RÉSUMÉ
Background: Infertility is defined as the inability of a sexually active couple to conceive within one year of regular unprotected coitus. Worldwide, it is estimated that 15% of couples are infertile; among them, the male factor is responsible for 50% of cases. This may be the sole underlying cause or a contributory factor to infertility. We aimed to assess the effects of a complementary treatment with a strong antioxidant (levo-carnitine) on sperm function and fertility of infertile men.Methods: This was a randomized controlled trial study and was conducted in the department of reproductive endocrinology and infertility, Bangabandhu Sheikh Mujib medical university (BSMMU), Dhaka, Bangladesh. during the period from July 2022 to June 2023. In our study, we included 72 infertile men presenting with asthenozoospermia. There were two groups-group A (Participants who received tab levo-carnitine 330 mg twice daily orally for three months) and group B (Tab placebo twice daily orally for three months)Result: The majority of patients in both groups, 51% in group A and 49% in group B, were aged 30-40 years, with no significant difference in mean age (35.36±5.50 vs 34.50±5.50, p>0.05). Overall, 62.5% of patients reported primary sub-fertility. Levo-carnitine administration leads to significant improvements in sperm motility (15±2.68 vs. 36.58±5.16, p<0.05). In the case of placebo treatment, there were no significant improvements in sperm motility (13.91±5.53 vs. 16.36±1.19, p>0.05). We found that the comparison of TMC of both groups reflected statistically significant differences (p<0.05) before treatment and after treatment with levo-carnitine and placebo (6.40±2.87 vs 22.91±14.88) 5.64±3.96 vs 7.71±4.91). Conclusions: Levo-carnitine treatment can lead to significant improvements in semen parameters, particularly in motility.
RÉSUMÉ
Background: Endometriosis, a chronic inflammatory disease, significantly affects reproductive health and fertility in women. This study compares the efficacy of pentoxifylline plus metformin versus metformin alone in treating symptomatic endometrioma in infertile women.Methods: This randomized controlled trial was conducted at the department of reproductive endocrinology and infertility, BSMMU, Dhaka, from July 2022 to June 2023, involving 51 women. Participants were randomly allocated into two groups: pentoxifylline plus metformin (n=25) and metformin alone (n=26). Baseline and post-treatment evaluations included the size of endometrioma, pain scores using the visual analogue scale (VAS), and serum interleukin-6 (IL-6) levels. Data analysis focused on comparing treatment outcomes between the two groups.Result: At baseline, both groups were comparable in terms of sociodemographic characteristics, BMI, and type and duration of infertility. Post-treatment, the pentoxifylline plus metformin group showed significant reductions in endometrioma size (2.23±0.97 cm), VAS score (2.73±1.21), and IL-6 levels, all with p<0.001s. In contrast, the metformin alone group exhibited a significant reduction in endometrioma size (3.12±1.42 cm, p=0.003s) and VAS score (3.48±1.89, p<0.001s), but not in IL-6 levels (p=0.505ns). Pregnancy rates were 8.0% in the pentoxifylline plus metformin group and 3.85% in the metformin alone group (p=0.610ns). Side effects were minimal and comparable between the two groups.Conclusions: Pentoxifylline plus metformin demonstrated superior efficacy in reducing endometrioma size, pain scores, and IL-6 levels compared to metformin alone. However, no significant differences were observed in pregnancy rates or side effects. These findings indicate that the combination therapy could offer greater benefits in managing endometrioma size and pain, although further research is required to evaluate its impact on fertility outcomes in endometriosis patients.