Light and electron microscopic study of the effect of L-carnitine on the sperm morphology among sub fertile men

Objective: This work was conducted to evaluate the effect of L-carnitine on sperm morphology in sub fertile patients who need enhance for intra cytoplasmic sperm injection (ICSI) as a method of infertility treatment.Setting: Assisted Reproduction Unit, at the International Islamic Centre for Population Studies and Researchs (IICPSR), Al-Azhar University and Zoology Department Faculty of Science (Girl's Branch), Al-Azhar University.Materials and methods: According to the routine semen analysis, 85 patients were divided into:Group 1: Ten normal fertile men.Group 2: 25 oligozoospermic cases with sperm count less than 20 million/ml.Group 3: 25 athenozoospermic cases with reduced sperm motility <40%.Group 4: 25 teratozoospermic cases with more than >40% abnormal forms.L. carnitine therapy in the form of Carnivita forte 1gm /tab. b.i.d. for three months were given to groups 2, 3 and 4. All the patients underwent semen analysis before and 90 days after therapy. Group 1 was subjected to two semen analysis 3 months apart as a control. Smears were made on slides, fixed in absolute ethyl alcohol and stained with H&E and methyl green pyronin for light microscopic study. A second semen sample was processed for electron microscopic study.Results: In the fertile control group, there have not been any statistically significant differences among the patients at the beginning of the study and after 3 months regarding all the studied parameters. In Oligo group, highly significant decrease in the mean percent of head defects, cytoplasmic droplet and mitochondrial sheath defects were observed after treatment. In both atheno and terato groups, highly significant decrease in the mean percent of head defects, midpiece defects, cytoplasmic droplet and mitochondrial sheath defects were observed after treatment. The mean of DNA content of sperm heads demonstrated highly significant increase in oligo, atheno and terato-zoospermia groups as compared to the same groups before treatment.Conclusion: These results clearly show that L-carnitine treatment has ameliorative impact on the quality of spermatozoa in the infertile men, resulting in a decrease number in morphologically abnormal spermatozoa. These data indicated that this agent affects the quality of spermatozoa in infertile patients who need intra cytoplasmic sperm injection (ICSI) as a method for infertility treatment