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 asthenozoospermia.
OBJECTIVE
To evaluate the effectiveness of L-carnitine (LC) or L-acetyl-carnitine (LAC) or combined LC and LAC treatment in improving semen kinetic parameters and the total oxyradical scavenging capacity in semen.


METHODS
Placebo-controlled, double-blind, randomized trial.


METHODS
Andrology unit, Department of Internal Medicine, Polytechnic University of Marche, Italy.


METHODS
Sixty infertile men, ages 20 to 40 years, with the following baseline sperm selection criteria: concentration > 20 x 10(6)/mL, sperm forward motility < 50%, and normal sperm morphology > 30%; 59 patients completed the study.


METHODS
Patients underwent a double-blind therapy of LC 3 g/d, LAC 3 g/d, a combination of LC 2 g/d and LAC 1 g/d, or placebo. The study design was 1 month of run in, 6 months of therapy or placebo, and 3 months of follow-up evaluation.


METHODS
Variations in semen parameters used for patient selection, and variations in total oxyradical scavenging capacity of the seminal fluid.


RESULTS
Sperm cell motility (total and forward, including kinetic features determined by computer-assisted sperm analysis) increased in patients to whom LAC was administered both alone or in combination with LC; combined LC + LAC therapy led to a significant improvement of straight progressive velocity after 3 months. The total oxyradical scavenging capacity of the semen toward hydroxyl and peroxyl radicals also increased and was positively correlated with the improvement of kinetic features. Patients with lower baseline values of motility and total oxyradical scavenging capacity of the seminal fluid had a significantly higher probability of responding to the treatment.


CONCLUSIONS
The administration of LC and LAC is effective in increasing sperm kinetic features in patients affected by idiopathic asthenozoospemia and improves the total oxyradical scavenging capacity of the seminal fluid in the same population.
Balercia
Giancarlo
G
Department of Internal Medicine, Polytechnic University of Marche, Ancona, Italy. g.balercia@ao-umbertoprimo.marche.it
Regoli
Francesco
F
Armeni
Tatiana
T
Koverech
Aleardo
A
Mantero
Franco
F
Boscaro
Marco
M
D000108:Acetylcarnitine / Q000008:administration & dosage*; D000704:Analysis of Variance; D002331:Carnitine / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000188:drug therapy* / Q000473:pathology; D010919:Placebos; D011247:Pregnancy; D013081:Sperm Motility / Q000187:drug effects* / Q000502:physiology
D010919:Placebos; D000108:Acetylcarnitine; D002331:Carnitine