Using L- and acetyl-L-carnintines in combination with clomiphene citrate and antioxidant complex for treating idiopathic male infertility: a prospective randomized trial

• Published in: Urologii͡a︡ (Moscow, Russia : 1999) no. 3; p. 22
• Main Authors: Bozhedomov, V A, Lipatova, N A, Bozhedomova, G E, Rokhlikov, I M, Shcherbakova, E V, Komarina, R A
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 01.07.2017
• Subjects: Acetylcarnitine - administration & dosage; Acetylcarnitine - pharmacology; Acetylcarnitine - therapeutic use; Adult; Antioxidants - administration & dosage; Antioxidants - pharmacology; Antioxidants - therapeutic use; Asthenozoospermia - drug therapy; Clomiphene - administration & dosage; Clomiphene - pharmacology; Clomiphene - therapeutic use; Drug Therapy, Combination; Humans; Male; Middle Aged; Minerals - administration & dosage; Minerals - pharmacology; Minerals - therapeutic use; Oligospermia - drug therapy; Selenium - administration & dosage; Selenium - pharmacology; Selenium - therapeutic use; Semen - drug effects; Sperm Motility - drug effects; Spermatozoa - drug effects; Teratozoospermia - drug therapy; Vitamins - administration & dosage; Vitamins - pharmacology; Vitamins - therapeutic use; Zinc - administration & dosage; Zinc - pharmacology; Zinc - therapeutic use; anti-estrogens; clomiphene citrate; carnitine; male infertility; anti-oxidants
• ISSN: 1728-2985
• DOI: 10.18565/urol.2017.3.22-32

The most common cause of male infertility is idiopathic oligo-, and or astheno-, and /or teratozoospermia. In such cases, anti-estrogens, antioxidants (vitamins and trace elements) or carnitines are used, but the evidence on their effectiveness is inconsistent; there are currently no published studies exploring their concurrent use. To investigate the efficacy and safety of the L- and acetyl-L-carnitine complex, vitamins A, E, C, selenium, zinc and other antioxidants ("SpermActin" + "More than vitamins") in combination with clomiphene citrate (CC) in managing male idiopathic infertility in the form of oligo, and/or astheno-, and/or teratozoospermia. The study comprised 173 men from infertile couples aged 25-45 years who were divided into two groups - the study group (n=88) and control group (n=85). All the patients were examined according to the WHO recommendations. Patients of the study group received L-carnitine fumarate (1 g), acetyl-L-carnitine (0.5 g) twice daily, a complex of vitamins and microelements and CC 25 mg twice daily orally. Patients of the control group were administered the same dosages of CC and a complex of vitamins. Ejaculate was evaluated before and after 3-4 months of treatment. Six months after the start of treatment, information about the onset or absence of pregnancy over the last six months was collected via telephone or online survey. Co-administration of L- and acetyl-L-carnitines concurrently with CC and antioxidant complex (vitamins and minerals) in patients with idiopathic oligo- and/or asteno- and/or teratozoospermia provides some additional positive effect on the concentration of spermatozoa, more pronounced in patients with multiple impaired semen parameters - oligoasthenoteratozoospermia, but does not improve the morphology, progressive sperm motility and pregnancy rates compared to patients receiving basic treatment.