| Objective:To evaluate the effect of prodom-assisted L-carnitine/CoQ10 supplementation in the semen of patients with asthenozoospermia on improving sperm quality and clinical pregnancy.Methods:In the in vitro test phase,patients with asthenozoospermia who were treated in our hospital from July 2019 to May 2021 were selected as the research objects,and 120 patients were randomly selected for L-carnitine/coenzyme Q10 supplementation in isolated semen.Each semen sample of 120 patients was divided into four equal parts,and divided into four groups according to the different added components,namely:L-carnitine in vitro semen addition group,Coenzyme Q10 in vitro semen addition group,L-carnitine and Coenzyme Q10 in vitro semen addition group and semen Blank control group.Hank’s solution was added to the semen blank control group,and both L-carnitine and Coenzyme Q10 were prepared with Hank’s solution.L-carnitine was added at 8 mmol/L and Coenzyme Q10 was added at 4mmol/L.After 30 minutes,semen quality analysis was performed,and sperm motility in each group was recorded.In the clinical treatment stage,257 patients with asthenozoospermia treated in our hospital from July 2019 to May 2021 were selected as the research objects,and were grouped according to different treatment methods,namely:prodom-assisted L-carnitine treatment group,prodom-assisted Coenzyme Q10 treatment group,prodom-assisted L-carnitine combined with Coenzyme Q10 treatment group,and oral L-carnitine combined with Coenzyme Q10 treatment group.L-carnitine was added at 8 mmol/L,and Coenzyme Q10 was added at 4mmol/L;in the oral treatment group,L-carnitine was orally 10 ml twice a day,and Coenzyme Q10 was 200 mg orally 3 times a day.From 3 to 9 months of treatment,the fertilization status and fertilization time of the spouses in each group were observed,and the fertilization rate and treatment cost were calculated.When P<0.05,the difference was statistically significant.Results:During the trial period,25 cases were discontinued(10 lost to follow-up,5 refused to continue the trial,and 10 did not take medication as prescribed),and the remaining 232 cases completed the trial.In addition to statistically significant differences in semen volume among the prodom-assisted L-carnitine treatment group,prodom-assisted Coenzyme Q10 treatment group,prodom-assisted L-carnitine combined with Coenzyme Q10 treatment group,and oral L-carnitine combined with Coenzyme Q10 treatment group(P<0.05),There were no statistically significant differences in baseline characteristics such as patient’s age,spouse’s age,infertility time,normal sperm morphology,seminal vesicutis history,sperm density and liquefaction time among all groups(ALL P>0.05).In the in vitro test stage,the progressive sperm motility of each group in the L-carnitine in vitro semen addition group,Coenzyme Q10 in vitro semen addition group,L-carnitine and Coenzyme Q10 in vitro semen addition group and semen Blank control group were:24.27±4.61%,22.96±4.78%,28.44±5.04%,19.68±4.44%;sperm motility were:38.14±5.11%,36.92 ±4.41%,43.75±5.35%,26.03±4.85%;The progressive sperm motility and sperm motility differences among L-carnitine in vitro semen addition group,Coenzyme Q10 in vitro semen addition group,L-carnitine and Coenzyme Q10 in vitro semen addition group and semen Blank control group were statistically significant(P<0.001);and after pairwise comparison,it can be seen that the improvement effect of L-carnitine and Coenzyme Q10 in vitro semen addition group on progressive sperm motility and sperm motility was better than the other three groups(P<0.001).The pregnancy rates of prodom-assisted L-carnitine treatment group,prodom-assisted Coenzyme Q10 treatment group,prodom-assisted L-carnitine combined with Coenzyme Q10 treatment group,and oral L-carnitine combined with Coenzyme Q10 treatment group in clinical treatment stage were 38.18%(21/55),35.42%(17/48),57.14%(36/63),30.30%(20/66);the conception time(months)were:6.10±1.84,6.24± 1.82,3.36±0.93,7.90±2.02;the treatment costs were:1348.32±411.41,2350.00±457.08,2454.94±434.35,2684.11 ± 333.73;through analysis,the difference in conception rate among the groups was statistically significant(P<0.05),and the difference in conception time was statistically significant(P<0.001).The difference in cost was statistically significant(P<0.001).Conclusions:1.Supplementation of L-carnitine and Coenzyme Q10 in isolated semen can improve sperm quality(motility/viability rate),and the combined supplementation of L-carnitine and Coenzyme Q10 is more effective.2.The prodom-assisted L-carnitine combined with Coenzyme Q10 in the treatment of asthenospermia patients can shorten the conception time of the spouse,reduce the cost of treatment,and improve the conception rate of the spouse. |
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