Double-blind, randomised, placebo-controlled trial on the effect of L-carnitine and L-acetylcarnitine on sperm parameters in men with idiopathic oligoasthenozoospermia

Andrologia. 2019 Jul;51(6):e13267. doi: 10.1111/and.13267. Epub 2019 Mar 15.


Carnitine is essential for energy metabolism and spermatozoa maturation. Combining L-carnitine and L-acetylcarnitine with micronutrients has been investigated as a treatment for infertility in men. We evaluated the effects of a therapeutic formulation, Proxeed Plus, on sperm parameters in oligoasthenozoospermic men. This prospective, randomised, double-blind, placebo-controlled clinical trial involved 175 males (19-44 years) with idiopathic oligoasthenozoospermia who failed to impregnate their partners (12 months). Males received Proxeed Plus or placebo for 3 and 6 months. Sperm volume, progressive motility and vitality significantly (p < 0.001) improved after 6 months compared to baseline. Sperm DNA fragmentation index significantly decreased compared to baseline (p < 0.001) and the 3-month therapy (p = 0.014) in treated men. Increased seminal carnitine and α-glucosidase concentration also positively correlated with improved progressive motility. Decreased DNA fragmentation index was the good predictor of progressive sperm motility >10%, and simultaneous measurement of changes in sperm vitality and DNA fragmentation index gave the highest probability of sperm motility 10% (AUC = 0.924; 95% CI = 0.852-0.996; p < 0.001). Logistic regression analyses revealed DNA fragmentation index decrease as the only independent predictor of sperm motility 10% (OR = 1.106; p = 0.034). We have demonstrated the beneficial effects of carnitine derivatives on progressive motility, vitality and sperm DNA fragmentation. Combining metabolic and micronutritive factors is beneficial for male infertility.

Keywords: L-acetylcarnitine; L-carnitine; male infertility; oligoasthenozoospermia; sperm parameters.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acetylcarnitine / administration & dosage*
  • Adult
  • Carnitine / administration & dosage*
  • DNA Fragmentation / drug effects
  • Double-Blind Method
  • Drug Combinations
  • Humans
  • Male
  • Micronutrients / administration & dosage*
  • Oligospermia / drug therapy*
  • Placebos / administration & dosage
  • Prospective Studies
  • Sperm Count
  • Sperm Maturation / drug effects
  • Sperm Motility / drug effects
  • Spermatozoa / drug effects*
  • Treatment Outcome


  • Drug Combinations
  • Micronutrients
  • Placebos
  • Acetylcarnitine
  • Carnitine