and an author. This may be because the herb is a veritable storehouse of useful substances, including alkaloids, essential and non-essential fatty acids and amino acids. Besides, “flavonoids of W. somnifera possess potent anti-oxidant activity and treatment with the herb counteracts the formation of free radicals in infertile men,” says Mahdi, who was Gupta’s PhD adviser.

Sperm production happens in an environment which is metabolically very active, so there is a high production of reactive oxygen species (ROS), a group of chemically reactive molecules containing oxygen. While ROS is critical for sperm generation as well as to help retain its motility and viability, excess production of ROS is detrimental, another study by Mahdi and others had found. That study appeared in the journal Reproductive Biomedicine in 2011. “Antioxidants can actually regulate the production of ROS and bring it under control,” says Mahdi.

Alex C. Verghese, an embryologist and founder of a web-based infertility education platform, does not seem surprised by the results of Gupta’s study. Nearly five years ago, Varghese together with others discovered how air pollution in Calcutta was making otherwise healthy people with normal sperm production infertile, with pollutants adversely affecting sperm DNA.

“No cause can be attributed to nearly 20 per cent of male infertility. Even though the sperm ejaculate of these patients looks normal in volume and in terms of motility and morphology, a detailed examination using sophisticated tools can reveal DNA damage in up to 90 per cent of sperm and lack of chromatin integrity,” Varghese told The Telegraph. Chromatin is the combination of the DNA and proteins that make up the contents of the nucleus of a cell. When the chromatin integrity is compromised, a process of programmed cell death is initiated so that the abnormal cell is prevented from getting into the system.

“What they seem to have shown is that W. somnifera has the ability to repair sperm DNA damage and retain its chromatin integrity,” says Verghese who, jointly with Suresh Sasidharan, a medical biochemist with the School of Medical Education at M.G. University Kottayam in Kerala, showed a few years ago that two other herbs used in Ayurveda can actually improve sperm quality. “In rats we could show that brahmi and triphala have a fertility enhancing effect. Similarly, they could reverse oxidative damage caused by heavy metals to the testicular system of the animals,” says Sasidharan, who presented the results at several international seminars.

“Maintaining normal sperm levels by natural means has many positive effects. Firstly, it helps maintain fertility levels through generations. Secondly, as a Danish study, which did the semen analysis of over 50,000 people over 38 years from 1963 to 2001, showed, a healthy sperm count determines how long a person lives,” says Varghese.

As always, Nature knows best.