Presentation Authors: Gian Maria Busetto*, Francesco Del Giudice, Roma, Italy, Ashok Agarwal, Cleveland, OH, Sava Micic, Belgrade, Serbia, Ashraf Virmani, Utrecht, Netherlands, Ettore De Berardinis, Roma, Italy
Introduction: Sperm is vulnerable to lack of energy and excess amount of reactive oxygen species, which can impair its function, leading to immotility, acrosomal reaction impairment, DNA fragmentation and cell death. For this reason is required that essential nutrients are available for spermatozoa when they develop, capacitate and acquire motility.
Methods: This randomized double-blind placebo controlled trial investigated the effect of 6 months of supplementation with carnitines and other micronutrients on sperm quality in 104 subjects with oligo-and/or astheno-and/or teratozoospermia with or without varicocele. Spermogram evaluation was done at the beginning of treatment and at the end. In addition to what presented in the statistical report as main analyses (sperm count, concentration, motility and morphology), which were the ones forecasted by the study protocol, the present post-hoc analyses were carried-out on the sample categorized by age and BMI. The analyses were performed considering two age classes (patients below and above 35 years old) and two BMI classes (patients below and above 25 of BMI).
Results: In 94 patients who completed the study, sperm concentration was significantly increased in supplemented patients compared to the placebo (p = .0186). Total sperm count also increased significantly (p = .0117) in the supplemented group as compared to the placebo group. Both, progressive and total motility were higher in supplemented patients (p = .0088 and p = .0120, respectively).As for the single classes of age, a significant difference was observed in the < 35 years class for the total motility (p = .0385). As for the single classes of the BMI, a significant difference was observed in the BMI < 25 class for the total sperm count (p = .0295), for the progressive motility (p = .0220) and for the total motility (p = .0385).As for the analyses on the combined classes (age & BMI), a statistical significance was observed in the total motility (p = .391).
Conclusions: The present post-hoc analysis highlighted that the supplementary product seems to be more effective in subjects aged less than 35 years and with a normal weight (i.e. below 25 BMI).Oxidative stress is a cause of male infertility with significant negative effect on semen parameters and varicocele is an additional cause of poor sperm quality. In conclusion, supplementation with metabolic and antioxidant compounds could be efficacious when included in strategies to improve fertility.