title: Comparison of the effect of a combination of eight micronutrients versus a standard mono preparation on sperm parameters.
abstract: BACKGROUND
  There are reports showing that l-carnitine alone or in combination with other micronutrients improve sperm parameters. However, comparative studies are still lacking. This study was carried out to compare the short term effects of a combination of eight micronutrients including l-carnitine vs. a mono-substance (l-carnitine alone) on sperm parameters.
  
  
  METHODS
  This was a prospective, open-labelled, nonrandomized study that included male subjects (20 to 60 years) with at least 1 year of subfertility and at least one pathological semen analysis who received 3 months treatment with a mono-substance (500 mg l-carnitine/twice a day, n = 156) or a combined compound (440 mg l-carnitine + 250 mg l-arginine + 40 mg zinc + 120 mg vitamin E + 80 mg glutathione + 60 μg selenium + 15 mg coenzyme Q10 + 800 μg folic acid/once a day, n = 143) for the same time period. Sperm parameters were analyzed before and after treatment and groups comparisons performed.
  
  
  RESULTS
  Baseline characteristics were similar among studied groups (age and body mass indices). Semen parameters (volume, density, overall progressive motility [including slow and fast motility]) and percentage of sperm with normal morphology improved after 3 months in both groups as compared to baseline. However, relative change (expressed as % increase of absolute values) for sperm density and overall progressive motility (including fast motility) was found to be higher for the combined micronutrient treatment group as compared to the mono-treatment using l-carnitine alone.
  
  
  CONCLUSIONS
  Both analyzed groups displayed a positive short term effect on all sperm parameters; however effect on density and motility was significantly better for the combined formulation. There is need for more research in this matter that includes long term outcome data.
  
  
  BACKGROUND
  Retrospectively registered at ISRCTN (7th October 2016). Study ID: ISRCTN48594239.
authors.affiliation: IMI Fertility Center, Vienna, Austria. markus@lipovac.at.|Karl Landsteiner Institute for cell-based therapy in Gynecology, Wiener Ring 3-5, 2100, Korneuburg, Austria. markus@lipovac.at.
authors.forename: Markus
authors.identifier: http://orcid.org/0000-0003-3583-6601
authors.initials: M
authors.lastname: Lipovac
authors.affiliation: IMI Fertility Center, Vienna, Austria.|Karl Landsteiner Institute for cell-based therapy in Gynecology, Wiener Ring 3-5, 2100, Korneuburg, Austria.
authors.forename: Florian
authors.initials: F
authors.lastname: Bodner
authors.affiliation: IMI Fertility Center, Vienna, Austria.|Karl Landsteiner Institute for cell-based therapy in Gynecology, Wiener Ring 3-5, 2100, Korneuburg, Austria.|Medical University of Vienna, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Imhof
authors.affiliation: Institute of Biomedicine, Research Area for Women's Health, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
authors.forename: Peter
authors.initials: P
authors.lastname: Chedraui
mesh_terms: D000328:Adult; D001120:Arginine / Q000627:therapeutic use; D002331:Carnitine / Q000627:therapeutic use; D004338:Drug Combinations; D005492:Folic Acid / Q000627:therapeutic use; D005978:Glutathione / Q000627:therapeutic use; D006801:Humans; D007248:Infertility, Male / Q000188:drug therapy*; D008297:Male; D018977:Micronutrients / Q000627:therapeutic use*; D008875:Middle Aged; D012643:Selenium / Q000627:therapeutic use; D055101:Semen Analysis; D013076:Sperm Count; D013081:Sperm Motility / Q000187:drug effects; D013094:Spermatozoa / Q000187:drug effects*; D014451:Ubiquinone / Q000031:analogs & derivatives / Q000627:therapeutic use; D014810:Vitamin E / Q000627:therapeutic use; D015032:Zinc / Q000627:therapeutic use
chemical_list: D004338:Drug Combinations; D018977:Micronutrients; D014451:Ubiquinone; D014810:Vitamin E; D005492:Folic Acid; D001120:Arginine; C024989:coenzyme Q10; D005978:Glutathione; D012643:Selenium; D015032:Zinc; D002331:Carnitine
keywords: Combined treatment; Micronutrients; Mono-treatment; Sperm parameters; l-carnitine