title: Use of carnitine therapy in selected cases of male factor infertility: a double-blind crossover trial.
abstract: OBJECTIVE
  To determine the efficacy of L-carnitine therapy in selected cases of male factor infertility.
  
  
  METHODS
  Placebo-controlled, double-blind, crossover trial.
  
  
  METHODS
  University tertiary referral center.
  
  
  METHODS
  One hundred infertile patients (ages 20-40 years) with the following baseline sperm selection criteria: concentration, 10-20 x 10(6)/mL; total motility, 10%-30%; forward motility, <15%; atypical forms, <70%; velocity, 10-30 micro/s; linearity, <4. Eighty-six patients completed the study.
  
  
  METHODS
  Patients underwent L-carnitine therapy 2 g/day or placebo; the study design was 2 months of washout, 2 months of therapy/placebo, 2 months of washout, and 2 months placebo/therapy.
  
  
  METHODS
  Variation in sperm parameters used in the patients selection criteria, in particular, sperm motility. Excluding outliers, a statistically significant improvement in semen quality, greater than after the placebo cycle, was seen after the L-carnitine therapy for sperm concentration and total and forward sperm motility. The increase in forward sperm motility was more significant in those patients with lower initial values, i.e., <5 x 10(6) or <2 x 10(6) of forward motile sperm/ejaculate or sperm/mL.
  
  
  CONCLUSIONS
  Based on a controlled study of efficacy, L-carnitine therapy was effective in increasing semen quality, especially in groups with lower baseline levels. However, these results need to be confirmed by larger clinical trials and in vitro studies.
authors.affiliation: Outpatient Department and Laboratory of Seminology and Reproductive Immunology at the Training Center in Andrology of the European Academy of Andrology, Rome, Italy. andrea.lenzi@uniroma1.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Lenzi
authors.forename: Francesco
authors.initials: F
authors.lastname: Lombardo
authors.forename: Paolo
authors.initials: P
authors.lastname: Sgrò
authors.forename: Pietro
authors.initials: P
authors.lastname: Salacone
authors.forename: Luisa
authors.initials: L
authors.lastname: Caponecchia
authors.forename: Franco
authors.initials: F
authors.lastname: Dondero
authors.forename: Loredana
authors.initials: L
authors.lastname: Gandini
mesh_terms: D002331:Carnitine / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D006801:Humans; D007248:Infertility, Male / Q000188:drug therapy*; D008297:Male; D010919:Placebos; D012661:Semen / Q000187:drug effects / Q000502:physiology*; D013076:Sperm Count; D013081:Sperm Motility / Q000187:drug effects*; D013094:Spermatozoa / Q000002:abnormalities / Q000187:drug effects
chemical_list: D010919:Placebos; D002331:Carnitine