Correlation between seminal carnitine and functional spermatozoal characteristics in men with semen dysfunction of various origins.
OBJECTIVE
L-carnitine is an essential molecule involved in mitochondrial metabolism, controlling the transport of acetyl and acyl groups across the mitochondrial inner membrane. Carnitine and acetylated carnitine (L-acetylcarnitine) are found in high concentrations in the epididymis, where they also act as antioxidants, protecting spermatozoa against damage caused by reactive oxygen species. In this open study we investigated the correlation between seminal carnitine levels and spermatozoal function, and the effect of combined L-carnitine + L-acetylcarnitine therapy, in infertile men.


METHODS
170 infertile men were enrolled in this study. Patients were divided into those with a total sperm motility below the normal WHO range (<50% motility, group 1 [n = 102]) and those with total sperm motility within the normal range (> or =50% motility, group 2 [n = 68]). Patients in group 1 were further divided into two groups: those with primary or secondary azoospermia (1B [n = 36]), and those without (1A [n = 66]). Patients in group 1A received L-carnitine 1 g/day and L-acetylcarnitine 500 mg twice daily for 6 months. Seminal carnitine levels were measured and correlated with sperm count and motility, eosin test, hypo-osmotic swelling test, acridine orange test for sperm nuclear DNA integrity and sperm kinetics evaluated by computer-assisted sperm analysis in all patients.


RESULTS
There was a significant correlation between seminal carnitine concentration and sperm concentration, total sperm count, sperm total motility, rapid forward progression, live sperm count, membrane function, nuclear DNA integrity, capacity for cervical mucus penetration, linearity of spermatic movement, and amplitude of lateral sperm head movement (all p < 0.0001) in the entire study population. In group 1A, there was a significant increase in total motility, live sperm count, membrane integrity and linearity of spermatic movement after 3 and 6 months of L-carnitine/L-acetylcarnitine treatment, and in capacity for cervical mucus penetration after 6 months of treatment, compared with baseline.


CONCLUSIONS
Seminal carnitine concentration may be an appropriate marker of sperm and epididymal function. L-carnitine/L-acetylcarnitine treatment may be an effective therapy to improve mainly functional seminal parameters.
De Rosa
Michele
M
Department of Molecular and Clinical Endocrinology and Oncology, University of Naples Federico II, Naples, Italy. miderosa@unina.it
Boggia
Bartolomeo
B
Amalfi
Biagio
B
Zarrilli
Stefano
S
Vita
Angela
A
Colao
Annamaria
A
Lombardi
Gaetano
G
D000108:Acetylcarnitine / Q000627:therapeutic use; D000165:Acridine Orange; D000328:Adult; D002331:Carnitine / Q000378:metabolism / Q000627:therapeutic use*; D004801:Eosine Yellowish-(YS); D006801:Humans; D007248:Infertility, Male / Q000188:drug therapy*; D008297:Male; D009845:Oligospermia / Q000188:drug therapy; D012661:Semen / Q000378:metabolism*; D013076:Sperm Count; D013081:Sperm Motility / Q000187:drug effects; D013084:Sperm-Ovum Interactions / Q000187:drug effects; D013094:Spermatozoa / Q000187:drug effects / Q000502:physiology* / Q000648:ultrastructure
D000108:Acetylcarnitine; D000165:Acridine Orange; D002331:Carnitine; D004801:Eosine Yellowish-(YS)