Reduction in sperm aneuploidy levels in severe oligoasthenoteratospermic patients after medical therapy: a preliminary report

Abstract

The objective of this study was to investigate whether medical therapy can reduce sperm aneuploidy levels and improve the results of intracytoplasmic sperm injection (ICSI) in patients with severe idiopathic oligoasthenoteratospermia (OAT). Thirty-three infertile couples requiring ICSI because of severe idiopathic OAT after at least one unsuccessful ICSI cycle were considered. Semen parameters (concentration, motility and morphology), the percentage of aneuploid sperm and the results of ICSI (the number of oocytes fertilized, embryos transferred, biochemical pregnancies, clinical pregnancies and live births) were compared before and after a 3-month course of treatment with L-carnitine 1 g given twice per day1acetyl-L-carnitine 500 mg given twice per day1one 30-mg cinnoxicam tablet every 4 days. Aneuploidy was assessed using fluorescent in situ hybridisation (FISH) performed on chromosomes X, Y, 13, 15, 16, 17, 18, 21 and 22. The results showed that 22 of the 33 patients had a reduced frequency of aneuploid sperm and improved sperm morphology after treatment (group 1), and 11 showed no change (group 2). The numbers of biochemical pregnancies, clinical pregnancies and live births were significantly higher in group 1 than in group 2. No significant difference was found between the groups regarding the numbers of oocytes fertilized and embryos transferred. The side effects were negligible. The numbers of ICSI pregnancies and live births in severe idiopathic OAT patients improved with a course of L-carnitine, acetyl-L-carnitine and cinnoxicam.

Role of L-carnitine in female infertility

“…Cavallini et al (2012), in their study, reported that 22 out of 33 male patients with severe idiopathic oligoasthenoteratozoospermia (OAT) of infertile couples whose partners had undergone at least one ICSI cycle, showed reduced sperm aneuploidy levels (assessed using fluorescent in situ hybridization performed on chromosomes X, Y, 13, 15, 16, 17, 18, 21 and 22) and improved sperm morphology after 3 months of treatment with LC 2 × 1 g/day, ALC 2 × 500 mg/day and cinnoxicam (a lipophilic NSAID) 1 × 30 mg/every 4 days [ 89 ]. Men with OAT have been reported to have elevated prostaglandin levels.…”

The Role of the Andrologist in Assisted Reproduction

“…The numbers of ICSI pregnancies and live births in severe idiopathic OAT patients improved with a course of L-carnitine, acetyl-L-carnitine, and cinnoxicam. The improvement occurred in the patients who had their sperm aneuploidy reduced and their sperm morphology increased [ 24 ]. Further varicocele correction presents a possible method to optimize a couples' reproductive potential increasing ICSI offspring or decreasing the need for complex assisted reproductive technology [ 25 ].…”

Sperm aneuploidy in infertile male patients: a systematic review of the literature

“…Cavallini et al . () reported reduced sperm aneuploidy, improved sperm quality and improved clinical outcomes in oligo‐astheno‐teratospermic patients who were treated with L‐carnitine, acetyl‐L carnitine and cinnoxicam. Young et al .…”