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Men's Fertility
Enhance with L-Carnitine and Acetyl L-Carnitine, Compare to Proxeed


[Sperm Quality | L-Carnitine for Male Infertility]
[Acetyl L-Carnitine for Male Infertility | Fructose and Citric Acid]
[Zinc Vitamin B, C and Antioxidants | Conclusion]
[Comparison of ProXeed to Off-the-Shelf Supplements | References]

For couples who have conception problems, male fertility can be enhanced with targeted nutritional supplementation.  Scientific studies have shown that Acetyl L-Carnitine, L-Carnitine, citric acid, fructose, zinc, B vitamins and antioxidants have proven to enhance male fertility.  

Though less expensive than funding a new wing at your local hospital fertility clinic, some very expensive formulations such as Proxeed are being marketed to address male infertility.  However, purchasing a selection of quality off-the-shelf nutritional supplements may prove equally effectively at a much more affordable cost.  

Modern diet, stress and environmental factors can contribute to a man's fertility problem. Men can have their sperm count checked to understand their needs, and take nutritional supplements that research has shown to improve sperm quality. 

This article will define sperm quality, summarize fertility research for men using various nutritional supplements, then compare the industry standard nutritional supplement - ProXeed - with a variety of off-the-shelf nutritional supplements. 

Sperm Quality

Five factors identified by the World Health Organization are used to assess sperm quality.  If any factor is deficient, this can affect the chances of conception.  The five factors are:

Number of Sperm Cells - this refers to the quantity of sperm in the ejaculate.  Normal ejaculate will contain more than 40 million sperm cells.

Concentration of Sperm - this refers to the number of sperm per milliliter of ejaculate.  A normal semen sample contains more than 20 million sperm per milliliter of ejaculate. 

Motility - Sperm motility refers to the sperm's ability to swim.  In a healthy semen sample, more than 50% of sperm will demonstrate excellent motility and 25% will move strongly in one direction.  Fertility specialists believe that this may be the most critical factor in men's fertility because sperm need to swim from the vagina through the cervix, into the womb to meet the released female egg where fertilization occurs. 

Speed - At least 25% of sperm should have fast and straight forward movement. 

Morphology - describes the size and shape of the sperm.  A healthy sperm looks like a tadpole.  At least 30% of sperm should have normal shape and size.  

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L-Carnitine for Male Infertility

A number of clinical studies have demonstrated the efficacy of oral administration of L-Carnitine for men with various forms of sperm dysfunction.  The following table summarizes those studies for men with male infertility (idiopathic asthenospermia). (L-Carnitine is a component of ProXeed™)

Treatment Duration
# patients
Campaniello (1989)1
2g bid L-Carnitine
treatment 3 months duration
9 patients
+ Increase sperm motility from 25% to 47% (p<0.001)
+ 1 pregnancy
Vitali (1995)2
3g /day L-Carnitine
treatment 3 months duration
47 patients
+ Increase sperm motility in 80% of patients
+ Increase rapid progression sperm motility from 21% to 32%
+ Increase sperm counts from 88 to 160 x 106/ml
Costa (1994)3
3g /day L-Carnitine
treatment 4 months duration
100 patients
+ Increase sperm motility from 26.9 to 37.7% (p<0.001)
+ Increase rapid progressive sperm motility from 10.8 to 18% (p<0.001)
+ Increase median sperm velocity (p<0.001)
+ Increase total sperm numbers in ejaculate and semen volume 

In patients with serious asthenospermia (<5% of sperm with rapid progressive motility)
+ Increase sperm motility from 19.3 to 40.9% (p<0.001)
+ Increase rapid progressive sperm motility from 3.1 to 20.3% (p<0.001)

Study Conclusions

In the Campaniello study, in patients affected by asthenospermia (with sperm motility <30%), long-term administration of L-Carnitine demonstrated a positive effect on sperm quality in terms of increasing sperm motility.1

The Vitali study demonstrated the efficacy of long-term administration of L-Carnitine in increasing the reduced motility of sperm in 47 patients affected by asthenospermia.  L-Carnitine was well tolerated.2

In the Costa study, a significant increase in sperm motility was observed in asthenospermic patients, particularly those presenting with serious forms.  L-Carnitine produced a parallel increase in sperm production and semen volume.3  

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Acetyl L-Carnitine for Male Infertility

One major clinical study demonstrates the efficacy of oral administration of Acetyl L-Carnitine for men with various forms of sperm dysfunction.  The table below summarizes this study for men with male infertility (idiopathic asthenospermia). (Acetyl L-Carnitine is a component of ProXeed™)

Treatment Duration
# patients
Moncada (1992)4
4g / day Acetyl L-Carnitine
treatment 2 months duration
20 patients
+ Increase progressive sperm motility from 22 to 38% with a sustained increase of >40% in 12/20 patients
+ 5 pregnancies during the treatment period and 2 during the 4-month period after discontinuing treatment

Study Conclusions

In the Moncada study, Acetyl L-Carnitine administration improved progressive sperm motility.  Improvements were particularly marked and sustained in 60% of patients.  Female partners of 5 patients became pregnant during the Acetyl L-Carnitine therapy.4  

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Fructose and Citric Acid

Fructose and citric acid are reported to play important roles in sperm motility and concentration, particularly with regard to energy metabolism.5  Fructose and citric acid are closely involved in certain aspects of energy metabolism, through glucose utilization. Fructose is one of the major energy-yielding nutritive substrates present in human seminal fluid.6   (Fructose and Citric Acid are components of ProXeed™)

A 1997 study reported that low levels of seminal fructose are positively correlated with low seminal volume, low sperm motility and high sperm chromatin stability under SDS and EDTA treatment7.  This indicates that fructose supplementation in certain patients with male infertility caused by sperm disorders may have potential to increase sperm motility and the integrity of sperm DNA, thereby enhancing male fertility. 

Zinc, Vitamins B, C, and Antioxidants

Semen is normally rich in zinc.  Administration of exogenous systemic zinc to males with zinc deficiency can improve sperm production.8  Zinc, B Vitamins (B6, B12 and folic acid), Vitamin C, and Antioxidants are critical nutrients in the male reproductive system for proper hormone metabolism, sperm formation and motility.9,10,11,12 


From the book Milestones in Medicine: L-carnitine & acetylcarnitine in male infertility:  "These positive effects of both L-carnitine and acetylcarnitine on sperm quality were observed after at least 2 months of use, consistent with the 74-day sperm maturation cycle.  Continued improvements appeared to be evident for up to at least 6 months of administration."

"Based on biochemical parameters of L-carnitine/acetylcarnitine ratios discussed in earlier sections, and preceding clinical results [see above], the administration of L-carnitine and acetylcarnitine in a combination therapy presents a valid option for improving sperm quality.  Improvements in sperm quality should be expected within 2 months of initiation of therapy, with maximum improvements after 6 months of therapy."  

"For males with idiopathic infertility, dietary supplementation with a combination of well tolerated, clinically efficacious and non-invasive vitamins and vitamin-like agents, such as L-carnitine, acetylcarnitine, vitamins C and E, and fructose, citric acid, selenium and zinc, provides an alternative pharmacological therapy which can improve sperm quality and aid a couple in achieving pregnancy."

"Administration of these compounds significantly improves sperm quality; and the higher the quality of sperm, the greater the likelihood of spontaneous conception, or the greater the likelihood of success of ART (the higher the quality of sperm used, the greater the odds of success)." 

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Comparison of ProXeed to Off-the-Shelf Nutritional Supplements

Off-the-shelf dietary supplements are available for couples who are trying to conceive. Clinical trials have shown that the ingredients in these individual supplements optimize sperm quality, as measured by sperm count, concentration, motility and speed.   

Because sperm require 74 days to mature, these nutritional supplements should be taken for at least three months to see initial improvement in sperm quality.*  Sperm also require up to 20 additional days to be capable of fertilization. Researchers have found continued improvement during the first 6 months of usage.  Use according to your fertility doctors recommendation or until conception.  

These off-the-shelf supplements provide top-quality products, conveniently available, and save you money. 

The combination of L-Carnitine and Acetyl L-Carnitine has been patented based on the presumption that it would not have been obvious to anyone who has studied fertility to consider using these two supplements in combination.  Please purchase the product ProXeed if you want to use this combination.  

Here is a comparison of a 1-month supply of off-the-shelf supplements to ProXeed™.

Off-the-shelf supplements ProXeed™*
1-month supply
1 bottle L-Carnitine Fumarate 500 mg 120 tablets 2 boxes with 30 pouches each (containing L-Carnitine, Acetyl L-Carnitine, Fructose and Citric Acid)
1 bottle Acetyl L-Carnitine 500 mg 60 tablets
30+ pouches Emer'gen-C Raspberry in 1 box (containing Fructose, Citric acid, Vitamins C & B-12, Folic acid, Zinc, alpha lipoic acid and Raspberry powder)
Each Daily Serving Contains  
2g L-Carnitine Fumarate 2g L-Carnitine Fumarate
1g Acetyl L-Carnitine 1g Acetyl L-Carnitine
4.4g Fructose 4g Fructose
Ascorbic, citric, tartaric, aspartic and malic acid base Citric Acid
1g Vitamin C as mineral ascorbates 1111% DV none
25 mcg Vitamin B-12 (Cyanocobalamin)  416% DV none
12.5 mcg Folic Acid 3.1% DV none
2mg Zinc 13% DV none
1mg Alpha lipoic acid - antioxidant none
1g Raspberry powder - antioxidant none
no preservatives polyethylene glycol**
natural flavorings artificial flavorings
Take 2 capsules L-Carnitine twice per day Take 1 pouch twice per day
Take 1 tablet Acetyl L-Carnitine twice per day  
Take 1 pouch Emer'gen-C once per day  
$59 per month $99 per month
$220 for 4 months $383 for 4 months
$330 for 6 months $535 for 6 months
30-day total satisfaction guarantee No returns allowed
$5 per order in the U.S., no matter how much you order Not disclosed

%DV = percent daily value
*Based on data published on the ProXeed
web site January, 2004.  Prices updated 9/6/06, reflecting a 16% price reduction.
** Polyethylene glycol-electrolyte solution (PEG-ES) is used to cleanse the bowel before a gastrointestinal examination or surgery. It works by causing diarrhea.
Polyethylene glycol, a preservative that penetrates wood and displaces water - Baltimore Sun, MD, Dec 29, 2003.


  1. Campaniello E, Petrarolo N, Meriggiola MC, Valdiserri A, Pareschi A, Ucci N, Flamigni C, Filicori M. Carnitine administration in asthenospermia [abstract]. In: IV Int Congress Andrology; 1989 May; Firenze. p.14-18(5).

  2. Vitali G, Parente R, Melotti C. Carnitine supplementation in human idiopathic asthenospermia: clinical results. Drugs Exp Clin Res 1995;21(4):157-9.

  3. Costa M, Canale D, Filicori MD, Iddio S, Lenzi A. L-carnitine in idiopathic asthenozoospermia: a multicenter study. Andrologia 1994 May;26(3):155-9.

  4. Moncada ML, Vicari E, Cimino C, Calogero AE, Mongioi A, D’Agata R. Effect of acetylcarnitine treatment in oligoasthenospermic patients. Acta Eur Fertil 1992;23(5):221-224.

  5. Prendergast FG, Veneziale CM. Control of fructose and citrate synthesis in guinea pig seminal vesicle epithelium. J Biol Chem 1975;250: 1282-1289.

  6. Videla E, Blanco AM, Galli ME, et al. Human seminal biochemistry: fructose, ascorbic acid, citric acid, acid phosphatase and their relationship with sperm count.  Andrologia 1981; 13:212-214. 

  7. Gonzales GF, Villena A. Influence of low corrected seminal fructose levels on sperm chromatin stability in semen from men attending an infertility service. Fertil Steril 1997;67:763-768.

  8. Takihara H, et al.  1987.  Zinc sulphate therapy for infertile male with or without varicocelectomy.  Urol 29(6):638-41.
  9. Moriyama H, et al. 1987. Studies on the usefulness of a long-term, high-dose treatment of methylcobalamin in patients with oligozoospermia.  Hin Kiyo 33(1):151-6.

  10. Czeizel AE.  1998.  Periconceptual folic acid containing multivitamin supplementation.  Eur J Obstet Gynecol Reprod Biol 78(2):151-61.

  11. Dawson EB, et al. 1992. Effect of ascorbic acid supplementation on the sperm quality of smokers. Fertil & Steril 58(5):1034-9.
  12. Geva E, et al. 1996. The effect of antioxidant treatment on human spermatazoa and fertilization rate in an in vitro fertilization program.  Fertil & Steril 66(3):430-4.

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