Journal of Andrology, Vol. 25, No. 5, September/October 2004
Cinnoxicam and L-Carnitine/Acetyl-L-Carnitine Treatment for Idiopathic and Varicocele-Associated Oligoasthenospermia
辛诺西可及左旋肉碱加乙酰左旋肉碱治疗先天性的和精索静脉曲张引起的少弱精子症
GIORGIO CAVALLINI,* ANNA PIA FERRARETTI,* LUCA GIANAROLI,* GIULIO BIAGIOTTI,† AND GIOVANNI VITALI*
From the *Headquarters of Societa` Italiana di Studi di Medicina della Riproduzione (SISMER), Bologna, Italy; and †SatelliteCenter of SISMER, Reproductive Medicine Unit, Fermo (Ascoli Piceno), Italy.
ABSTRACT: The objective of this study was to detect a therapy for idiopathic and varicocele-associated oligoasthenospermia (OAT). Id¬iopathic and varicocele OAT patients were randomized into 3 groups. Each group was composed of varying degrees of left vari-coceles (graded into 5 grades with echo-color Doppler) and of idio¬pathic OATs. Group 1 used a placebo, group 2 used oral L-carnitine (2 g/d) + acetyl-L-carnitine (1 g/d), group 3 used L-carnitine/acetyl-L-carnitine + 1 × 30-mg cinnoxicam suppository every 4 days. Drugs were administered for 6 months. The groups were composed as follows: group 1, 71 varicoceles and 47 idiopathic OATs; group 2, 62 varicoceles and 39 idiopathic OATs; group 3, 62 varicoceles and 44 idiopathic OATs. Sperm concentration, motility, and mor¬phology before during and after treatments were assessed. Preg¬nancy rates and side effects were recorded. Group 1 did not have modified sperm patterns during treatment. Group 2 had significantly increased sperm patterns at 3 and 6 months into therapy in idio¬pathic patients and in patients with grades I, II, and III varicocele, but not in grades IV and V. Group 3 had significantly increased sperm parameters in all patients, with the exception of grade V var-icocele. Group 3 sperm patterns proved significantly higher during therapy than group 2. All sperm patterns fell to baseline after therapy suspension. Minor side effects occurred. Pregnancy rates were 1.7% (group 1), 21.8% (group 2), and 38.0% (group 3) (P< .01). L-Carnitine/acetyl-L-carnitine + cinnoxicam suppositories proved a re¬liable treatment for low-grade varicoceles and idiopathic OATs.
Key words: Male infertility, idiopathic oligoasthenospermia, vari¬cocele, L-carnitine, acetyl-L-carnitine, cinnoxicam.
