Use of carnitine therapy in selected cases of male factor infertility: a double-blind crossover trial.
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.
Lenzi
Andrea
A
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
Lombardo
Francesco
F
Sgrò
Paolo
P
Salacone
Pietro
P
Caponecchia
Luisa
L
Dondero
Franco
F
Gandini
Loredana
L
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
D010919:Placebos; D002331:Carnitine