Background: Oligoasthenozoospermia is the leading cause of
male infertility, seriously affecting men's health and increasing the societal medical burden. In recent years,
obesity-related oligoasthenozoospermia has attracted increased attention from researchers to find a cure. This study aimed to evaluate the efficacy of Hua-Tan-Sheng-Jing decoction (HTSJD) in treating
obesity with oligoasthenozoospermia, determine its active ingredients and identify its mechanism of action. Methods: The ingredients of HTSJD were determined by combining the ultra-performance liquid chromatography with mass spectrometry (UPLC-MS/MS) and systems pharmacology approach. The common pathogenesis of
obesity and oligoasthenozoospermia and the potential mechanism of HTSJD against
obesity with oligoasthenozoospermia were obtained through target fishing, network construction, and enrichment analyses. Further, molecular docking of the key ingredients with the upstream receptors of the key signaling pathways of the potential mechanism was used to predict their affinity. Finally, high-fat-induced
obesity with oligoasthenozoospermia rat model was constructed to determine the effects of HTSJD on semen concentration, sperm motility,
body weight, and serum lipid metabolism. The key
proteins were validated by immunohistochemistry (IHC). Results: A total of 70 effective components and 847 potential targets of HTSJD (H targets) were identified, of which 743 were common targets related to
obesity and oligoasthenozoospermia (O-O targets) mainly enriched in the pathways related to
inflammation, oxidative stress and
hormone regulation. Finally, 143 common targets (H-O-O targets) for HTSJD against
obesity with oligoasthenozoospermia were obtained. Combining the hub genes and the results of Gene Ontology (GO) functional and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of H-O-O targets, PI3K-AKT and MAPK signaling pathways were identified as the key pathways. Molecular docking results showed that
Diosgenin,
Kaempferol,
Quercetin,
Hederagenin,
Isorhamnetin may act on the related pathways by docking EGFR, IGF1R and INSR. The animal-based in vivo experiments confirmed that HTSJD improves the sperm quality of high-fat diet-fed rats by reducing their
body weight and blood
lipid levels, influencing the PI3K-AKT and MAPK signaling pathways and altering the corresponding
protein expressions. Conclusion: HTSJD treats
obesity with oligoasthenozoospermia by up-regulating the PI3K-AKT signaling pathway and down-regulating the MAPK signaling pathway, which are at the crossroad of
obesity and oligoasthenozoospermia.