Effects of treatment with carnitines in infertile patients with prostato-vesiculo-epididymitis

Hum Reprod. 2001 Nov;16(11):2338-42. doi: 10.1093/humrep/16.11.2338.

Abstract

Background: We have recently shown that patients with prostato-vesiculo-epididymitis (PVE) have a greater reactive oxygen species (ROS) overproduction than patients with prostatitis or prostato-vesiculitis. Since this biochemical stress persists even after treatment with antimicrobials, it may relate to an imbalance between pro- and anti-oxidant factors at the epididymal level.

Methods: To evaluate the effects of antioxidant treatment of patients with PVE, whether in the presence or absence of pro-oxidant factors, abacterial PVE infertile patients with normal (<1x10(6)/ml, group A, n = 34) or abnormal (>1x10(6)/ml, group B, n = 20) seminal white blood cell (WBC) concentrations received carnitines (L-carnitine 1 g and acetyl-carnitine 0.5 g twice/day) for 3 months followed by a wash-out period of 3 months. Semen parameters, ROS production and pregnancy outcome were evaluated before, during and following carnitine treatment.

Results: Carnitines increased sperm forward motility and viability in group A patients. This was associated with a significant reduction in ROS production which persisted during wash-out. Carnitines increased only the percentage of viable spermatozoa in group B patients. Within 3 months after the discontinuation of carnitines, the rate of spontaneous pregnancy in group A patients was significantly higher than that of group B patients, being 11.7% (4/34) compared with 0%.

Conclusion: These results indicate that carnitines are only an effective treatment in patients with abacterial PVE and elevated ROS production when seminal WBC concentration is normal.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylcarnitine / administration & dosage
  • Acetylcarnitine / therapeutic use
  • Adult
  • Antioxidants / administration & dosage
  • Antioxidants / therapeutic use
  • Carnitine / administration & dosage
  • Carnitine / therapeutic use*
  • Epididymitis / complications
  • Epididymitis / drug therapy*
  • Female
  • Genital Diseases, Male / complications
  • Genital Diseases, Male / drug therapy*
  • Humans
  • Infertility, Male / complications*
  • Infertility, Male / metabolism
  • Infertility, Male / therapy
  • Leukocyte Count
  • Male
  • Pregnancy
  • Prostatitis / complications
  • Prostatitis / drug therapy*
  • Reactive Oxygen Species / metabolism
  • Semen / cytology
  • Seminal Vesicles*
  • Sperm Count
  • Sperm Motility
  • Spermatozoa / abnormalities
  • Testis

Substances

  • Antioxidants
  • Reactive Oxygen Species
  • Acetylcarnitine
  • Carnitine