Objective: Idiopathic oligoathenoteratozoospermia (iOAT) is a common ﬁnding in male infertility evaluation. Oxidative stress (OS) may underlie its pathology. Tamoxifen and L-carnitine are used to treat idiopathic male infertility. Aim of this work is to detect the efﬁcacy of tamoxifen and L-carnitine on sperm parameters, sperm ultrastructure and seminal OS in iOAT patients.
Material and Methods: 60 patients were recruited in this study and divided into three groups, the 1st was treated with tamoxifen, 2nd with l-carnitine, 3rd with both drugs. Semen analysis, malondialdehye (MDA) level and transmission electron microscopy (TEM) have been performed before and after three months treatment.
Results: The ﬁrst group showed signiﬁcant improvement in MDA levels, sperm concentration, sperm morphology, ultrastructural head, acrosomal and mitochondrial anomalies (P < 0.01). Other parameters
were not signiﬁcantly improved. In the 2nd group, signiﬁcant improvement in MDA, sperm motility, sperm morphology, ultrastructural mitochondrial and tail anomalies were detected (P < 0.01). No signiﬁ- cant improvement in the other parameters. 3rd group showed improvement in MDA, all semen parameters and all ultastructural anomalies (P < 0.01).
Conclusion: Tamoxifenand L-carnitine are effective in improving seminal OS, semen parameters and sperm ultrastructure. Combination of both drugs is superior to monotherapy.