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Introduction Asthenozoospermia, characterized by reduced progressive motility of spermatozoa, is one of the leading causes of male infertility ( In recent years, the gut microbiota, which is often referred to as the second genome, has attracted increasing attention for its role in male reproductive health ( Traditional Chinese medicine (TCM) has a long-standing history in the treatment of male infertility

Several next-generation treatments are in clinical trials that may further shift the balance

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notably, the protocol did not include guidance on caloric restriction

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