Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
권호 표지

Nonspecific Empirical Medical Therapy with Acetylcarnitine Effective in Oligoasthenospermic Men?

불임남성에서 Acetylcarnitine이 정액지표에 미치는 영향

  • Kim, Jong-Woo (Department of Urology Sungkyunkwan University School of Medicine) ;
  • Lee, Jae-Seok (Department of Urology Sungkyunkwan University School of Medicine) ;
  • Park, Jeong-Su (Department of Urology, Bundang Jesaeng Hospital) ;
  • Kim, Won-Tae (Department of Urology Sungkyunkwan University School of Medicine) ;
  • Seo, Ju-Tae (Department of Urology Sungkyunkwan University School of Medicine)
  • 김종우 (성균관대학교 의과대학 비뇨기과교실) ;
  • 이재석 (성균관대학교 의과대학 비뇨기과교실) ;
  • 박정수 (분당제생병원 비뇨기과) ;
  • 김원태 (성균관대학교 의과대학 비뇨기과교실) ;
  • 서주태 (성균관대학교 의과대학 비뇨기과교실)
  • Published : 2004.09.30
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Abstract

Purpose: To determine the efficacy of $Carnitil^{(R)}$ (acetylcarnitine, Hanmi, Korea) therapy in idiopathic oligoasthenospermic men. Materials and Methods: Forty-four subfertile men with abnormal semen parameters were treated between March, 2003 and March, 2004 with 3 g of $Carnitil^{(R)}$ daily for 3 months. Changes in semen parameters were evaluated 3 months after this therapy. Results: The mean age was 34.2 years and the mean follow-up duration was 3.7 months. In asthenospemic patients (n=28), semen analysis before and after $Carnitil^{(R)}$ treatment showed an increase in volume ($2.64{\pm}1.65\;ml$ vs. $3.10{\pm}1.60\;ml$), motility ($35.1{\pm}17.7%$ vs. $45.9{\pm}20.4%$) and viability ($51.4{\pm}20.3%$ vs. $59.3{\pm}13.6%$) respectively. In oligoasthenospermic patients (n=16), semen analysis before and after $Carnitil^{(R)}$ treatment showed an increase in sperm count ($10.7{\pm}54.4\;million/ml$ vs. $38.4{\pm}32.5\;million/ml$) respectively. Conclusions: These results suggested that in idiopathic oligoasthenospermic men the empirical medical therapy with acetylcarnitine may be considered as primary treatment.

Keywords

References

  1. Carlsen E, Giwercman A, Keiding N, Skakkebaek NE. Evidence for decreasing quality of semen during past 50 years. BMJ 1992; 305: 609-13 https://doi.org/10.1136/bmj.305.6854.609
  2. Gandini L, Lombardo F, Culasso F, Dondero F, Lenzi A. Myth and reality of the decline in semen quality: An example of the relativity of data interpretation. J Endocrinol Invest 2000; 23: 402-11
  3. Swan SH, Elkin EP, Fenster L. The question of decli- ning sperm density revisted: An analysis of 101 stu- dies published 1934-1996. Environ Health Perspect 2000; 108: 961-6 https://doi.org/10.2307/3435055
  4. Tremblay RR, Chapdelaine P, Roy R, Thabet M. Correlation between L-carnitine and alpha-1, 4-glu- cosidase activity in the semen of normal, infertile and vasectomized men. Infertility 1982; 5: 61-70
  5. Marquis NR, Fritz IB. Effects of testosterone on the distribution of carnitine, acetylcarnitine, and carnitine acetytransferase in tissues of the reproductive system of the male rat. J Biol Chem 1965; 240: 2197-200
  6. Frenkel J, Lewin LM. Investigation on carnitine deri- vatives in human seminal fluid. J Androl 1979; 2: 299-307 https://doi.org/10.1111/j.1365-2605.1979.tb00063.x
  7. Casillas ER. Accumulation of carnitine by bovine spermatozoa during maturation in the epididymis. J Biol Chem 1973; 248: 8227-32
  8. Guerin JF, Rollet J, Perrin P, Menezo Y, Orgiazzi A, Czyba JC. Enzymes in the seminal plasma from azo- ospermic men: Correlation with the origin of their azoospermia. Fertil Steril 1981; 36: 368-72 https://doi.org/10.1016/S0015-0282(16)45740-7
  9. Lenzi A, Lombardo F, Sgro P, Salacone P, Capone- cchia L, Dondero F, et. al. Use of carnitine therapy in selected cases of male factor infertility: A double- blind crossover trial. Fertil Steril 2003; 79: 292-300 https://doi.org/10.1016/S0015-0282(02)04679-4
  10. 박남철. 남성불임의 약물치료. In: 대한남성과학회, 남성과학, 제1판, 서울: 도서출판 군자출판사, 2003. p.108
  11. 대한비뇨기과학회. 비뇨기과학. 제3판. 서울: 도서출판 고려의학, 2001; 507
  12. 성인기, 정우식, 이무상. 남성불임증 진단에 있어서 부고환지표의 의의. 대한비뇨회지 1988; 29: 943-9
  13. 정병준, 김윤진, 최형민, 전명권, 이응수, 나오순. Progesterone 및 acetyl-L-carnitine이 정자의 동결-융해에 미치는 영향. 대한불임회지 2001; 28: 295-300
  14. 박남철. 남성불임에서 L-carnitine과 acetylcarni- tine에 의한 정액지표 개선 효과. 부산지방남성회지 2000; 3: 21-31
  15. Carter AL, Stratman FW, Hutson SM, et al. The role of carnitine and its esters in sperm metabolism. In: Frenkel RA, McGarry JD (eds), Carnitine, Biosyn- thesis, Metabolism and Functions. New York: Aca- demic Press; 1980. p.251
  16. Lenzi A, Lombardo F, Gandini L, Dondero F. Meta- bolism and action of L-carnitine: Its possible role in sperm tail function. Arch Ital Urol Nefrol Androl 1992; 64: 187-96
  17. Duru NK, Morshedi M, Schuffner A, Oehninger S. Semen treatment with progesterone and/or acetyl- L-carnitine does not improve sperm motility or mem- brane damage after cryopreservation-thawing. Fertil Steril 2000; 74: 715-20 https://doi.org/10.1016/S0015-0282(00)01494-1
  18. Butterfield DA, Rangachari A. Acetylcarnitine incre- ases membrane cytoskeletal protein-protein interacti- ons. Life Sci 1993; 52: 297-303 https://doi.org/10.1016/0024-3205(93)90221-N
  19. Ruiz-Pesini E, Alvarez E, Enriquez JA, Lopez-Perez MJ. Association between seminal plasma carnitine and sperm mitochondrial enzymatic activites. J An- drol 2001; 24: 335-40
  20. Vanella A, Russo A, Acquaviva R, Campisi A, Di Giacomo C, Sorrenti V, et al. L-propionyl-carnitine as superoxide scavenger, antioxidant, and DNA clea- vage protector. Cell Biol Toxicol 2000; 16: 99-104 https://doi.org/10.1023/A:1007638025856
  21. Tanphaichitr N. In vitro stimulation of human sperm motility by acetylcarnitine. Int J Fertil 1977; 22: 85- 91
  22. Vitali G, Parente R, Melotti C. Carnitine suppleme- ntation in human idiopathic asthenospermia: Clinical results. Drugs Exp Clin Res 1995; 21: 157-9
  23. Costa M, Canale D, Filicori M, D'lddio S, Lenzi A. L-carnitine in idiopathic asthenozoospermia: A mu- lticenter study. Italian Study Group on Carnitine and Male Infertility. Andrologia 1994; 26: 155-9 https://doi.org/10.1111/j.1439-0272.1994.tb00780.x
  24. Caviglia D, Scarabelli L, Palmero S. Effects of carn- itines on rat sertoli cell protein metabolism. Horm Metab Res 2004; 36: 221-5 https://doi.org/10.1055/s-2004-814451
  25. Moncada ML, Vicari E, Cimino C, Calogero AE, Mongioi A, D, Agata R. Effects of acetylcarnitine tre- atment in oligoasthenospermic patients. Acta Eur Fe- rtil 1992; 23: 221-4
  26. 이 완, 박남철. 생체외 L-carnitine과 acetylcarnitine의 정자지표 개선효과. 대한불임회지 2002; 29: 149-57