Monday Pharmaceutical Mystery: May 6
A middle-aged lady, in her 40s, comes to your pharmacy buying a pregnancy test. As you ring her up, she tells you, “I can believe it. I just can’t believe it. I’m pregnant, and I don’t know how it happened. Well, I do…and I don’t. You see my husband and I had to go to the fertility doctor to have our 2 children because he has a really low sperm count. But our kids are teenagers now and I have never had to worry about birth control.”
You refrain from making any sort of comment. The customer continues to speak freely. “We have been together 20 years, and I have never had to worry about getting pregnant, but now I have morning sickness, and my pregnancy test yesterday was positive. I’m going to repeat the test because I think maybe my pregnancy test is not accurate.”
The customer asks you, “Is it possible that he just randomly started making sperm? The fertility doctor said his sperm count was permanently low due to an infection that left irreversible damage? I don’t how it magically got repaired. He’s going through a middle-aged crisis and taking all sorts of dietary supplements to get healthy. It doesn’t look like they are working, but could they possibly affect his sperm?”
Mystery: How did this woman unexpectedly get pregnant if her husband has been diagnosed with a permanently low sperm count? What is going on?
Solution: There is 1 dietary supplement on the market that is used by fertility doctors to increase sperm count and motility. It is an amino acid and an energy precursor. Many people looking to get healthy take it. The customer’s husband is taking that product. It is called L-carnitine/l-acetyl-carnitine.
Lenzi A, Sgro P, Salacone P, et al. A placebo-controlled double-blind randomized trial of the use of combined l-carnitine and l-acetyl-carnitine treatment in men with asthenozoospermia. Fertil Steril 2004;81:1578-84
Cavallini G, Ferraretti AP, Gianaroli L, Biagiotti G, Vitali G. Cinnoxicam and L-carnitine/acetyl-L-carnitine treatment for idiopathic and varicocele-associated oligoasthenospermia. J Androl 2004;25(5):761-770