{"title":"L-CARNITINE SUPPLEMENTATION BEFORE ASSISTED REPRODUCTION FOR MALE INFERTILITY","authors":"Gokalp Oner , Cansu Oner , Noor Nabi Junejo","doi":"10.1016/j.rbmo.2024.104593","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>L-Carnitine, a pivotal compound present in mammals, is essential for the transport of long-chain fatty acids across the inner mitochondrial membrane. L-Carnitine is used for male infertility enhancing sperm parameters and it may serve as a protective mechanism against the overproduction of reactive oxygen species in the testis, which can damage sperm. This protective effect is accomplished by increasing the expression and activity of antioxidant enzymes as it demonstrates the ability to enhance sperm quality and overall fertility (1). However, the optimal and effective dosages for treatment has not been determined, yet.</div><div>In this retrospective multicentric study we aimed to find the effective dosages to improve the sperm parameters, embryo quality, and pregnancy rates of intracytoplasmic sperm injection (ICSI).</div></div><div><h3>Materials and Methods</h3><div>The ethic commitee approval was taken from Istanbul Aydin University (31-2024). 600 asthenoteratozoospermia men divided to 4 groups. Group1 is control, group 2 take 500 mg L-carnitine per daily before 3 months of ICSI attempt, group 3 take 1000 mg L-carnitine per daily before 3 months of ICSI attempt, group 4 take 2000 mg L-carnitine per daily before 3 months of ICSI attempt. There has been no female factor included in this study such as low ovarian reserve, advanced maternal aged, genetic problem, endometriosis, uterine anomalies, and hydrosalpinges.</div></div><div><h3>Results</h3><div>The clinical properties of the patients are summarized in Table 1. After carnitine usage, the sperm volume of the groups are similar. Sperm counts are significantly higher in group 3 and 4. Similarly sperm motility morphology are significantly increased in Group 3 and 4. Embryo quality is better in group2 and best in group 3 and 4 comparing the control. The chemical and clinical pregnancies are significantly high in group 4.</div></div><div><h3>Discussion and conclusion</h3><div>L-Carnitine demonstrates potential as a therapeutic intervention to enhance male fertility and mitigate sperm-related problems. There has been lots of study and different dosages found in these studied to improve sperm parameters (2). This multicentric study shows that 2000 mg L-carnitine levels is effective to enhance sperm parameters and get good quality embryos for assisted reproduction technology (ART). Additionaly, pregnancy rates are preferable if the L-carnitine has been begun before the assisted reproduction technology for asthenoteratozoospermia. Therefore, if there has been no female factor, L-carnitine may be started to men before ART attempts to improve sperm parameters, embryo quality, and pregnancy rates in ART.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104593"},"PeriodicalIF":3.7000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reproductive biomedicine online","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S147264832400782X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
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Abstract
Objective
L-Carnitine, a pivotal compound present in mammals, is essential for the transport of long-chain fatty acids across the inner mitochondrial membrane. L-Carnitine is used for male infertility enhancing sperm parameters and it may serve as a protective mechanism against the overproduction of reactive oxygen species in the testis, which can damage sperm. This protective effect is accomplished by increasing the expression and activity of antioxidant enzymes as it demonstrates the ability to enhance sperm quality and overall fertility (1). However, the optimal and effective dosages for treatment has not been determined, yet.
In this retrospective multicentric study we aimed to find the effective dosages to improve the sperm parameters, embryo quality, and pregnancy rates of intracytoplasmic sperm injection (ICSI).
Materials and Methods
The ethic commitee approval was taken from Istanbul Aydin University (31-2024). 600 asthenoteratozoospermia men divided to 4 groups. Group1 is control, group 2 take 500 mg L-carnitine per daily before 3 months of ICSI attempt, group 3 take 1000 mg L-carnitine per daily before 3 months of ICSI attempt, group 4 take 2000 mg L-carnitine per daily before 3 months of ICSI attempt. There has been no female factor included in this study such as low ovarian reserve, advanced maternal aged, genetic problem, endometriosis, uterine anomalies, and hydrosalpinges.
Results
The clinical properties of the patients are summarized in Table 1. After carnitine usage, the sperm volume of the groups are similar. Sperm counts are significantly higher in group 3 and 4. Similarly sperm motility morphology are significantly increased in Group 3 and 4. Embryo quality is better in group2 and best in group 3 and 4 comparing the control. The chemical and clinical pregnancies are significantly high in group 4.
Discussion and conclusion
L-Carnitine demonstrates potential as a therapeutic intervention to enhance male fertility and mitigate sperm-related problems. There has been lots of study and different dosages found in these studied to improve sperm parameters (2). This multicentric study shows that 2000 mg L-carnitine levels is effective to enhance sperm parameters and get good quality embryos for assisted reproduction technology (ART). Additionaly, pregnancy rates are preferable if the L-carnitine has been begun before the assisted reproduction technology for asthenoteratozoospermia. Therefore, if there has been no female factor, L-carnitine may be started to men before ART attempts to improve sperm parameters, embryo quality, and pregnancy rates in ART.
期刊介绍：
Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients.
Context:
The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy.
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