Summary: In a trial in diabetic men with reduced sperm motility and a traditional Chinese medicine qi-yin deficiency pattern, the herbal Wuziyuye Decoction improved sperm progressive motility and concentration more than L-carnitine over 12 weeks, but did not improve pregnancy rates.
PICO Summary
| Element | Detail |
|---|---|
| Population | 100 men with type 2 diabetes, qi-yin deficiency syndrome, and asthenospermia; single centre, China. |
| Intervention | Wuziyuye Decoction for 12 weeks plus standard glucose-lowering therapy (n=50), with 24 weeks’ follow-up. |
| Comparison | Oral L-carnitine for 12 weeks plus standard therapy (n=50). |
| Outcome | Progressive motility rose to 35.5% (vs 29.5% control) and sperm concentration to 54.0 (vs 45.0 ×10⁶/ml), with better TCM symptom scores (all p<0.05 between groups). No significant difference in reproductive hormones or partner pregnancy rates. No serious adverse events. |
Wuziyuye Decoction vs L-carnitine in diabetic asthenospermia
RCT · type 2 diabetes · 12 weeks
Wuziyuye Decoction improved sperm motility and concentration more than L-carnitine over 12 weeks, but did not increase pregnancy rates. Semen-parameter gains did not translate into the outcome couples want.
Expert Commentary
This trial is more rigorous than many herbal studies because it used an active comparator, L-carnitine, rather than placebo, and the semen-parameter improvements were real and modestly larger with the decoction, nudging motility above the conventional threshold. But the result that should anchor interpretation is the one the authors report honestly: there was no difference in pregnancy outcomes. Sperm parameters are intermediate markers, and a six-point motility gain that does not translate into more pregnancies illustrates exactly the gap between laboratory improvement and the outcome a couple actually wants. The study is also single-centre, built on a traditional Chinese medicine syndrome that does not transfer cleanly to general practice, and the fertility follow-up is short and underpowered for conception. Can I use this with my patients? Only marginally and with candour. For a diabetic man with low sperm motility who is specifically interested in a TCM approach and has access to a qualified practitioner, it is a low-risk option that may improve semen parameters, but I would be explicit that it has not been shown to improve the chance of pregnancy, and that optimising glycaemic control and standard fertility evaluation come first.
References
Yu Y, Xu G, Jin P, et al. Wuziyuye Decoction for type-II diabetes mellitus with qi-yin deficiency complicated by asthenospermia: a randomized controlled trial. Zhonghua Nan Ke Xue. 2024;30(12):1122–1127. (Article in Chinese.) PMID:40783924