L-CARNITINE SUPPLEMENTATION BEFORE ASSISTED REPRODUCTION FOR MALE INFERTILITY

IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Reproductive biomedicine online Pub Date : 2024-11-01 Epub Date: 2024-12-04 DOI:10.1016/j.rbmo.2024.104593
Gokalp Oner , Cansu Oner , Noor Nabi Junejo
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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.
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辅助生殖前补充左旋肉碱治疗男性不育症
目的:肉碱是哺乳动物中存在的一种关键化合物,对长链脂肪酸在线粒体内膜上的运输至关重要。左旋肉碱用于男性不育症,增强精子参数,它可能作为一种保护机制,防止睾丸中活性氧的过量产生,这可能会损害精子。这种保护作用是通过增加抗氧化酶的表达和活性来实现的,因为它证明了提高精子质量和整体生育能力的能力(1)。然而,最佳和有效的治疗剂量尚未确定。本研究是一项多中心的回顾性研究,目的是寻找改善卵胞浆内单精子注射(ICSI)中精子参数、胚胎质量和妊娠率的有效剂量。材料与方法伦理委员会批准自伊斯坦布尔艾丁大学(31-2024)。将600例弱异精子症男性分为4组。组1为对照组,组2在ICSI尝试前3个月每日服用500 mg左旋肉碱,组3在ICSI尝试前3个月每日服用1000 mg左旋肉碱,组4在ICSI尝试前3个月每日服用2000 mg左旋肉碱。本研究未纳入卵巢储备不足、高龄产妇、遗传问题、子宫内膜异位症、子宫异常、输卵管积液等女性因素。结果患者的临床特征总结于表1。使用肉碱后,两组精子数量相近。第三组和第四组的精子数量明显更高。同样,第3组和第4组精子活力形态显著增加。与对照组相比,2组胚胎质量较好,3、4组最好。第4组化学妊娠和临床妊娠明显增高。讨论与结论左旋肉碱具有提高男性生育能力和减轻精子相关问题的治疗干预作用。有很多研究发现不同剂量的左旋肉碱可以改善精子参数(2)。这项多中心研究表明,2000毫克左旋肉碱水平可以有效提高精子参数,为辅助生殖技术(ART)获得高质量的胚胎。此外,如果在辅助生殖技术治疗弱异精子症之前就开始使用左旋肉碱,则怀孕率更高。因此,如果没有女性因素,在ART尝试改善精子参数、胚胎质量和妊娠率之前,男性可以开始使用左旋肉碱。
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来源期刊
Reproductive biomedicine online
Reproductive biomedicine online 医学-妇产科学
CiteScore
7.20
自引率
7.50%
发文量
391
审稿时长
50 days
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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