Human Reproduction, Vol. 16, No. 11, 2338-2342,
November 2001
© 2001 European Society of Human Reproduction and Embryology
Effects of treatment with carnitines in infertile patients with prostato-vesiculo-epididymitis
Section of Andrology, Endocrinology and Internal Medicine, Department of Biomedical Sciences, University of Catania, Italy
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 (<1x106/ml, group A, n = 34) or abnormal (>1x106/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.
Key words: carnitines/leucocytospermia/prostato-vesiculo-epididymitis/reactive oxygen species/sperm parameters
1 To whom correspondence should be addressed at: Cattedra di Endocrinologia, Dipartimento di Scienze Biomediche,Università di Catania, Ospedale Garibaldi, Piazza S. Maria Gesù, 95123 Catania, Italy. E-mail: acaloger{at}unict.it
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