Meta-analysis of the efficacy and safety of L-carnitine and N-acetylcysteine monotherapy for male idiopathic infertility.

Revista internacional de andrologia Pub Date : 2025-03-01 Epub Date: 2025-03-30 DOI:10.22514/j.androl.2025.004

Xiaohong Ma, Yingying Yang, Shiguo Liu, Yuanshan Cui, Jitao Wu

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Abstract

Background: Oral antioxidants especially L-carnitine (LC) and N-Acetylcysteine (NAC) are commonly used as the drug treatment method for idiopathic male infertility (IMI).

Methods: Randomized controlled trials (RCTs) of LC and NAC monotherapy for IMI were searched systematically by using MEDLINE, EMBASE and the Cochrane Controlled Trials Register. The reference lists of retrieved studies were also perused. We analyzed the sperm concentration, normal morphology, sperm motility, and ejaculation volume.

Results: Seven Randomized controlled trials were included. Four trials compared the efficacy of LC with placebo, and three trials compared the efficacy of NAC with placebo. In the efficacy analysis, LC increased sperm concentration (p < 0.001), normal morphology (p = 0.03), and sperm motility (p = 0.02); NAC improved the first three indicators while also increasing ejaculation volume (p = 0.002). In hormone level analysis, LC increased serum testosterone levels (p < 0.001), but the changes in other hormone levels were not statistically significant.

Conclusions: Both LC and NAC can improve sperm motility, sperm concentration, and normal morphology, and increase serum testosterone concentration, but have no significant effect on other serum hormones.

The prospero registration: CRD42024552120.

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左旋肉碱和n -乙酰半胱氨酸单药治疗男性特发性不育症的疗效和安全性的meta分析。

背景：口服抗氧化剂尤其是左旋肉碱（LC）和n -乙酰半胱氨酸（NAC）是治疗特发性男性不育症（IMI）的常用药物。方法：通过MEDLINE、EMBASE和Cochrane对照试验Register系统检索LC和NAC单药治疗IMI的随机对照试验（RCTs）。还仔细阅读了检索到的研究的参考文献列表。我们分析了精子浓度、正常形态、精子活力和射精量。结果：纳入7项随机对照试验。4项试验比较LC与安慰剂的疗效，3项试验比较NAC与安慰剂的疗效。在疗效分析中，LC提高了精子浓度（p < 0.001）、正常形态（p = 0.03）和精子活力（p = 0.02）；NAC改善了前三项指标，同时也增加了射精量（p = 0.002）。在激素水平分析中，LC提高了血清睾酮水平（p < 0.001），但其他激素水平的变化无统计学意义。结论：LC和NAC均能改善精子活力、精子浓度和正常形态，提高血清睾酮浓度，但对其他血清激素无显著影响。普洛斯彼罗注册：CRD42024552120。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Revista internacional de andrologia

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