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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.
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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.
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Background: Premature ovarian insufficiency (POI) is a condition where the ovary loses its normal reproductive potential earlier than 40 years, compromising fertility. There is no treatment for POI, only ovum or embryo donation. Autologous stem cell ovarian transplant (ASCOT) may be a procedure that creates new eggs in the ovaries of women with POI. The aim of the study was to find out the efficacy of ASCOT in patients suffering from POI.Methods: A total of 50 patients were included according to inclusion and exclusion criteria in this prospective observational study. POI was confirmed with low levels of anti-mullerian hormone (AMH) (<0.5 ng/dl), high level of follicle stimulating hormone (FSH) >25 ng/ml, and or a low number of antral follicle count (AFC) (<3 in each ovary).Results: Results showed that after stem cell therapy, mean AMH values increased by 0.48±0.306 and mean FSH values increased by 2.73±3.98 but the difference was not statistically significant. AFC values significantly decreased by 1.33±0.625 at 1st post-stem-cell cycle. During the second cycle, AMH and AFC increased by 0.110±0.051 and 4.63±1.49, respectively, and FSH decreased by 7.4±2.78. In third cycle, AMH & FSH was significantly increased by 0.820±0.44 & 4.120±0.470 and FSH has been decreased by 2.150±3.625. The increase in AMH & AFC was statistically significant, and the decrease in FSH was not statistically significant compared to baseline values.Conclusions: The study showed that autologous stem cell therapy can have a significant effect on women’s ovarian function and fertility. It showed that ASCOT can increase AMH and AFC, and decrease FSH in patients with POI, with a total pregnancy rate of 4% after the third cycle follow-up.