Letter to the Editor on: “The Effect of Ceratonia siliqua L. on Semen Parameters in Infertile Men: A Systematic Review”

Document Type : Letter to the Editor

Authors

1 Assistant Professor, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

2 Professor, Department of Pharmacognosy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Graduated, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Graduated, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

Abstract

Dear editor
I would like to congratulate the authors for this systematic review article, and make some contributions regarding the representation of our research article titled "Comparison of the Effect of Ceratonia siliqua L. (Carob) Syrup and Vitamin E on Sperm Parameters, Oxidative Stress Index, and Sex Hormones in Infertile Men: a Randomized Controlled Trial," published in Reproductive Sciences in 2020 (1), which was cited in the recent article titled "The Effect of Ceratonia siliqua L. on Semen Parameters in Infertile Men: A Systematic Review" published in the Journal of Midwifery and Reproductive Health 2024; 12(1): 4006-4018 (2).

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Main Subjects


Dear editor

I would like to congratulate the authors for this systematic review article, and make some contributions regarding the representation of our research article titled "Comparison of the Effect of Ceratonia siliqua L. (Carob) Syrup and Vitamin E on Sperm Parameters, Oxidative Stress Index, and Sex Hormones in Infertile Men: a Randomized Controlled Trial," published in Reproductive Sciences in 2020 (1), which was cited in the recent article titled "The Effect of Ceratonia siliqua L. on Semen Parameters in Infertile Men: A Systematic Review" published in the Journal of Midwifery and Reproductive Health 2024; 12(1): 4006-4018 (2).

Upon reviewing the citing article, we have identified some differences in the assessment of the risk of bias in our previous study. The article categorized our study as having an unclear or high risk of bias for random sequence generation and allocation concealment. We believe there is room for clarification on our randomization methodology. Our original study (1) followed CONSORT guidelines in the protocol published in the Caspian Journal of Internal Medicine in 2019 (3). Random allocation and concealment were achieved through permuted block randomization and a password-protected computer. We are open to discussing with the citing article's authors to address discrepancies and provide more insights into the method of our study.

Moreover, the citing article appears to misinterpret the blinding procedures implemented in our study, indicating an unclear risk for blinding of participants, personnel, and outcome assessors. However, our original article clearly stated that the outcome assessors responsible for analyzing data from semen samples, endocrine tests, and biomarker analysis was blinded to participant grouping. This information was not properly reflected in the citing article, possibly causing a misconception about the comprehensiveness and reliability of our study.

We also noted an inconsistency in the description of the randomization method in another study featured in the systematic review entitled "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" by Pilehvari et al. (2024) (4). The citing study mentions using cards in envelopes with group names and numbered sequences for randomization, while the original authors did not specify the exact randomization and concealment methods. They only stated that volunteers were randomly assigned based on mixed cards labeled A and B.

We acknowledge that this observation may be subject to interpretation, and we welcome any reasonable response or clarification from the authors of the citing article to address this matters. We have concerns about the citation's impact on our research credibility. To uphold result integrity, we request the journal to thoroughly review the citations and possibly issue corrections or clarifications on the risk of bias assessments in the cited studies. This proactive step is crucial for upholding research standards and readers' confidence. We respectfully ask the editor to consider these suggestions and promote constructive dialogue with the citing authors to address any discrepancies.

Conflicts of interest

Authors declared no conflicts of interest.

  1. Aghajani MMR, Mahjoub S, Mojab F, Namdari M, Gorji NM, Dashtaki A, et al. Comparison of the effect of Ceratonia siliqua L.(carob) syrup and vitamin E on sperm parameters, oxidative stress index, and sex hormones in infertile men: A randomized controlled trial. Reproductive Sciences. 2021; 28(3): 766-774.
  2. Asghari S, Taghipour A, Mahmoudinia M, Farshbaf-Khalili A, Latifnejad Roudsari R. The Effect of Ceratonia siliqua L. on Semen Parameters in Infertile Men: A Systematic Review. Journal of Midwifery & Reproductive Health. 2024;12(1): 4006-4018.
  3. Aghajani MMR, Gorji NM, Mirabi P, Mojab F. Effect of Ceratonia siliqua (Carob) syrup and vitamin E on sperm parameters, oxidative stress index and sex hormones in infertile men: Protocol for a randomized controlled trial. Caspian Journal of Internal Medicine. 2019; 10(4): 452.
  4. Pilehvari S, Masoumi SZ, Bahar TG, Kazemi F, Moradkhani S, Maleki P. Effect of Carob and Ginseng Supplements on Semen Analysis Parameters, Sexual Function, and Sex Hormones in Infertile Men: Double-Blind, Randomized Controlled Trial Study. Iranian Journal of Nursing and Midwifery Research. 2024; 29(1): 113-119.