Background: Erectile dysfunction (ED) can negatively affect men's mental health, interpersonal relationships, and overall wellbeing. ED has affected >150 million men worldwide, and this number will reach approximately 322 million by 2025. Although PDE5-Is is a landmark in the treatment of erectile dysfunction, it may have side effects such as penile pain, cardiovascular dysfunction, and deafness. Some studies have shown that acupuncture may have a positive effect on the pathophysiology of ED. Therefore, we will select all randomized controlled trials related to evaluate the efficacy and safety of acupuncture treatment of ED.Methods: This study will systematically search 7 digital databases including China National Knowledge Infrastructure, Wanfang, VIP, China Biology Medicine, Cochrane Library, PubMed, and Embase for randomized controlled trials without language restrictions. Two researchers will independently read the title, abstract, and full text to screen for studies that can be included in the meta-analysis. If there is any dispute, the third party will be required to reach a consensus.Results: The purpose of this study is to evaluate the efficacy and safety of acupuncture in the treatment of ED and the difference in the impact of different types of acupuncture on ED.Conclusion: Judge whether acupuncture and moxibustion can help improve the symptoms of ED by evaluating relevant literatures, and make up for the lack of relevant research.

Background: According to the World Health Organization, the global incidence of infertility is about 15%, and more than 50% of infertility cases are caused by male infertility. Asthenozoospermia is caused by male fertility decline and male infertility. Due to work pressure, environmental pollution, sexual diseases, and other factors, the number of patients with asthenozoospermia has increased in recent years. It has been confirmed that acupuncture has a certain effect on patients with asthenozoospermia. Acupuncture and moxibustion can be an adjuvant treatment plan for the treatment of asthenozoospermia in addition to drug treatment. Methods: Randomized controlled trials of acupuncture for asthenozoospermia will be searched in the relevant database, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), and Chinese Scientific Journal Database (VIP database). The studies of electronic searches will be exported to EndNote V.9.1 software. We will run meta-analyses using the Review Manager (RevMan) V.5.3 software. Any disagreements will be solved in consultation with a third reviewer. Results: Our study aims to explore the efficacy of acupuncture for asthenozoospermia and to provide up-to-date evidence for clinical of asthenozoospermia. Conclusion: This study will perform a comprehensive systematic review and meta-analysis on the efficacy of acupuncture for asthenozoospermia, making up for the lack of relevant evidence of the clinical use of acupuncture. INPLASY registration number: INPLASY 202140032.

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Review question / Objective: 1. Type of s t u d i e s . A l l R C Ts w h i c h c o m p a re d acupuncture with either placebo or other d r u g s . R C Ts c o n d u c t e d i n a d u l t s (participants aged > 18 years) without regional and language restrictions. 2. Type of participants. Males diagnosed with asthenozoospermia will be considered. The INPLASY 1

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