Original Articles

Effect of Carob Supplement on Spermogram Parameters and Sexual Function of Infertile Men Referred to the Infertility Center, Hamadan, Iran, 2019: A Randomized Controlled Trial


Objective: The purpose of this study is comparison of carob with placebo in the treatment of male infertility.
Materials and methods: This study was performed as a clinical trial with two-group pretest-posttest design. Each group consisted of 30 members. The first group received 1.5 grams of carob per day, and the second group received placebo treatments. Treatment lasted for 12 weeks. Semen analysis as well as testosterone, prolactin, (LH), (FSH) and (TSH) were performed before and after drug treatment in two groups. Sexual function was assessed in the groups in two stages before and after the intervention using the standard International Index of Erectile Function. P-value less than 0.05 was considered statistically significant. Statistical analysis of data was performed using SPSS 16.
Results: The participants’ mean age was 34.83 ±6.22 in the placebo and 33.67 ±5.82 years in the Carob group. The results showed in the carob group compared to the placebo group, the rate of normal sperm counts increased by 17% and also the normal level of testosterone was 40% higher than the abnormal levels of the placebo group and these differences were statistically significant (P <0.05). And in most areas of sexual function, the mean scores after the intervention were higher than before (P> 0.05).
Conclusion: It is recommended to use carob supplements to improve spermogram parameters and male sex hormones.

1. Direkvand Moghadam A, Delpisheh A, Sayehmiri K. The trend of infertility in Iran, an original review and meta-analysis. Nursing Practice Today. 2015;1(1):46-52.
2. Okonofua FE, Ntoimo LFC, Omonkhua A, Ayodeji O, Olafusi C, Unuabonah E, Ohenhen V. Causes and Risk Factors for Male Infertility: A Scoping Review of Published Studies. Int J Gen Med. 2022;15:5985-5997
3. Babakhanzadeh E, Nazari M, Ghasemifar S, Khodadadian A. Some of the Factors Involved in Male Infertility: A Prospective Review. Int J Gen Med. 2020;13:29-41.
4. Durairajanayagam D. Lifestyle causes of male infertility. Arab J Urol. 2018;16(1):10-20.
5. Alsalman ARS, Almashhedy LA, Alta'ee AH, Hadwan MH. Effect of Zinc Supplementation on Urate Pathway Enzymes in Spermatozoa and Seminal Plasma of Iraqi Asthenozoospermic Patients: A Randomized Controlled Trial. Int J Fertil Steril. 2020;13(4):315-323.
6. Calislar S, Kaplan Y. Effects of carob (Ceratonia siliqua) pod byproduct on quail performance, egg characteristics, fatty acids, and cholesterol levels. Revista Brasileira de Zootecnia. 2017;46(2):113-7.
7. Mahmoudi S, Mahmoudi N, Benamirouche K, Estévez M, Mustapha MA, Bougoutaia K, Djoudi NEHB. Effect of feeding carob (Ceratonia siliqua L.) pulp powder to broiler chicken on growth performance, intestinal microbiota, carcass traits, and meat quality. Poult Sci. 2022;101(12):102186.
8. u X, Zhang S, Chen L, Zhang XY, Wang Q. High incidence of sexual dysfunction and timed intercourse was found only in infertile males who with known impairment of sperm quality for a long period: evidence from a hospital-based cross-sectional study. Reprod Biol Endocrinol. 2022;20(1):139.
9. Agha RA, Franchi T, Sohrabi C, Mathew G, Kerwan A; SCARE Group. The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) Guidelines. Int J Surg. 2020;84:226-230.
10. Mahdiani E, Khadem Haghighian H, Javadi M, Karami A A, Kavianpour M. Effect of Carob (Ceratonia siliqua L.) oral supplementation on changes of semen parameters, oxidative stress, inflammatory biomarkers and reproductive hormones in infertile men. Scientific Journal of Kurdistan University of Medical Sciences. 2018; 23 (3) :56-66.
11. Ahmadi S, Bashiri R, Ghadiri-Anari A, Nadjarzadeh A. Antioxidant supplements and semen parameters: An evidence based review. Int J Reprod Biomed. 2016;14(12):729-736.
12. Soleimanzadeh A, Malekifard F, Kabirian A. Protective effects of hydro-alcoholic garlic extract on spermatogenic disorders in streptozotocin-induced diabetic C57BL/6 mice. Scientific Journal of Kurdistan University of Medical Sciences. 2017;22(4):8-17.
13. O'Flaherty C. Reactive Oxygen Species and Male Fertility. Antioxidants (Basel). 2020;9(4):287.
14. Vafaei A, Mohammadi S, Fazel A, Soukhtanloo M, Mohammadipour A, Beheshti F. Effects of carob (Ceratonia siliqua) on sperm quality, testicular structure, testosterone level and oxidative stress in busulfan-induced infertile mice. Pharmaceutical Sciences. 2018;24(2):104-11.
15. Alsalman A, Almashhedy LA, Hadwan MH. Zinc supplementation attenuates lipid peroxidation and increases antiperoxidant activity in seminal plasma of Iraqi asthenospermic men. Life Science Journal. 2013;10(4):989-97.
16. ElSheikh MG, Hosny MB, Elshenoufy A, Elghamrawi H, Fayad A, Abdelrahman S. Combination of vitamin E and clomiphene citrate in treating patients with idiopathic oligoasthenozoospermia: A prospective, randomized trial. Andrology. 2015;3(5):864-7.
17. Greco E, Iacobelli M, Rienzi L, Ubaldi F, Ferrero S, Tesarik J. Reduction of the incidence of sperm DNA fragmentation by oral antioxidant treatment. J Androl. 2005;26(3):349-53.
18. Faramarzi A, Aghaz F, Bakhtiari M, Khazaei M. In vitro application of Ceratonia siliqua improved sperm parameters and chromatin quality after vitrifacation in normozoospermic aged men. Middle East Fertility Society Journal. 2020;24(1):1-5.
19. Sanagoo S, Farshbaf-Khalili A, Asgharian P, Hazhir S, Oskouei BS. Comparison of the effect of Ceratonia siliqua L. fruit oral capsule and vitamin E on semen parameters in men with idiopathic infertility: a triple-blind randomized controlled clinical trial.
J Complement Integr Med. 2021;18(4):791-796.
20. Sadeghzadeh F, Sadeghzadeh A, Changizi-Ashtiyani S, Bakhshi S, Mashayekhi FJ, Mashayekhi M, Poorcheraghi H, Zarei A, Jafari M. The effect of
hydro-alcoholic extract of Ceratonia Silique L. on spermatogenesis index in rats treated with cyclophosphamide: An experimental study. Int J Reprod Biomed. 2020;18(4):295-306.
IssueVol 17, No 3 (September 2023) QRcode
SectionOriginal Articles
DOI https://doi.org/10.18502/jfrh.v17i3.13537
Carob Clinical Trial Male Infertility Sexual Dysfunction

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Pilehvari S, Gharakhani Bahar T, Masoumi SZ, Kazemi F, Moradkhani S, Rastgoo Haghi A, Maleki P. Effect of Carob Supplement on Spermogram Parameters and Sexual Function of Infertile Men Referred to the Infertility Center, Hamadan, Iran, 2019: A Randomized Controlled Trial. J Family Reprod Health. 2023;17(3):142-150.