[L-carnitine combined with coenzyme Q10 for idiopathic oligoasthenozoospermia: A double-blind randomized controlled trial].

To evaluate the clinical therapeutic effect of L-carnitine (LC) in combination with coenzyme Q10 (CoQ10) on idiopathic oligoasthenozoospermia (iOAT).Using the computer-generated random number sequence, we randomly assigned 262 infertile men with iOAT to four groups to receive oral administration of LC at 10 mL bid (n = 62), CoQ10 (n = 63) at 20 mg tid, LC combined with CoQ10 at the above dose (n = 63), and vitamin B1 as the placebo control (n = 74). After 3 months of treatment, we obtained sperm concentration, sperm motility, the percentage of progressively motile sperm, sperm DNA fragmentation index, the rate of sperm acrosome reaction, and the outcomes of clinical pregnancy and compared them among the four groups of patients.After treatment, the combination group, as compared with the LC, CoQ10 and control groups, showed significantly higher sperm motility and percentage of progressively motile sperm (P <0.05). The percentage of sperm DNA fragments was markedly lower in the combination group than in the control (P <0.05), while the rate of clinical pregnancy remarkably higher in the former than in the latter group (30.0% vs 6.8%, P <0.008). There were no statistically significant differences among the four groups in the rates of sperm acrosome reaction and abortion (P >0.05).Combination of LC and CoQ10 can improve the semen parameters and outcome of clinical pregnancy in the iOAT patient.目的： 探讨左卡尼汀(LC)联合辅酶Q10（CoQ10）治疗特发性少、弱精子症(iOAT)的临床疗效。 方法： 将262例iOAT患者按照Excel软件随机数字排序分为4组，LC组：62例，口服左卡尼汀口服溶液10 ml/次，2次/d；CoQ10组：63例，口服CoQ10片剂，20 mg/次，3次/d；联合用药组：63例，按照上述剂量联合服用LC和CoQ10；对照组组：74例，服用不含抗氧化作用的安慰剂（维生素B1）。治疗3个月后比较各组治疗前、后精子浓度、活动率、前向运动精子百分率、DNA碎片百分率、顶体反应发生率及妊娠结局。结果： 联合用药组的活动率及前向运动精子百分率均显著高于其他各组及自身治疗前（P < 0.05）；精子DNA碎片百分率则显著低于对照组和自身治疗前（P < 0.05）；临床妊娠率显著高于对照组（30.0% vs 6.8%，P < 0.008）。各组间的精子顶体发生率及流产率无统计学差异(P > 0.05)。结论： LC联合CoQ10可显著提高iOAT患者的精子质量，并能改善iOAT患者的临床结局。.