A systematic review and meta-analysis of clinical trials on saffron (Crocus sativus) effectiveness and safety on erectile dysfunction and semen parameters

Objective: We performed this systematic review and meta-analysis study to determine saffron (Crocus sativus) effectiveness and safety in male infertility problems. Materials and Methods: The databases PubMed, Scopus, Cochrane, Google Scholar, SID, IranMedex and Magiran until July 2016 and reference section of relevant articles, were searched to find both English and Persian clinical trials on male infertility issues that used saffron as medical treatment. Also, the quality of these trials was evaluated by Oxford Center for Evidence Based Medicine checklist. A total of six trials was ultimately included. All statistical analyses were done by Comprehensive Meta-analysis (CMA) Version 2. Results: Only in one study conducted on sperm parameters, the mean percentage of sperm with normal morphology (p<0.001) and sperm motility (p<0.001) were increased. Quantitative analysis showed that saffron had a significantly positive effect on all dimensions of Erectile Function questionnaire (MD for Erectile function=5.36(p=0.00), Orgasmic function=1.12 (p=0.007), Overall satisfaction=1.23 (p=0.005), Satisfaction with intercourse=2.18 (p=0.00) and Sexual desire=0.78 (p=0.00), Fixed effects model using 3 trials). The result of subgroup analysis based on dimensions of Erectile Function questionnaire showed statistically significant differences among subgroups (p=0.00). Conclusion: saffron has a positive effect on erectile dysfunction. However, our study showed contradictory results about semen parameters. So, interpretation of results is limited because of methodological flaws of the included studies, erectile dysfunction status and a large heterogeneity among them. Further trials are still needed to confirm the current findings.