Effects of treatment with carnitines in infertile patients with prostato-vesiculo-epididymitis.
BACKGROUND
We have recently shown that patients with prostato-vesiculo-epididymitis (PVE) have a greater reactive oxygen species (ROS) overproduction than patients with prostatitis or prostato-vesiculitis. Since this biochemical stress persists even after treatment with antimicrobials, it may relate to an imbalance between pro- and anti-oxidant factors at the epididymal level.


METHODS
To evaluate the effects of antioxidant treatment of patients with PVE, whether in the presence or absence of pro-oxidant factors, abacterial PVE infertile patients with normal (<1x10(6)/ml, group A, n = 34) or abnormal (>1x10(6)/ml, group B, n = 20) seminal white blood cell (WBC) concentrations received carnitines (L-carnitine 1 g and acetyl-carnitine 0.5 g twice/day) for 3 months followed by a wash-out period of 3 months. Semen parameters, ROS production and pregnancy outcome were evaluated before, during and following carnitine treatment.


RESULTS
Carnitines increased sperm forward motility and viability in group A patients. This was associated with a significant reduction in ROS production which persisted during wash-out. Carnitines increased only the percentage of viable spermatozoa in group B patients. Within 3 months after the discontinuation of carnitines, the rate of spontaneous pregnancy in group A patients was significantly higher than that of group B patients, being 11.7% (4/34) compared with 0%.


CONCLUSIONS
These results indicate that carnitines are only an effective treatment in patients with abacterial PVE and elevated ROS production when seminal WBC concentration is normal.
Vicari
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Section of Andrology, Endocrinology and Internal Medicine, Department of Biomedical Sciences, University of Catania, Italy. acalogere@unict.it
Calogero
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AE
D000108:Acetylcarnitine / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use; D002331:Carnitine / Q000008:administration & dosage / Q000627:therapeutic use*; D004823:Epididymitis / Q000150:complications / Q000188:drug therapy*; D005832:Genital Diseases, Male / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007248:Infertility, Male / Q000150:complications* / Q000378:metabolism / Q000628:therapy; D007958:Leukocyte Count; D008297:Male; D011247:Pregnancy; D011472:Prostatitis / Q000150:complications / Q000188:drug therapy*; D017382:Reactive Oxygen Species / Q000378:metabolism; D012661:Semen / Q000166:cytology; D012669:Seminal Vesicles; D013076:Sperm Count; D013081:Sperm Motility; D013094:Spermatozoa / Q000002:abnormalities; D013737:Testis
D000975:Antioxidants; D017382:Reactive Oxygen Species; D000108:Acetylcarnitine; D002331:Carnitine