- Sepideh Peivandi
 - - Department of Obstetrics and Gynecology, Faculty of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Iran
- Abasali Karimpour
- - Department of Anatomy and Embryology, Faculty of Medicine, Mazadaran University of Medical Sciences, Mazandaran, Iran
- Narges Moslemizadeh
- - Department of Obstetrics and Gynecology, Faculty of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Iran
Received: 5/27/2009 Accepted: 9/1/2009 - Publisher : Avicenna Research Institute |
| Related Articles |
|
| Other Format |
|
|
|
Abstract
Introduction: Male infertility is one of the most challenging problems in andrology. The common cause of male infertility is related to disorders in sperm production and its improvement is synonymous with better treatment outcomes. Although, the etiology of infertility is not clear in most cases but different treatment options have been suggested to increase sperm count and motility. L-carnitine, which is found in different food items and it is derived from lysine and methionine, is a substance essential for the oxidation of long-chain fatty acids in the mitochondria and protection of cell membranes from damages caused by free oxygen radicals. This study was done to evaluate the efficacy of L-carnitine in improving sperm quality in infertile men.Materials and Methods: This double blind randomized cross-over, clinical trial was conducted on 30 infertile men attending Sari Imam Khomeini Hospital’s Infertility Clinic during 2005- 2006. Subjects that had at least two abnormal spermograms, based on WHO criteria, with a two-week interval during four weeks and their gonadotropins, testosterone an prolactin concentrations were within normal range were recruited for the study. The exclusion criteria were composed of individuals with medical conditions other than infertility such as grade 3 or 4 varicocele, testicular atrophy, ejaculatory disorders, use of any medications in the past two months prior to the study, azoospermia, endocrinological disorders, ICSI candidacy for severe spermogram abnormalities or other causes of infertility.The patients were randomly allocated to two groups of A and B. Group A and B received L-carnitine and placebo 2g/day for 8 weeks respectively. After a washout period of 8 weeks, the two groups, changed place and received placebo and L-carnitine (2g/day×8w). Sperm analyses were done in four stages: Before and after the first intervention, at the end of washout period and after the second intervention.Results: There were significant improvements in mean sperm concentration and progressive sperm motility upon two months of L-carnitine intake (p<0.05 ) but no significant changes were found in sperm volume or morphology. the aforementioned changes retracted to the primary status after two months. no changes were seen following the intake of placebos in the cases.conclusion: l-carnitine intake effectively improved the mean sperm count and progressive sperm motility. however, confirmation of these results warrants more thorough clinical trials.< pan>
Keywords:
Gonadotropin, L-carnitine, Male infertility, Oligoastenospermia, Prolactin, Sperm analysis, Sperm motility, Testosterone To cite this article:References
- Rowe PJ, Comhaire FH, Hargreave TB, Mahmoud Ahmed MA. WHO manual for the standardized investigation, diagnosis and management of the infertile male. London: Cambridge University Press; 2000. p. 37-60.
- Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. 1334 p.
- Sinclair S. Male infertility: nutritional and environ-mental considerations. Altern Med Rev. 2000;5(1):28-38. [PubMed]
- Lenzi A, Sgrò P, Salacone P, Paoli D, Gilio B, Lombardo F, et al. A placebo-controlled double-blind randomized trial of the use of combined l-carnitine and l-acetyl-carnitine treatment in men with asthenozoospermia. Fertil Steril. 2004;81(6): 1578-84. [PubMed]
- Jeulin C, Lewin LM. Role of free L-carnitine and acetyl-L-carnitine in post-gonadal maturation of mammalian spermatozoa. Hum Reprod Update. 1996;2(2):87-102. Review. [PubMed]
- Jeulin C, Dacheux JL, Soufir JC. Uptake and release of free L-carnitine by boar epididymal spermatozoa in vitro and subsequent acetylation rate. J Reprod Fertil. 1994;100(1):263-71. [PubMed]
- Arduini A. Carnitine and its acyl esters as secondary antioxidants? Am Heart J. 1992;123(6):1726-7. [PubMed]
- Sigman M, Glass S, Campagnone J, Pryor JL. Carnitine for the treatment of idiopathic astheno-spermia: a randomized, double-blind, placebo-controlled trial. Fertil Steril. 2006;85(5):1409-14. [PubMed]
- Hinton BT, Snoswell AM, Setchell BP. The concen-tration of carnitine in the luminal fluid of the testis and epididymis of the rat and some other mammals. J Reprod Fertil. 1979;56(1):105-11. [PubMed]
- Zöpfgen A, Priem F, Sudhoff F, Jung K, Lenk S, Loening SA, et al. Relationship between semen quality and the seminal plasma components carnitine, alpha-glucosidase, fructose, citrate and granulocyte elastase in infertile men compared with a normal population. Hum Reprod. 2000;15 (4):840-5. [PubMed]
- Lewin LM, Beer R, Lunenfeld B. Epididymis and seminal vesicle as sources of carnitine in human seminal fluid: the clinical significance of the carni-tine concentration in human seminal fluid. Fertil Steril. 1976;27(1):9-13. [PubMed]
- Menchini-Fabris GF, Canale D, Izzo PL, Olivieri L, Bartelloni M. Free L-carnitine in human semen: its variability in different andrologic pathologies. Fertil Steril. 1984;42(2):263-7. [PubMed]
- Lenzi A, Lombardo F, Sgrò P, Salacone P, Caponecchia L, Dondero F, et al. Use of carnitine therapy in selected cases of male factor infertility: a double-blind crossover trial. Fertil Steril. 2003; 79(2):292-300. [PubMed]
- Moncada ML, Vicari E, Cimino C, Calogero AE, Mongioì A, D'Agata R. Effect of acetylcarnitine treatment in oligoasthenospermic patients. Acta Eur Fertil. 1992;23(5):221-4. [PubMed]
- Vitali G, Parente R, Melotti C. Carnitine supple-mentation in human idiopathic asthenospermia: clinical results. Drugs Exp Clin Res. 1995;21(4): 157-9. [PubMed]
- Costa M, Canale D, Filicori M, D'lddio S, Lenzi A. L-carnitine in idiopathic asthenozoospermia: a multicenter study. Italian Study Group on Carnitine and Male Infertility. Andrologia. 1994;26(3):155-9. [PubMed]
- Balercia G, Regoli F, Armeni T, Koverech A, Mantero F, Boscaro M. Placebo-controlled double-blind randomized trial on the use of L-carnitine, L-acetylcarnitine, or combined L-carnitine and L-acetylcarnitine in men with idiopathic asthenozoo-spermia. Fertil Steril. 2005;84(3):662-71. [PubMed]
- Zhou X, Liu F, Zhai S. Effect of L-carnitine and/or L-acetyl-carnitine in nutrition treatment for male infertility: a systematic review. Asia Pac J Clin Nutr. 2007;16(Suppl 1):383-90. [PubMed]