Abstract
Introduction. In recent years, research has focused on the impact that diabetes mellitus (DM) has on male reproductive function. The available evidence has mainly considered type 2 DM (DM2). However, we have previously shown that type 1 DM (DM1) also affects male reproductive health. Given the efficacy of carnitine in the treatment of male infertility, a topic that merits further investigation is its role in the treatment of infertile patients with DM1. Aim. To investigate the efficacy of carnitines for the treatment of asthenozoospermia in DM1 patients. Methods. This was a two-arm single-blind, randomized control trial. The patients enrolled in this study were assigned to the group receiving L-acetylcarnitine (LAC) (1.5 g daily for 4 months) or to the group receiving LAC (same dosage) plus L-carnitine (LC) (2 g daily for 4 months). Serum-glycated hemoglobin levels did not differ significantly after either of the two treatments given. Administration of LAC plus LC showed greater efficacy on progressive sperm motility than single therapy (increase 14% vs. 1% after treatment, respectively). Discussion. The results of this study showed that the administration of LAC plus LC is more effective than the administration of LAC alone. The lower efficacy of LAC alone could be due to the lower overall administered dosage. Alternatively, a selective defect of carnitine transporters at an epididymal level could be hypothesized in patients with DM1. Further studies are needed to clarify this point.
Highlights
In recent years, research has focused on the impact that diabetes mellitus (DM) has on male reproductive function
The results of the present study showed that the administration of LAC (1.5 g daily for 4 months)—a treatment currently adopted in the andrological clinical practice to improve sperm motility [8] is not effective for the treatment of asthenozoospermia in DM1 patients
The concomitant administration of LAC plus LC (2 g daily) to age-matched DM1 patients was shown to be efficacious in improving progressive sperm motility
Summary
Scientific interest for the potential male reproductive consequences of diabetes mellitus (DM) has been growing [1]. A recent meta-analysis has shown a significant decrease in the volume of ejaculate in DM1 patients [7]. Total and free carnitine levels have been reported to be low in patients with DM1 This decrease is related to the duration of the disease, and could potentially affect long-term complications in these patients [10,11,12]. We have no evidence regarding the consequences of this deficiency on sperm parameters or the effects of integration in DM1 patients [10,11,12]. The present study was undertaken to evaluate the effects on sperm parameters of the administration of LAC alone or in combination with LC in DM1 patients with asthenozoospermia
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