Effect of L-carnitine supplementation on fertility outcomes among patients with polycystic ovary syndrome: a systematic review and dose-response meta-analysis of randomized clinical trials.
Ahmed Abu-Zaid, Ghadeer Adel Alghamdi, Alaa Saleh Alharbi, Saeed Baradwan, Saleh A K Saleh, Heba M Adly, Mooza M Alzayed, Mohammed Abuzaid, Raghad Sindi, Mohannad Alsabban, Osama Alomar
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Abstract
This systematic review and meta-analysis of randomized controlled trials (RCTs) assessed the effect of L-carnitine (LC) supplementation on the fertility outcomes of patients with polycystic ovary syndrome (PCOS). Online databases (Scopus, Web of Science, Cochrane Library, EMBASE, and PubMed) were searched to identify eligible RCTs published until March 2024. A dose-response meta-analysis was performed using a random-effects model. Meta-regression was also performed to investigate the source of heterogeneity based on the LC dose and duration of treatment. The pooled analysis included eight RCTs with 1,046 participants. The LC-treated group had significantly increased chemical and clinical pregnancy rates, ovulation rate, progesterone levels, number of preovulatory follicles >17 mm in diameter, and endometrial thickness compared to the untreated groups. The meta-analysis model indicated that LC supplementation did not change the serum levels of estrogen and testosterone; however, the dose-response meta-analysis indicated that prolonged LC intake significantly increased estrogen levels. LC supplementation has significant effects on fertility outcomes of women with PCOS. Additional large-scale longer RCTs are required to confirm the findings of this study.
本研究对随机对照试验（RCTs）进行了系统回顾和荟萃分析，评估了补充左旋肉碱（LC）对多囊卵巢综合征（PCOS）患者生育结局的影响。检索在线数据库（Scopus, Web of Science, Cochrane Library， EMBASE和PubMed）以确定在2024年3月之前发表的符合条件的rct。采用随机效应模型进行剂量-反应荟萃分析。我们还进行了meta回归来研究基于LC剂量和治疗持续时间的异质性来源。合并分析包括8项随机对照试验，共有1046名参与者。与未治疗组相比，lc治疗组的化学和临床妊娠率、排卵率、黄体酮水平、排卵前卵泡数量（直径17mm）和子宫内膜厚度均显著增加。meta分析模型显示，补充LC不会改变血清雌激素和睾酮水平；然而，剂量-反应荟萃分析显示，延长LC摄入可显著提高雌激素水平。补充LC对PCOS患者的生育结局有显著影响。需要更多的大规模、更长的随机对照试验来证实本研究的结果。
期刊介绍：
Obstetrics & Gynecology Science (NLM title: Obstet Gynecol Sci) is an international peer-review journal that published basic, translational, clinical research, and clinical practice guideline to promote women’s health and prevent obstetric and gynecologic disorders. The journal has an international editorial board and is published in English on the 15th day of every other month. Submitted manuscripts should not contain previously published material and should not be under consideration for publication elsewhere. The journal has been publishing articles since 1958. The aim of the journal is to publish original articles, reviews, case reports, short communications, letters to the editor, and video articles that have the potential to change the practices in women''s health care. The journal’s main focus is the diagnosis, treatment, prediction, and prevention of obstetric and gynecologic disorders. Because the life expectancy of Korean and Asian women is increasing, the journal''s editors are particularly interested in the health of elderly women in these population groups. The journal also publishes articles about reproductive biology, stem cell research, and artificial intelligence research for women; additionally, it provides insights into the physiology and mechanisms of obstetric and gynecologic diseases.
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