Oxidative stress is one of the main mechanisms responsible for male infertility. Various conditions such as varicocele, obesity, advanced age, and lifestyle can lead to an increase in reactive oxygen species, causing an oxidative imbalance in the reproductive environment. Spermatozoa are sensitive to reactive oxygen species and require energy to carry out their main function of fertilizing the egg. Excessive reactive oxygen species can affect sperm metabolism, leading to immobility, impaired acrosome reaction, and cell death, thereby impairing reproductive success. This double-blind randomized study evaluated the effect of supplementation with L-carnitine, acetyl-L-carnitine, vitamins, and other nutrients on semen quality in 104 infertile patients with or without varicocele, while also investigating the impact of factors such as obesity and advanced age on treatment. Sperm concentration significantly increased in the supplemented group compared to the placebo group (P = 0.0186). Total sperm count also significantly increased in the supplemented group (P = 0.0117), as did sperm motility (P = 0.0120). The treatment had a positive effect on patients up to 35 years of age in terms of sperm concentration (P = 0.0352), while a body mass index (BMI) above 25 kg m-2 had a negative effect on sperm concentration (P = 0.0110). Results were not showing a net benefit in stratifying patients in accordance with their BMI since sperm quality increase was not affected by this parameter. In conclusion, antioxidant supplementation may be beneficial for infertile patients and has a more positive effect on younger patients with a normal weight.
Asian journal of andrology. 2024 Feb 02 [Epub ahead of print]
Gian Maria Busetto, Bernarde F Rodrigues, Ashraf Virmani, Andrea Checchia, Antonella Ninivaggi, Anna Ricapito, Giovanni Barbieri, Piero Fischetti, Ugo G Falagario, Pasquale Annese, Nicola d'Altilia, Vito Mancini, Matteo Ferro, Felice Crocetto, Angelo Porreca, Carlo Bettocchi, Luigi Cormio, Ashok Agarwal, Giuseppe Carrieri
University of Foggia, Foggia 71122, Italy., Department of Urology, Human Reproduction Section, Federal University of Sao Paulo, Sao Paulo 05403-000, Brazil., Alfasigma Healthscience, Utrecht 3528 BG, The Netherlands., Department of Urology and Renal Transplantation, Policlinico of Foggia, Foggia 71122, Italy., Urology Unit, European Institute of Oncology (IEO) IRCCS, Milan 20142, Italy., University of Naples Federico II, Naples 80126, Italy., Department of Oncological Urology, Veneto Institute of Oncology (IOV) IRCCS, Padua 35039, Italy., Global Andrology Forum, Moreland Hills, OH 44022, USA.