Vitamins for male factor-- is it a good idea?
1 Replies
oct01 - May 30

Dr. Smith,

I'm getting conflicting information about the benefits of vitamins for male factor, specifically those such as Conception XR, Proxeed, Proceptin, and FertileOne.

While they may differ in some of their ingredients, my RE says that the main ingredient, L-carnitine, is what makes them beneficial. So... does it matter which one my DH uses?

Also, I've read many chat postings from women who claim their husbands' sperm parameters actually worsened after taking these vitamins (sperm concentration, morphology, etc.) Is it possible that these vitamins could have a detrimental effect or is there another factor causing the changes that has not been identified?

My DH has been taking Conception XR, recommended by our RE, for the past 3 months and we've noticed that at our last two IUI's, his pre-wash sperm concentration has been fairly low (26 mil and 33 mil) and his post wash totile motile count has also been low (9 mil and 8 mil). Much different than what is was just a year ago before his varicocelectomy when most of his post wash totile motile count was 15-20 mil.

Could this be related to the vitamins? He is about to switch to Proxeed, recommended by a urologist.

Should he be taking ANY vitamins? We are getting ready to do ICSI in July and we don't want to do anything that could jeopardize our chances while obviously doing everything we can to improve our odds.


Dr Smith - May 30

All these "sperm-enhancing" products contain the same "active" ingredient: L-carnitine which is a amino acid, not a vitamin [i]per se[/i].

There have been only two well-designed studies done. One concluded that L-carnitine had no effect while the other said it did. I gues the jury is still out (see below):

Carnitine for the treatment of idiopathic asthenospermia: a randomized, double-blind, placebo-controlled trial. Sigman M, Glass S, Campagnone J, Pryor JL. Fertil Steril. 2006 85(5):1409-14.

OBJECTIVE: To determine the effect of oral carnitine supplementation on the semen parameters of men with idiopathic asthenospermia. DESIGN: Prospective, randomized, double-blind placebo-controlled study. SETTING: Academic tertiary referral centers. PATIENT(S): Male patients presenting with infertility and with sperm motility of 10%-50% were selected. INTERVENTION(S): Patients were randomized to 24-week treatment arms of oral carnitine (2,000 mg L-carnitine and 1,000 mg L-acetyl-carnitine per day) or placebo. MAIN OUTCOME MEASURE(S): Sperm motility and total motile sperm counts at baseline, 12 weeks, and 24 weeks. Seminal plasma and sperm free, acetyl, and total L-carnitine levels at baseline and at week 24. RESULT(S): Twenty-one patients entered the study, with 12 patients in the carnitine arm and 9 in the placebo arm. There were no significant differences in baseline semen parameters between the carnitine and placebo arms. There was no statistically significant or clinically significant increase in motility or total motile sperm counts between baseline, 12 week, or 24 weeks in the carnitine or placebo arms.
[b]CONCLUSION(S): Carnitine supplementation demonstrated no clinically or statistically significant effect on sperm motility or total motile sperm counts in men with idiopathic asthenospermia.[/b]

Placebo-controlled double-blind randomized trial on the use of L-carnitine, L-acetylcarnitine, or combined L-carnitine and L-acetylcarnitine in men with idiopathic asthenozoospermia. Balercia G, Regoli F, Armeni T, Koverech A, Mantero F, Boscaro M. Fertil Steril. 2005;84(3):662-71.

OBJECTIVE: To evaluate the effectiveness of L-carnitine (LC) or L-acetyl-carnitine (LAC) or combined LC and LAC treatment in improving semen kinetic parameters and the total oxyradical scavenging capacity in semen. DESIGN: Placebo-controlled, double-blind, randomized trial. SETTING: Andrology unit, Department of Internal Medicine, Polytechnic University of Marche, Italy. PATIENT(S): Sixty infertile men, ages 20 to 40 years, with the following baseline sperm selection criteria: concentration > 20 x 10(6)/mL, sperm forward motility < 50%, and normal sperm morphology > 30%; 59 patients completed the study. INTERVENTION(S): Patients underwent a double-blind therapy of LC 3 g/d, LAC 3 g/d, a combination of LC 2 g/d and LAC 1 g/d, or placebo. The study design was 1 month of run in, 6 months of therapy or placebo, and 3 months of follow-up evaluation. MAIN OUTCOME MEASURE(S): Variations in semen parameters used for patient selection, and variations in total oxyradical scavenging capacity of the seminal fluid. RESULT(S): Sperm cell motility (total and forward, including kinetic features determined by computer-assisted sperm analysis) increased in patients to whom LAC was administered both alone or in combination with LC; combined LC + LAC therapy led to a significant improvement of straight progressive velocity after 3 months. The total oxyradical scavenging capacity of the semen toward hydroxyl and peroxyl radicals also increased and was positively correlated with the improvement of kinetic features. Patients with lower baseline values of motility and total oxyradical scavenging capacity of the seminal fluid had a significantly higher probability of responding to the treatment. [b]CONCLUSION(S): The administration of LC and LAC is effective in increasing sperm kinetic features in patients affected by idiopathic asthenozoospemia and improves the total oxyradical scavenging capacity of the seminal fluid in the same population.

I don't think taking L-carnitine is harmful. It may be a waste of money, but not outright harmful. Even in men with normal sperm parameters, sperm concentration varies markedly from one day to the next, so its always difficult to determine the effect of any drug or compound. Not understanding the normal fluctuations in sperm parameters can lead to inaccurate conclusions. Because of this, I'm not sure I believe either of the studies described above. The number patients particpating in the studies were low and I think it would easy to interpret the data either way



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