DOI: https://doi.org/10.30841/2307-5090.1.2018.144143

Antioxidants in the treatment of male infertility

І. І. Горпинченко, М. Г. Романюк, П. В. Аксьонов, Ю. Ф. Балацька, М. М. Лисенко

Abstract


The objective: the study was to determine the efficacy of the drugs containing L-carnitine (Novofertil and Novocarnitine) in certain cases of male infertility. The study is prospective and controlled.

Materials and methods. One hundred patients (aged 20–40 years) with anamnesis of infertility with such parameters of spermogram – concentration 10–20×106/ml, total motility 10–30%, progressive motility <15%, atypical forms <70%, speed 10–30 μm/s, linearity <4. 86 patients completed the study. Patients received Novofertil therapy 1 capsule 2 times a day and Novocarnitine 1 vial 3.00 g ones per day or basic therapy (vitamins E and C, zinc, selenium); before the therapy was a 2-month washout period, then 2 months of Novofertil /base therapy, 2 months of followup, the next 2 months of cross therapy (basic therapy / Novofertil). The main parameters studied were spermogram parameters, in particular, motility.

Results. Against the background of the use of Novofertil and Novocarnitine, there was a significant improvement in the parameters of total and progressive sperm motility, sperm concentration (compared with baseline). Improvement of motility was more pronounced in patients with worse motility rates, in particular <5 mln of progressively motile spermatozoa in the ejaculate and <2 million in ml.

Conclusion. Based on a controlled study, the efficacy of Novofertil and Novocarnitineis effective in improving sperm quality, especially in groups with lower initial parameters.

Keywords


fertility; male infertility; oligozoospermia; L-carnitine; motility of spermatozoa; mitochondria

References


Carlsen E, Giwercman A, Keiding N, Skakkebaek NE. Evidence for decreasing quality of semen during the past 50 years. Br Med J 1992;305:609–13. https://doi.org/10.1136/bmj.305.6854.609

Auger J, Kunstmann JM, Czyglik F, Jouannet P. Decline in semen quality among fertile men in Paris during the past 20 years. N Engl J Med 1995;332:281–5. https://doi.org/10.1056/NEJM199502023320501

Gandini L, Lombardo F, Culasso F, Dondero F, Lenzi A. Myth and reality of the decline in semen quality: an example of the relativity of data interpretation. J Endocrinol Invest 2000;23:402–11. https://doi.org/10.1007/BF03343745

Swan SH, Elkin EP, Fenster L. The question of declining sperm density revisited, an analysis of 101 studies published 1934–1996. Environ Health Perspect 2000;108:961–6. https://dx.doi.org/10.1289%2Fehp.00108961

WHO manual for the standardized investigation, diagnosis and management of the infertile male. Rowe P, Comhaire F, Hargreave B, Mahmoud A, eds. Cambridge: Cambridge University Press: 2000:37–60.

Nieschlag E. Care for the infertile male. Clin Endocrinol 1993;38:123– 33. https://doi.org/10.1111/j.1365-2265.1993.tb00983.x

O’Donovan PA, Vandekerckhove P, Lilford RJ, Hughes E. Treatment of male infertility: Is it effective? Review and Meta-analyses of published randomized controlled trials. Hum Reprod 1993;8:1209–22. http://dx.doi.org/10.1093/oxfordjournals.humrep.a138230

Kamischke A, Nieschlag E. Analysis of medical treatment of male infertility. Hum Reprod 1999;14(Suppl 1):1–23. https://doi.org/10.1093/humrep/14.suppl_1.1

Adamopoulos DA. Present and future therapeutic strategies for idiopathic oligozoospermia. Int J Androl 2000;23:320–31. https://doi.org/10.1046/j.1365-2605.2000.00258.x

Oehninger S. Clinical and laboratory management of male infertility: an opinion on its current status. J Androl 2000;21:814–21. https://doi.org/10.1002/j.1939-4640.2000.tb03411.x

Scottish Infertility Group. The effect of clomiphene citrate and vitamin C for male infertility: a randomized trial. Brit J Urol 1982;54:780–4. https://doi.org/10.1111/j.1464-410X.1982.tb13647.x

Scottish Infertility Group. The effect of mesterolone versus vitamin C for male infertility: a randomized trial. Brit J Urol 1984;56:740–4. https://doi.org/10.1111/j.1464-410X.1984.tb06160.x

Knuth UA, Honingl W, Bals-Pratsch M, Schleicher G, Nieschlag E. Treatment of severe oligozoospermia with hCG/hMG, a placebo-controlled, double blind trial. J Clin Endoc Metab 1987;65:1081–7. https://doi.org/10.1210/jcem-65-6-1081

World Health Organization. Mesterolone and idiopathic male infertility, a double blind study. Int J Androl 1989;12:254–64. http://dx.doi.org/10.1111/j.1365-2605.1989.tb01312.x

World Health Organization. A double-blind trial of clomiphene citrate for the treatment of idiopathic male infertility. Int J Androl 1992;15: 299–307. https://doi.org/10.1111/j.1365-2605.1992.tb01129.x

Lenzi A, Culasso F, Gandini L, Lombardo, Dondero F. Placebo-controlled, double-blind, cross-over trial of glutathione therapy in male infertility. Hum Reprod 1993;8:1657–62. http://dx.doi.org/10.1093/oxfordjournals.humrep.a137909

Keck C, Behre HM, Jockenhovel F, Nieschlag E. Ineffectiveness of kallikrein in treatment of idiopathic male infertility: a double-blind, randomized, placebo-controlled trial. Hum Reprod 1994;9:325–9. https://doi.org/10.1093/oxfordjournals.humrep.a138501

Kessopoulou E, Powers HJ, Sharma KK, Pearson MJ, Russell JM, Cooke ID, et al. A double blind randomized placebo controlled trial using the antioxidant vitamin E to treat oxygen species associated male infertility. Fertil Steril 1995;64:825–31. https://doi.org/10.1016/S0015-0282(16)57861-3

Vandekerckhove P, Lilford R, Hughes E. The medical treatment of idiopathic oligo/asthenospermia, androgens (mesterolone or testosterone) versus placebo or no treatment. In: Lilford R, Hughes E, Vandekerckhove P, eds. Subfertility module of the Cochrane database of systematic reviews. Oxford: The Cochrane Library, Update Software,1996.

Vandekerckhove P, Lilford R, Hughes E. The medical treatment of oligo/asthenospermia, anti-oestrogens (clomiphene or tamoxifen) versus placebo or no treatment. In: Lilford R, Hughes E, Vandekerckhove P, eds. Subfertility module of the Cochrane database of systematic reviews. Oxford: The Cochrane Library, Update Software, 1998.

Kamischke A, Behre HM, Bergmann M, Simoni M, Schafer T, Nieschlag E. Recombinant human follicle stimulating hormone for treatment of male idiopathic infertility: a randomized, double-blind, placebo– controlled, clinical trial. Hum Reprod 1998;13:596–603. https://doi.org/10.1093/humrep/13.3.596

Rolf C, Cooper TG, Yeung CH, Nieschlag E. Antioxidant treatment of patients with asthenozoospermia a moderate oligoasthenozoospermia with high-dose vitamin C and vitamin E: a randomized, placebocontrolled, double blind study. Hum Reprod 1999;14:1028–33. https://doi.org/10.1093/humrep/14.4.1028

Lenzi A, Picardo M, Gandini L, Lombardo F, Terminali O, Passi S, et al. Glutathione treatment of dyspermia: effect on the lipoperoxidation process. Hum Reprod 1994;9:2044–50. https://doi.org/10.1093/oxfordjournals.humrep.a138391

Lenzi A, Picardo M, Gandini L, Dondero F. Lipids of sperm plasma membrane: from polyunsaturated fatty acid considered as markers of sperm function to possible scavenger therapy. Hum Reprod Update 1996;2:246–56. https://doi.org/10.1093/humupd/2.3.246

Lenzi A, Gandini L, Picardo M. A rationale for glutatione therapy. In debate on: is antioxidant therapy a promising strategy to improve human reproduction? Hum Reprod 1998;13:1419–22. https://doi.org/10.1093/oxfordjournals.humrep.a019708

Frenkel RA, Mc Garry JD, eds. Carnitine biosyntesis, metabolism and function. [Italian edition] New York: Academic Press, 1984.

Peluso G, Nicolai R, Reda E, Benatti P, Barbarisi A, Calvani M. Cancer and anticancer therapy-induced modifications on metabolism mediated by carnitine system. J Cell Physiol 2000;182:339–50. https://doi.org/10.1002/(SICI)1097-4652(200003)182:3%3C339::AID-JCP4%3E3.0.CO;2-B

Arduini A. Carnitine and its acyl esters as secondary antioxidants? Am Heart J 1992;123:1726–7. https://doi.org/10.1016/0002-8703(92)90850-U

Costa M, Canale D, Filicori M, D’Iddio S, Lenzi A. L-carnitine in idiopathic asthenozoospermia, a multicenter study. Andrologia 1994; 26:155–9. https://doi.org/10.1111/j.1439-0272.1994.tb00780.x

Vicari E, Calogero AE. Effects of treatment with carnitines in infertile patients with prostato-vesiculo-epididymitis. Hum Reprod 2001;16: 2338–42. https://doi.org/10.1093/humrep/16.11.2338

World Health Organization. Laboratory manual for the examination of human semen and semen-cervical mucus interaction, 4th ed. Cambridge: Cambridge University Press, 1999.

Soufir JC, Marson J, Jouannet P. Free L-carnitine in human seminal plasma. Int J Androl 1981;4:388–97. https://doi.org/10.1111/j.1365-2605.1981.tb00723.x

Aitken RJ, Clarkson JS, Fishel S. Generation of reactive oxygen species, lipid peroxidation and human sperm function. Biol Reprod 1989; 41:183–97. https://doi.org/10.1095/biolreprod41.1.183

Gandini L, Menditto A, Chiodo F, Lenzi A. Italian pilot study for an external quality control scheme in semen analysis and antisperm antibiotics detection. Int J Androl 2000;23:1–3. https://doi.org/10.1046/j.1365-2605.2000.00208.x

Lenzi A. Computer-aided semen analysis (CASA) 10 years later, a test-bed for the European scientific andrological community. Int J Androl 1997;20:1–2. https://doi.org/10.1046/j.1365-2605.1997.00107.x

Dondero F, Gandini L, Lombardo F, Salacone P, Caponecchia L, Lenzi A. Antisperm antibody detection: 1. Methods and standard protocol. Am J Reprod Immunol 1997;38:218–23. https://doi.org/10.1111/j.1600-0897.1997.tb00302.x

Bolton S. Pharmaceutical statistics practical and clinical application. New York: Marcell Dekker, 1997:410–5.

Nieschlag E, Leifke E. Empirical therapies for male idiopathic infertility. In: Nieschlag E, Behre G, eds. Andrology: male reproductive health and dysfunction. Berlin: Springer Verlag, 1997:313–24.

Ruiz-Pesini E, Alvarez E, Enriquez JA, Lopez-Perez MJ. Association between seminal plasma carnitine and mitochondrial enzymatic activities. Int J Androl 2001;24:335–40. https://doi.org/10.1111/j.1365-2605.2001.00311.x

Comhaire F. Clinical andrology: from evidence-base to ethics. The “E” quintet in clinical andrology. Hum Reprod 2000;15:2067–71. https://doi.org/10.1093/humrep/15.10.2067

Radford JA. Is prevention of sterility possible in men? Ann Oncol 2000;11(Suppl 3):173–4. https://doi.org/10.1093/annonc/11.suppl_3.173

Sandlow JI. Shattering the myths about male infertility. Treatment of male factors may be more successful and costeffective than you think. Postgrad Med 2000;107:235–9. https://doi.org/10.3810/pgm.2000.02.902

Falcone T. What the internist needs to know about infertility. Cleve Clin J Med 2001;68:65–72.

Giancarlo Balercia, Francesko Regoli, Tatiana Armeni, Aleardo Koverech, Franco Mantero, Marco Boscaro. Placebo-controlled double-blind randomized trial on the use of L-carnitine, L-acetylcarnitine, or combined L-carnitine and L-acetylcarnitine in men with idiopathic asthenozoospermia. Fertility and Sterility 2005;84(3): 662-71. https://doi.org/10.1016/j.fertnstert.2005.03.064

Jehan J. Aram, Kassim J. Al-Shamma, Ansam N. Al-Hassani, Effect of L-carnitine, Multivitamins and their Combination in the Treatment of Idiopathic Male Infertility. Iraqi J Pharm Sci, Vol.21(1) 2012




Copyright (c) 2020 І. І. Горпинченко, М. Г. Романюк, П. В. Аксьонов, Ю. Ф. Балацька, М. М. Лисенко

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

ISSN 2412-5547 (Online), ISSN 2307-5090 (Print)