Antioxidant treatment with carnitines is effective in infertile patients with prostatovesiculoepididymitis and elevated seminal leukocyte concentrations after treatment with nonsteroidal anti-inflammatory compounds

Objective: To evaluate whether the association of antioxidants and anti-inflammatory compounds may bebeneficial in treatment of patients with abacterial prostatovesiculoepididymitis (PVE) and elevated seminalleukocyte concentrations.Design: Open, prospective, random study.Setting: Academic research environment.Patient(s): Ninety-eight patients with PVE who had increased seminal leukocyte concentrations (1 106cells/mL).Intervention(s): Carnitines (group A; n 30) or nonsteroidal anti-inflammatory drugs (group B; n 16) for4 months; nonsteroidal anti-inflammatory drugs for 2 months, followed by treatment with carnitines for 2months (group C; n 26); or nonsteroidal anti-inflammatory treatment given concomitantly with carnitines(group D; n 26) for 4 months.Main Outcome Measure(s): Semen variables, production of reactive oxygen species, and pregnancy outcomewere evaluated before and after treatment and following a 3-month washout period.Result(s): Patients in group C had the highest reduction in production of reactive oxygen species associatedwith increased sperm motility and viability. Groups B and D experienced intermediate effects, and group Aexperienced the least effect.Conclusion(s): Antioxidant treatment with carnitines is effective in patients with abacterial PVE andincreased seminal leukocyte concentrations if these patients have been pretreated with nonsteroidal antiinflammatorydrugs. (Fertil Steril 2002;78:1203– 8. ©2002 by American Society for Reproductive Medicine.)Key Words: Carnitine, acetyl carnitine, nonsteroidal anti-inflammatory drugs, prostatovesiculoepididymitis,reactive oxygen species, sperm variables