Effect of L-carnitine on sperm parameters in patients with Thalassemia major: A pilot study

  • Azadeh Kiumarsi Department of Pediatric hematopoietic stem cell transplantation,Hematology-Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Amir Hesabi Department of Pediatric Hematology and Oncology, Hormozgan University of Medical Sciences, Bandar   bbas,Iran.
  • Masoumeh Tavanayan M.D., Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
  • Davoud Amirkashani Department of Pediatric endocrinology, Iran University of Medical Sciences, Tehran, Iran.
  • Azita Azarkeivan Transfusion Research Center, High institute for research and education in transfusion medicine, Department of thalassemia clinic, Tehran, Iran.
  • Mohammad Ali Molavi Department of Pediatric Hematology and Oncology, Hormozgan University of Medical Sciences, Bandar Abbas,Iran.

Abstract

Background: More than one-half of men with transfusion dependent thalassemia major (TDTM) are dealing with decreased fertility potentials. As antioxidants such as L-carnitine were reported to improve fertility in healthy males, we aimed to assay the effect of L-carnitine on sperm parameters in adult males with TDTM.


Materials and Methods: Twenty six male TDTM patients older than 18 years were included in a pilot study, all had semen analysis; 3 were found to be azoospermic and were excluded. So further analysis for sperms and DNA defects was conducted on the remaining 10 participants. Participants were then given L-carnitine for 3 months. All sperm parameters were reassessed after therapy.


Results: In patients with low volume ejaculation, the mean volume of semen increased significantly (p=0.034). In oligospermic patients with a mean sperm concentration of 4.62 million/mL, the mean sperm concentration raised to 22.50 million/mL after therapy (p=0.008). In patients who had lower than normal sperm motility percentage and sperm progressive motility percentage, both variables raised after therapy.


Conclusion: Thalassemia major patients showed significant increase in sperm concentration and sperm motility with the use of L-carnitine.


 

Keywords: Thalassemia major, Male Infertility, Semen Quality, Sperm Parameter

Downloads

Download data is not yet available.

Author Biographies

Azadeh Kiumarsi, Department of Pediatric hematopoietic stem cell transplantation,Hematology-Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Department of Pediatric hematopoietic stem cell transplantation,Hematology-Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Amir Hesabi, Department of Pediatric Hematology and Oncology, Hormozgan University of Medical Sciences, Bandar   bbas,Iran.

Department of Pediatric Hematology and Oncology, Hormozgan University of Medical Sciences, Bandar   bbas,Iran.

Masoumeh Tavanayan, M.D., Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

M.D., Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

Davoud Amirkashani, Department of Pediatric endocrinology, Iran University of Medical Sciences, Tehran, Iran.

Department of Pediatric endocrinology, Iran University of Medical Sciences, Tehran, Iran.

Azita Azarkeivan, Transfusion Research Center, High institute for research and education in transfusion medicine, Department of thalassemia clinic, Tehran, Iran.

Transfusion Research Center, High institute for research and education in transfusion medicine, Department of thalassemia clinic, Tehran, Iran.

Mohammad Ali Molavi, Department of Pediatric Hematology and Oncology, Hormozgan University of Medical Sciences, Bandar Abbas,Iran.

Department of Pediatric Hematology and Oncology, Hormozgan University of Medical Sciences, Bandar Abbas,Iran.

References

1. Perera D, Pizzey A, Campbell A, et al. Sperm DNA damage in potentially fertile homozygous beta-thalassaemia patients with iron overload. Hum Reprod. 2002; 17:1820–1825.
2. Safarinejad MR. Evaluation of semen quality, endocrine profile and hypothalamus-pituitary-testis axis in male patients with homozygous beta-thalassemia major. J Urol. 2008;179:2327–2332.
3. Agarwal A, Virk G, Ong C, et al. Effect of oxidative stress on male reproduction. World J Mens Health. 2014; 32:1–17.
4. Walter PB, Fung EB, Killilea DW, Jiang Q, Hudes M, Madden J, Porter J, Evans P, Vichinsky E, Harmatz P. Oxidative stress and inflammation in iron‐overloaded patients with β‐thalassaemia or sickle cell disease. British journal of haematology. 2006 ;135(2):254-63.
5. Scott, M.D., Van Den Berg, J.J., Repka, T., Rouyer‐Fessard, P., Hebbel, R.P., Beuzard, Y. & Lubin, B.H. (1993) Effect of excess alpha‐hemoglobin chains on cellular and membrane oxidation in model beta‐thalassemic erythrocytes. Journal of Clinical Investigation, 91, 1706–1712.
6. The importance of folate, zinc and antioxidants in the pathogenesis and prevention of subfertility.
7. Ebisch IM, Thomas CM, Peters WH, Braat DD, Steegers-Theunissen RP. Hum Reprod Update. 2007 Mar-Apr; 13(2):163-74.
8. Livrea MA, Tesoriere L, Pintaudi AM, et al. Oxidative stress and antioxidant status in beta-thalassemia major: Iron overload and depletion of lipid-soluble antioxidants. Blood. 1996; 88:3608–3614.
9. Claster S, Wood JC, Noetzli L, et al. Nutritional deficiencies in iron overloaded patients with hemoglobinopathies. Am J Hematol. 2009;84:344–348
10. Singer ST, Killilea D, Suh JH, Wang ZJ, Yuan Q, Ivani K, Evans P, Vichinsky E, Fischer R, Smith JF. Fertility in transfusion‐dependent thalassemia men: Effects of iron burden on the reproductive axis. American journal of hematology. 2015 ;90(9):E190-2.
11. A. Lenzi, F. Lombardo, P. Sgro, P. Salacone, L. Caponecchia, F. Dondero, et al.Use of carnitine therapy in selected cases of male factor infertility a double blind crossover trial. Fertil Steril, 79 (2003): 292-300
12. C. Jeulin, L.M. LewinRole of free L-carnitine and acetyl-L-carnitine in post-gonadal maturation of mammalian spermatozoa. Hum Reprod Update, 1996; (2):87-102
13. Zopfgen, F. Priem, F. Sudhoff, K. Jung, S. Lenk, S.A. Loening, et al.Relationship between semen quality and the seminal plasma components carnitine, alpha-glucosidase, fructose, citrate and granulocyte elastase in infertile men compared with a normal population
14. Hum Reprod.2000; 15:840-845
15. E. Ruiz-Pesini, E. Alvarez, J.A. Enriquez, M.J. Lopez-PerezAssociation between seminal plasma carnitine and sperm mitochondrial enzymatic activities
16. Int J Androl, 2001; (24):335-340
17. Garolla A, Maiorino M, Roverato A, Roveri A, Ursini F, Foresta C. Oral carnitine supplementation increases sperm motility in asthenozoospermic men with normal sperm phospholipid hydroperoxide glutathione peroxidase levels. Fertility and sterility. 2005; 1; 83(2):355-61.
18. World Health OrganizationLaboratory manual for the examination of human semen and sperm-cervical mucus interaction. Cambridge University Press, New York (1999)
19. Perera D, Pizzey A, Campbell A, Katz M, Porter J, Petrou M, Irvine DS, Chatterjee R. Sperm DNA damage in potentially fertile homozygous beta-thalassaemia patients with iron overload. Hum Reprod 2002; 17:1820-5.2.
20. Aitken RJ, Gordon E, Harkiss D, Twigg JP, Milne P, Jen-nings Z, Irvine DS. Relative impact of oxidative stress on the functional competence and genomic integrity of human sper-matozoa. Biol Reprod. 1998; 59:1037-46
21. Aitken RJ, Smith TB, Jobling MS, Baker MA, De Iuliis G. Oxidative stress and male reproductive health. Asian J Androl 2014; 16:31-8.
22. Costa M, Canale D, Filicori M, D’Iddio S, Lenzi A: L-Carnitine in idiopathic asthenozoospermia: A multicenterstudy. Italian Study Group on Carnitine and Male infertility.Andrologia 1994; 26:155–1594.
23. Lenzi A, Lombardo F, Sgro P, Salacone P, Caponecchia L,Dondero F, Gandini L: Use of carnitine therapy in selectedcases of male factor infertility: A double-blind crossover trial. Fertil Steril 2003; 79:292–3005.
24. Vicari E, Calogero AE: Effects of treatment with carnitinesin infertile patients with prostato-vesiculo-epididymitis. HumReprod 2001;16:2338–2342
25. Campaniello E., Petrarolo N., Meriggiola M.C., et al. (1989) Carnitine administration in asthenospermia (Abstract). ɓ International Congress of Andrology, Firenze, May 14-18.
26. Vicari E, La Vignera S & Calogero AE. (2002) Antioxidant treatment with carnitines is effective in infertile patients with prostate vesiculo epididymitis and elevated seminal leukocyte concentrations after treatment with non-steroidal anti-inflammatory compounds. Fertil Steril78, 1203–1208.
27. Abad C, Amengual MJ, Gosalvez J, Coward K, Hannaoui N, Benet J,Garcıa-Peiro A & Prats J. (2013) Effects of oral antioxidant treatmentupon the dynamics of human sperm DNA fragmentation andsubpopulations of sperm with highly degraded DNA.Andrologia45,211–216.
28. Ng CM, Blackman MR, Wang C & Swerdloff RS. (2004) The role ofcarnitine in the male reproductive system.Ann N Y Acad Sci1033,177–188
29. Zhou X, Liu F, Zhai S. Effect of L-carnitine and/or L-acetyl-carnitine in nutrition treatment for male infertility: a systematic review. Asia Pacific journal of clinical nutrition. 2007;16:383.
30. Costa M, Canale D, Filicori M, D’lddio S & Lenzi A. (1994) L-carnitine in idiopathic asthenozoospermia: a multicenter study. Italian Study Group on Carnitine and Male Infertility.Andrologia26, 155–159.
31. Vicari E, Rubino C, De Palma A, Longo G, Lauretta M, Consoli S &Arancio A. (2001) Antioxidant therapeutic efficiency after theuse of carnitine in infertile patients with bacterial or nonbacterial prostato-vesiculo-epididymitis.Arch Ital Urol Androl73,15–25.
32. Lenzi A, Sgro P, Salacone P, Paoli D, Gilio B, Lombardo F, Santulli M, Agarwal A & Gandini L. (2004) A placebo-controlled double-blindrandomized trial of the use of combined l-carnitine and l-acetyl-carnitine treatment in men with asthenozoospermia.Fertil Steril81,1578–1584.
33. Balercia G, Regoli F, Armeni T, Koverech A, Mantero F & Boscaro M.(2005) Placebo-controlled double-blind randomized trial on the use ofL-carnitine, L-acetylcarnitine, or combined L-carnitine and L-acetylcarnitine in men with idiopathic asthenozoospermia.Fertil Steril84, 662–671.
34. De Rosa M, Boggia B, Amalfi B, Zarrilli S, Vita A, Colao A & Lombardi G.(2005) Correlation between seminal carnitine and functionalspermatozoal characteristics in men with semen dysfunction ofvarious origins.Drugs R D6, 1–9.
35. Elsedfy H, De Sanctis V, Ahmed AY, Mohamed NR, Arafa M, Elalfy MS. A pilot study on sperm DNA damage in β-thalassemia major: is there a role for antioxidants?. Acta bio-medica: Atenei Parmensis. 2018;89(1):47.
36. Hammadeh ME, Radwan M, Al-Hasani S, Micu R, Rosen-baum P, Lorenz M, Schmidt W. Comparison of reactive oxygen species concentration in seminal plasma and semen parameters in partners of pregnant and non-pregnant patients after IVF/ICSI. Reprod Biomed Online 2006; 13: 696-706.
Statistics
14 Views | 21 Downloads
How to Cite
Kiumarsi, A., Hesabi, A., Tavanayan, M., Amirkashani, D., Azarkeivan, A., & Molavi, M. (2020). Effect of L-carnitine on sperm parameters in patients with Thalassemia major: A pilot study. Asian Journal of Pharmaceutical Research and Development, 8(5), 14-17. https://doi.org/https://doi.org/10.22270/ajprd.v8i5.820