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Oligoastenospermic men treated with proxeed plus showed correlation between sperm motility and seminal carnitine

      Objective

      To study L-carnitine (LC) and acetyl-L-carnitine (ALC) which are involved in energy metabolism and promote sperm motility and maturation. Studies have reported either no effect or that therapy with combined high dose L-C and ALC significantly increase sperm parameters (forward motility and concentration).

      Design

      The study was randomized, double blind, placebo controlled (DBPC) and examined the effect of test formulation, Proxeed Plus, containing L-C 2g and ALC 1g, as well as antioxidants, vitamins and minerals, in men with oligo-asthenozoospermia. The protocol was 2 months wash-out and 6 months treatment (T-2, T0, T+3, T+6), with test formulation (125 patients) or placebo (50 patients).

      Materials and Methods

      Men visiting the Andrology center, (18-50 years) and with difficulty in conceiving >12 months, were randomized. Analysis of ejaculate was done according to WHO 5th guideline, and progressive sperm motility (A+B grade of rapid and progressive) was done manually. Statistical evaluation used McNemar-Boweker test, Spearman’s rank-order correlation test and Wilcoxon signed-rank test.

      Results

      In the treated group there was statistically significant difference, p=0.004 by McNemar-Boweker test, of progressive sperm motility in the three different time periods: T0=22.50% (11.50±38.00), T3=30.00% (12.00±39.00) and T6=31.00% (20.00±41.00). The seminal plasma carnitine at T0 was 700.50 micromol/L (625.50±800.00) and at T6=751.50 micromol/L (671.10±896.80), and alpha glucosidase at T0 was 25,50 U/L (20.00±44.70) and at T6=32.60 U/L (22.35±45.15) and both these differences were significant (p=0.014, by Wilcoxon signed-rank test). Further the Spearman’s rank-order correlation test showed that the increase of seminal carnitine (R=0.274; p=0.023) and alpha glucosidase (R=0.246; p=0.046) levels influenced the progressive sperm motility. Thus the correlation of seminal plasma carnitine (AUC=0.726) and alpha glucosidase (AUC=0.752) and progressive sperm motility showed that in man an increase of seminal carnitine of 7.7% and alpha glucosidase of 12%, after six months therapy, would impact progressive sperm motility >10% with moderate accuracy (AUC=0.726). In the placebo group there was no significant improvement in the progressive sperm motility.

      Conclusions

      This randomized DBPC study showed significant improvement in percentage of progressive sperm motility after six months of therapy and also underlines the importance of duration of therapy (3 and 6 months). The study demonstrated that an increase of seminal carnitine and glucosidase positively impacted upon the patient progressive sperm motility.