Inclusion Criteria:
1. Males aged between 25-45 years with a Body Mass Index (BMI) of 20-29 kg/m2.
2. Subjects with a history of infertility of at least 12 months despite regular unprotected intercourse.
3. Subjects with semen analysis showing abnormal sperm concentration (\< 16 million/ml), progressive motility (\< 30%), and total motility (\< 42%), normal morphology (\< 4%). (WHO guidelines- 6th edition, 2021)
4. Subjects with total testosterone ≥300 ng/dL.
5. Subjects who are willing to abstain from sexual activity that results in ejaculation for 3 to 5 days before semen analysis.
6. Subjects who are in a stable sexual relationship and sexually active during the study.
7. Subjects willing to use contraceptives during study period.
8. Subjects agree to maintain current diet and activity level.
9. No urogenital infection or anatomical abnormality of this system, including varicocele; no prior history of surgery in the pelvic area; no uncontrolled systemic illness, such as liver and gallbladder cancers, renal failure, thyroid disorders, and cerebral haemorrhage; no prior history of trauma to the testes; no unilateral testicular atrophy; no previous history of chemotherapy or treatment with anticoagulants, corticosteroids, testosterone and anti-androgen medications during the 8 weeks before the study.
10. Subject considered generally healthy as per health history and routine clinical investigations during screening.
11. Ability to understand the risks/benefits of the protocol and willing to sign the written informed consent.
Exclusion Criteria:
1. Employees working on night shifts.
2. Subjects with identifiable cause for Oligoasthenoteratozoospermia (OAT) (includes Cryptorchidism, Orchitis and Radiation or chemotherapy etc.).
3. Subjects with Systolic \>140 and Diastolic \>90 mmHg blood pressure and Fasting blood glucose (FBG) \>125 mg/dl.
4. Smokers and alcoholics.
5. Subjects underwent treatment for COVID 19 within the last 3 months or tested positive during the study will be excluded.
6. Subject with any physical disability that may limit sexual function.
7. Subjects with history of taking medications for oligospermia or any other sexual problems, including PDE-5 inhibitors, and dysfunctions related to genito-urinary system, muscular dystrophy and coagulation.
8. Subjects with clinical history of genital surgery, endocrine disorders e.g. hypopituitarism, pituitary tumors, hypo- and hyperthyroidism, hypogonadism, inherited (genetic and chromosomal) disorders, etc.
9. Subjects diagnosed with sleep apnea or related disorders.
10. Subjects consuming medications that can interfere with muscle mass such as corticosteroids, testosterone replacement or anabolic drugs.
11. Subjects who consume recreational drugs (such as cocaine, methamphetamine, marijuana, etc.) or chewable tobacco products.
12. Subjects having history of Benign Prostate Hyperplasia (BPH), stroke, myocardial infarction, coronary artery disease, cardiac failure, angina, life-threatening arrhythmia within the past 6 months.
13. Subjects under medications including vitamins, antidepressants, anticholinergics, inhaled beta agonists, anti- hyperlipidemic, psychotropics etc.
14. Subjects using any centrally acting anorectic agents, drugs that inhibit the absorption of nutrients and endocannabinoid neuromodulators during the two weeks prior to enrolment into the study.
15. Subjects who underwent major surgical procedures in last 6 months, which may affect their quality of life.
16. Subject with HIV positive or any other STDs.
17. History of psychiatric disorder that may impair the ability of subjects to provide written informed consent.
18. Subject has participated in a clinical study within the last 90 days prior to recruitment or concurrently participating in another study.
