To explore the effects of the dialectical Bushenzengye decoction combined with L-carnitine for treating patients with asthenospermia on their semen parameters and the related indexes of their in vitro fertilization. Methods: 94 patients with asthenospermia who wanted the treatment of IVF cycle were selected and were divided into control group (41 cases with the treatment of L-carnitine for 12 weeks) and the study group (53 cases with the treatment of the dialectical Bushenzengye decoction combined with L-carnitine for 12 weeks) according to the different treatment methods from January 2020 to January 2022. The treatment effect, the semen quality analysis before and after treatment, the sexual function and IVF cycle related indexes of the patients were compared between the two groups. Results: The semen volume (3.71±0.75ml), the sperm concentration (30.05±5.75 106 cells/ml), the sperm survival rate (58.63±10.14%), the rate of the a+b level sperm (66.65±10.45%) of the patients in the study group after treatment were significantly higher than those (3.08±0.89ml, 27.63±5.07 106 cells /ml, 53.17±8.45% and 60.74±8.71%) of the patients in the control group. The scores of the erection confidence (3.65±0.46 points), the erection time (3.89±0.35 points), the erection maintenance time (3.63±0.45 points), the difficulty of sexual intercourse (4.35±0.25 points), the sexual satisfaction (4.05±0.21 points) and the total score (19.57±1.72 points) of the patients in the study group were significantly higher than those  (3.37±0.31points, 3.41±0.29 points, 3.23±0.23 points, 4.11±0.16 points, 3.33±0.15 points and 17.45±1.14 points) of the patients in the control group. The fertilization rate (82.8±5.1%), the high-quality embryo rate (56.9±10.3%), the number of transferrable embryos (2.4±0.5 pieces) and the clinical pregnancy rate (60.0%) of the patients in the study group were significantly higher than those (81.0±3.7%, 48.5±8.0%, 1.5±0.5 pieces and 37.5%) of the patients in the control group. The total effective rate (90.6%) of the patients in the study group was significantly higher than that (73.2%) of the patients in the control group (all P<0.05). Conclusion: The dialectical Bushenzengye decoction combined with L-carnitine for treating the patients with asthenospermia can improve their semen quality and sexual function, and which is conducive to improving the indicators related to IVF cycle and increasing the success rate of IVF.