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Journal of Andrology, Vol. 25, No. 5, September/October 2004
Copyright © American Society of Andrology

Cinnoxicam and L-Carnitine/Acetyl-L-Carnitine Treatment for Idiopathic and Varicocele-Associated Oligoasthenospermia

GIORGIO CAVALLINI*, ANNA PIA FERRARETTI*, LUCA GIANAROLI*, GIULIO BIAGIOTTI{dagger} AND GIOVANNI VITALI*

From the * Headquarters of Società Italiana di Studi di Medicina della Riproduzione (SISMER), Bologna, Italy; and {dagger} Satellite Center of SISMER, Reproductive Medicine Unit, Fermo (Ascoli Piceno), Italy.

Correspondence to: Dr Giorgio Cavallini, via Mascheraio 46, 44100 Ferrara, Italy (e-mail: giorgiocavallini{at}libero.it).


The objective of this study was to detect a therapy for idiopathic and varicocele-associated oligoasthenospermia (OAT). Idiopathic and varicocele OAT patients were randomized into 3 groups. Each group was composed of varying degrees of left varicoceles (graded into 5 grades with echo-color Doppler) and of idiopathic OATs. Group 1 used a placebo, group 2 used oral Lcarnitine (2 g/d) + acetyl-Lcarnitine (1 g/d), group 3 used Lcarnitine/acetyl-L-carnitine + 1 x 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 morphology before during and after treatments were assessed. Pregnancy 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 idiopathic 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 varicocele. 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 reliable treatment for low-grade varicoceles and idiopathic OATs.

     Key words: Male infertility, idiopathic oligoasthenospermia, varicocele, L-carnitine, acetyl-L-carnitine, cinnoxicam




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