Table 4.

Characteristics of included studies in the review research.

First author and reference	Title	Study type	Purpose/aim/objectives of the study	Design and study sample	Investigation methods	Major findings	Year
Falahatian et al. [25]	Modulatory effects of R10 fraction of garlic (Allium sativum L.) on hormonal levels, T cell polarization, and fertility-related genes in mice model of polycystic ovarian syndrome	Animal experimental study	To evaluate the potential immune-modulatory effects of R10 fraction of garlic in a mouse model of PCOS.	The therapeutic effects of R10 fraction were investigated in the PCOS mouse model. To do this, PCOS was induced by intramuscular injection of estradiol valerate.	Treatment with R10 fraction, isolated from garlic, and changes in hormone levels (estradiol, progesterone, and testosterone), markers of T cell polarization (IFN-γ, IL-4, and IL-17), and expression of fertility-genes (Gpx3 and Ptx3) were investigated.	Hormonal levels were increased in the PCOS model compared to normal animals, but were significantly modulated after treatment with R10 fraction. Treatment with R10 fraction also showed modulating effects on T cell polarization by increasing IL-4 and decreasing IL-17 and IFN-γ levels. Our study clarified that the R10 fraction of garlic has immuno-modulatory effects in reducing PCOS symptoms.	2022
Ghyasi et al. [43]	Combination Effect of Voluntary Exercise and Garlic (Allium sativum) on Oxidative Stress Biomarkers and Lipid Profile in Healthy Rats	Animal experimental study	To investigate the combination effect of voluntary exercise and garlic on serum oxidative stress biomarkers and lipid profile in healthy rats.	The rats were randomly assigned to four groups (n = 7): Control, Garlic, Exercise, and Garlic with Exercise.	Mice were fed fresh raw garlic homogenate by oral gavage (250 mg/kg) or subjected to voluntary exercise using stainless steel wheels alone or together for 6 weeks.	The serum levels of glutathione peroxidase (Gpx), superoxide dismutase (SOD), catalase (CAT) and total antioxidant (TAC) increased significantly after the aforementioned interventions. The results showed that simultaneous treatment of mice with garlic and voluntary exercise improved the antioxidant defense system and lipid profile in healthy mice.	2019
Desai et al. [44]	Revealing the Therapeutic Uses of Garlic (Allium sativum) and Its Potential for Drug Discovery	Animal experimental study	To investigate the testicular toxicity of the pyrethroid insecticide, deltamethrin (DM) in male albino Swiss mice, Mus musculus and to evaluate the protective role of Allium sativum (AS) in mitigating the harmful effect of DM.	Forty male mice were divided into five experimental groups (8 mice per every group).	Animals were randomized into control and treated groups and were caged separately. Moreover, the experiments were conducted for duration of 45 days.	The group treated with DM showed a significant increase in the concentration of testicular malondialdehyde (MDA) and cholesterol. In contrast, treatment with Allium satium ameliorated DM-induced oxidative damage and other evaluated indices of testes. DM also showed significant harmful effects on male rats and co-administration of Allium sativum ameliorates the harmful effects of DM.	2015
Elkelawy et al. [45]	Effect of garlic (Allium sativum) on hematological, biochemical, hormonal and fertility parameters of female Bouscat rabbits	Animal experimental study	To evaluate the effect of garlic on hematological, biochemical, hormonal and fertility parameters of female Bouscat rabbits	This experimental study lasted two months (from 6 to 8 months) to investigate the effects of garlic treatment on blood, biochemical, hormonal and fertility parameters of male Bouscat rabbits. For this purpose, 24 male Bouscat rabbits weighing 3150–3300 g were divided into four experimental groups with equal numbers (6 people).	The first group was used as a control and was injected subcutaneously with saline solution (1 ml of 0.9 % sodium chloride), the second, third and fourth groups were given garlic once a week for 8 weeks with doses of 3, 9 and 27 mg/kg of body were injected subcutaneously. Weight respectively	Fat, total cholesterol and triglyceride levels in male rabbits treated with different doses of garlic decreased with increasing doses of garlic. This reduction was statistically significant with higher doses (9 and 27 mg/kg body weight). Garlic treatment of buck rabbits caused a slight increase in high-density lipoprotein (HDL) levels, while a significant decrease in low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL) levels. A low dose of garlic improved fertility parameters of buck rabbits.	2020
Hajiuon et al. [46]	Effects of Garlic (Allium sativum L.) Hydroalcoholic Extract on Estrogen, Progesterone and Testosterone Levels in Rats Exposed to Cell Phone Radiation	Animal experimental study	Investigating the possible effects of radiation and garlic consumption on estrogen, progesterone and testosterone levels.	The 5 groups of male and 5 female rats were used: control, sham (exposed to light), experiment 1 (receiving garlic extract), experiments 2 and 3 (receiving extract and microwave). After one month, mice were weighed and serum levels of hormones were measured.	Animals were randomly divided into 5 groups of 6 males and 5 females of 6 including control (untreated), sham group (exposed to 900 MHz wavelength), experimental group 1 (received 400 mg/kg of garlic extract), experimental group 2 were placed receiving 200 mg of the extract plus 900 MHz waves, and experimental group 3 (receiving 400 mg/kg of the extract plus 900 MHz waves).	Estrogen decreased and progesterone increased in all groups. Microwaves and garlic extract had fewer effects on women's reproductive system, which is only reflected in serum progesterone concentration. They were also reflected in the number of Leydig cells and serum concentrations of testosterone and estrogen.	2014
Jafari et al. [47]	Comparative effects of garlic (Allium sativum) powder and atorvastatin in female reproductive system of hypercholesterolemic rats: A histological and biochemical evaluation	Animal experimental study	Investigating the comparative effect of garlic powder and atorvastatin on reproductive failure caused by hypercholesterolemia in female rats.	48 adult female Wistar rats were divided into eight groups (n = 6) including control, atorvastatin (10 mg/kg per day; oral), atorvastatin (20 mg/kg per day; oral), garlic. powder (100 mg/kg/d; oral), hypercholesterolemia (1.5 mg/kg/d cholesterol; oral), hypercholesterolemia + atorvastatin (10 mg/kg/d), hypercholesterolemia + atorvastatin (20 mg/kg/d) and hypercholesterolemia + garlic powder	After 30 days, mice were euthanized and blood samples were taken from their hearts for serological evaluation. The right ovary was transferred to 10 % formalin for histological analysis, and the left ovary was transferred to −80 °C freezer to evaluate oxidative stress markers.	The number of healthy primary, primary, secondary and antral follicles, catalase activity, total antioxidant capacity (TAOC) as well as estrogen and progesterone levels was lower in hypercholesterolemic rats than in the control group. In addition, the number of primary, secondary and antral atretic follicles and malondialdehyde (MDA) levels were higher in hypercholesterolemic rats. But garlic powder and atorvastatin 10 improved the changes in the mentioned parameters (P = 0.99). Garlic powder improved ovarian toxicity in hypercholesterolemic rats better than atorvastatin.	2021
Risikat et al. [48]	Comparative oestrogenic effects of Allium sativum and Allium cepa in ovariectomized rats	Animal experimental study	Evaluation of therapeutic effectiveness of Allium cytium and Allium cepa on estrogenic activities of ovariectomized adult Wistar rats.	Institutional Animal Care and Use Committee (IACUC) guidelines were strictly followed during animal transport (IACUC, 2011). Accordingly, this research was conducted in line with the guidelines of the ethical review committee of the University of Ilorin.	A total of 36 (thirty-six) adult female Wistar rats were fed pelleted feed (breeders mesh) purchased from Ogo-Oluwa Feed, Sango Ilorin and had free access to clean water.	Allium cepa and quercetin increased the thickness of the endometrium, increased the number of neurons in cells stained with synaptophysin of the hippocampus and dentate gyrus. Allium cepa, which has similar estrogenic properties to the estradiol group in these ovariectomized rats, could provide some ameliorating effects of estrogen deficiency.	2022
Raji et al. [33]	The Effects of Aqueous Extract of Allium sativum (Garlic) on Some Aspects of Reproduction in the Female Albino Rat (Wistar Strain)	Animal experimental study	Investigating the effect of its extract on some aspects of reproduction in female albino rats (Wistar strain).	Seventy-five female albino rats in proestrus were divided into five groups of fifteen. Group A was given distilled water as a control, and groups B, C, D, and E were given daily oral doses of 200, 400, 600, and 800 mg/kg body weight of aqueous garlic extract for twenty-eight days and during the period 28–30 days of pregnancy were given.	Five mice in each group were sacrificed on the 14th day and the 28th day for gross and histological examinations in the first stage. The remaining five mice (in each group) were mated in the second step.	The body weight of the uterus and cervix in group E (P < 0.05) has a significant decrease compared to groups A, B, C and D, while the ovaries did not show significant changes. A significant increase in the length of the right uterine horn and a decrease in the length of the left uterine horn (P < 0.05) were observed in groups B, C, D and E compared to group A. Mated mice all became pregnant without abortion. There was no significant difference (p > 0.05) in infant size, live birth weight, and infant mortality among the groups. These findings show that the aqueous extract of garlic has no harmful effect on the reproductive performance of female mice.	2012
Batool et al. [49]	Curative Potentials of Garlic (Allium sativum) Extract against Di-(2-Ethylhexyl) Phthalate Induced Reproductive Toxicity in Female Mice	Animal experimental study	To explore the therapeutic potential of garlic (Allium sativum) against the toxicity caused by di-(2-ethylhexyl) phthalate (DEHP) in the reproductive system of female rats.	Forty female rats were divided into four groups (n = 10), which (a) control group was given normal food and drinking water, (b) group treated with aqueous extract of garlic (500 mg/kg), (c) group received DEHP 500 mg/kg in corn oil and (d) DEHP + garlic aqueous extract each at a dose of 500 mg/kg body weight.	After completion of the experiment, all animals were dissected through cervical dislocation to obtain reproductive organs. The collected organs were weighed and processed through the conventional histological technique of staining with eosin and hematoxylin.	Treatment with DEHP plus garlic extract showed protective effects on the uterus, such as a significant increase in uterine diameter, muscularity, mean number of endometrial glands, and endometrial epithelial height compared to the DEHP-only group. Hence, garlic extract showed significant amelioration potential against DEHP-induced reproductive abnormalities in female rats.	2022
Iram et al. [50]	Effect of aqueous garlic (Allium sativum) extract against di-(2-ethylhexyl) phthalate induced reproductive toxicity in male mice	Animal experimental study	Evaluation of testicular and male reproductive system histopathologies and lipid profile against exposure to diethylhexyl phthalate (DEHP) in mice and the therapeutic potential of aqueous extract of garlic (Allium sativum).	Four groups (n = 10) were named and treated (A) control (C): (normal food and drinking water + 0.2 ml corn oil). (b) Aqueous extract of garlic (AGE) group: (500 mg/kg body weight of aqueous extract of garlic). c) DEHP group: (500 mg/kg body weight DEHP, dissolved in corn oil; d) AGE + DEHP group (500 mg/kg body weight garlic aqueous extract, and DEHP 500 mg/kg body weight corn oil dissolved).	Doses were given once daily by gavage for 28 days, and on day 29, all animals were killed by cervical dislocation, and reproductive organs and blood samples were collected.	Exposure to DEHP on body weight, testis weight, serum cholesterol, triglyceride, lipid profile, mean seminiferous tubule cross-sectional area, seminiferous tubule lumen ACSA, spermatogenic cells, Leydig cell count, diameter of vas deferens, lumen, Muscle thickness and height of epithelial cells of the vas deferens. This study found that exposure to DEHP can be harmful to male reproductive health, and that an aqueous extract of garlic can reduce the toxic effects of DEHP in male rats.	2022
Hagag et al. [51]	Effect of Feeding Pomegranate (Punica granatum) Peel and Garlic (Allium sativum) on Antioxidant Status and Reproductive Efficiency of Female Rabbits	Animal experimental study	To investigate how adding pomegranate peel (PP), garlic powder (GP) or a mixture of the two to their diet affects their weight, number of offspring, reproductive performance, blood and antioxidant indices, as well as liver and kidney functions.	A total of 20 female and adult mixed rabbits aged 4.5–5 months with an average weight of 3.05 ± 0.63 kg were divided into four experimental groups (5 people).	The first group was fed with basal diet and was considered as control animals, while the second, third and fourth groups were fed with basal diet supplemented with PP 3.0 %, GP 3.0 % and a mixture of PP 1.5 % + GP 1.5. %, Respectively. After 2 weeks of feeding the experimental diets, natural mating was performed with untreated pairs.	The results showed that creatinine levels in PP (3 %) and GP (3 %) rabbits decreased significantly compared to control rabbits. The results of superoxide dismutase, catalase, glutathione and total antioxidant capacity also indicated a significant decrease in the groups treated with GP (3 %) compared to other treated groups. In conclusion, pomegranate is a promising ingredient to include in the diet of rabbits, followed by garlic to increase reproductive efficiency.	2023
Parvez et al. [52]	Antifertility Activity of Methanol Bulb Extract of Allium sativum on Swiss Albino Male Mice and Teratogenic Effect on Neonates of female Mice	Animal experimental study	Investigating the anti-fertility activity of methanolic onion extract of Allium satium on Swiss albino male rats.	Adult albino Swiss mice (number = 22) aged 30–35 days were used. Mice were collected from Faculty of Pharmacy, Jahangirnagar University. Mice weighing about 30–40 g were placed in colony cages (4 mice per cage). Albino Swiss mice were divided into three groups.	The plant of Allium satium L. was cut into small pieces and 500 g of chopped onion of Allium satium was soaked in 1000 ml of methanol and placed in a rotary shaker with continuous shaking for 7 days.	The results of this study showed that the methanolic onion extract of Allium sativum plant has an anti-fertility effect on male mice and has no teratogenic or non-beneficial effect on female mice.	2015
Kadir et al. [53]	Oestrogenic Effects of Onion and Garlic Extracts: Potential Alternatives to Synthetic Oestradiol?	Animal experimental study	Evaluating the estrogenic activities of onion and garlic and their effects on the uterus of adult female Wistar rats.	A total number of 30 rats including five rats in six groups were used. Group I received only feed and water and served as control. The second group (estradiol group) was administered oral estradiol 10 μg/kg. Groups III and IV were given 1.14 g/kg and 1.7 g/kg body weight of onion extract respectively, while groups V and VI were given 1.14 g/kg and 1.7 g/kg body weight of garlic extract respectively for four weeks.	The microscopic structure of the uterus of all studied animals was observed under a light microscope after the preparation of tissues (uterus) and subsequent staining with hematoxylin and eosin dyes. And serum estrogen levels were measured and compared after menopausal women and women of all ages with four weeks of treatment.	Animals in the control group had higher estrogen levels than other treatment groups, including the estradiol group. The results of this study also showed that the use of onion or garlic as a potential substitute for synthetic estradiol in the treatment of estrogen deficiency associated with menopause cannot be proven.	2018
Ene et al. [54]	The effect of Allium Sativum (Garlic) on Pregnancy, Fetal Weights, and Some Hematological Parameters in Albino Rats	Animal experimental study	Investigating the effect of Allium satium (garlic) on pregnancy, fetal weight and some blood parameters in Wistar rats	The animals were divided into four (4) groups A, B, C and D of ten female mice (n = 10). Group A (control) was fed with normal rat food and water ad libitum. Group B induced pregnancy and treated with aqueous extract of AS, group C (n = 10) pregnant and receiving AS extract, group D (n = 10) non-pregnant and receiving AS extract.	Each of the basic parameters of the mice was determined before the induction of pregnancy and then the parameters were evaluated weekly.	There was a significant difference between groups B, C and D compared to group A on days 14 and 21. The number of platelets decreased significantly in all groups and no significant difference was observed between groups compared to A. The results showed that the consumption of garlic during pregnancy has a beneficial effect in reducing the weight of the mother/fetus.	2017
Sheweita et al. [55]	Antioxidants (selenium and garlic) alleviated the adverse effects of tramadol on the reproductive system and oxidative stress markers in male rabbits	Animal experimental study	Investigating the protective effects of antioxidants (garlic and selenium) against the toxic effects of tramadol on the characteristics of semen, steroid hormones, protein expression of different cytochrome P450 isozymes and the activity of antioxidant enzymes in the testes of rabbits.	Western immunoblotting, spectrophotometry and histology methods were used in this study.	Tramadol (1.5 mg/kg body weight) orally to male rabbits for up to three months (three times a week) and after treatment with garlic (800 mg/kg body weight) and/or selenium (1 mg/kg body weight) of rabbits was administered.	The results showed that such toxic effects of tramadol were reduced and returned to their normal level after pretreatment of rabbits with garlic, selenium and/or their combination. This finding may pave the way for a new approach to reduce tramadol toxicity.	2022
Bashir et al. [35]	Effect of aqueous garlic extract on androgen induced changes in ovaries of prepubertal female albino rats	Animal experimental study	Evaluation of the effect of garlic extract on androgen -induced changes in the ovary of prenatal rats and assessment of protection provided by aqueous garlic extract.	Fifty pre -operative rats at the age of 21 were divided into five groups A, B, C, D and E. Group A as a witness and received 5 ml/kg per day from subcutaneous propylene glycol for 14 days. Group B Testosterone Propionate (TP) dissolved 10 mg/kg/day at 5 ml/kg subcutaneous propylene glycol for 14 days.	Group C received 10 mg/kg per day at 5 ml/kg of subcutaneous propylene glycol and the age of 200 mg/kg orally for 14 days. Group D was dissolved for 14 mg/kg per day at 5 mg/kg of propylene glycol for 14 days and water garlic extract 200 mg/kg orally from day 14–21. Group E 10 mg/kg dissolved In 5 ml/kg of propylene glycol for 14 days without intervention by day 21. Group A, B and C animals were sacrificed on day 15 and Group D and E on day 22, the ovaries were removed and examined.	Histological sections increased significantly in the number of large cystic and anthral follicles in groups B and C, respectively. However, the number and size of cystic follicles decreased after treatment with water extract. The results showed that the extract of water garlic prevents and reduced the number and size of cystic follicles in ovaries treated with androgen of immature mice.	2017
Ukpanukpong et al. [56]	Hormonal and electrolyte assessment on the effect of garlic (Allium sativum), Vitamin C and E in tramadol induced toxicity in female Wistar rats	Animal experimental study	Evaluation of the antioxidant effect of vitamin C, E and garlic on toxicity caused by tramadol in wistar rats	The rat (35) was dedicated to five studies from seven mice. Group A: NT Determined Mice contains positive control mice and without any therapy B: TM designated mice with 0.2 mg of tramadol C tramadol: specified TMVC includes 0.2 mg tramadol mice and 0.2 ml vitamin C D: The specified TMVE included mice prescribed 0.2 mg tramadol and 0.2 ml vitamin E. Group E: TMG included mice with 0.2 mg tramadol and 0.2 ml garlic	It was adapted to the animals for two weeks and their weight was measured before treatment. At the end of the experimental period, the mouse took a day overnight and was sacrificed to anesthesia with the cervical displacement. After the mice were sacrificed, 2–4 ml of blood was collected from each mice and placed in specific sterile bottles for hormonal and electrolyte analysis.	The total level of vitamin C, E and garlic antioxidants increased significantly compared to the negative control group. In TmVC, TmV, TmG groups, the amount of bicarbonate increased significantly compared to the control group. The levels of serum hormones of the LH group and estrogen showed a significant decrease in the negative control group compared to the positive control group. But in groups of TmVC, TmV and TmG, the LH and estrogen group increased significantly.	2019
Al-Shaibani et al. [57]	Histological Study of Aqueous Extracts Leek Allium porrum L. in Female Reproductive System of Laboratory White Rats	Animal experimental study	To evaluate the impact of the water extracts of the porrum leaf of alum on the reproductive system in the female albino mice.	The study included 30 female white rats type Rattus rattus age average between 8 and 12 weeks.	The animals were placed in appropriate laboratory conditions, temperature of about 30–20° and at a constant speed of lighting system 13 h and 11 h of darkness.	Aqueous Extracts Leek Allium porrum had anti -fertility effects on white mice through negative effects on the ovaries and the uterus. It also affected the number of follicles and the thickness of the endometrium and mythometer.	2014