| Objectives: To assess the effectiveness and safety of carnitine in thetreatment of idopathic asthenozoospermia.Methods: The Cochrane Library, MEDLINE, EMBASE and CNKIbetween Jan,1995 and Dec,2006 were searched. Both English and Chinesestudies were included in the review if they were RCTs (randomizedcontrolled trials) involving men with idopathic asthenozoospermia who weretreated with camitine. Data were processed by RevMan 4.2.10.Results: Five RCTs involving 346 patients met the inclusion criteria,and 307 patients were included in the meta analysis. Meta analysis based onincluded studies showed that (1) after treated with carnitine for 3～6 months,the difference of the patients' partners' spontaneous pregnancy rate betweentreatment group and control group was statistically significant[Z=2.26(P=0.02), OR(95% CI) is 2.80 (1.15, 6.82)] (2) after treated withcarnitine for 3 and 6 months, the difference of forward motile sperm perejaculate between treatment group and control group were not statisticallysignificant [Z=1.99 (P=0.05), WMD=9.16(0.14, 18.18) and Z=1.06 (P=0.29),WMD=5.28(-4.45, 15.01)] (3) after treated with carnitine for 3 and 6 months,the difference of percentage of forward sperm motility between treatmentgroup and control group were not statistically significant [Z=1.50 (P=0.13),WMD=14.56(-4.49, 33.61) and Z=1.08 (P=0.28), WMD=7.34(-5.93, 20.61)] (4) after treated with carnitine for 3 and 6 months, the difference of totalmotile sperm per ejaculate between treatment group and control group werenot statistically significant [Z=1.80 (P=0.07), WMD=15.32(-1.34, 31.98) andZ=1.32 (P=0.19), WMD=6.20(-3.00, 15.39)] (5) after treated with carnitinefor 3 and 6 months, the difference of percentage of total sperm motilitybetween treatment group and control group were not statistically significant[Z=0.67 (P=0.50), WMD=2.97(-5.75, 11.69) and Z=0.64 (P=0.52),WMD=4.48(-9.17, 18.14)] (6) after treated with carnitine for 3 and 6 months,the difference of semen volume between treatment group and control groupwere not statistically significant [Z=0.57 (P=0.57), WMD=-0.12(-0.55, 0.30)and Z=0.16 (P=0.87), WMD=0.03(-0.38, 0.45)] (7) after treated withcarnitine for 3 and 6 months, the difference of sperm concentration betweentreatment group and control group were not statistically significant [Z=1.44(P=0.15), WMD=7.92(-2.85, 18.68) and Z=0.33 (P=0.74), WMD=1.02(-5.09,7.14)]. Three RCTs reported the side effects of carnitine, the results showedthat there were no serious side effects of carnitine during the treatmentperiod.Conclusions: The available evidence indicates that spontaneouspregnancy rate would increase with carnitine therapy, while it is short ofimprovement of semen parameters. There is no serious side effects ofcarnitine. Because of lack of evidence, we cannot conclude that carnitine iseffective in improving the prognosis of infertile patients with idiopathicasthenozoospermia. More high quality trials with large sample are proposed.
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