Evaluation of Sperm Parameters in Asthenozoospermic Men: A Comparative Study of Swim-Up and Layering Techniques with Lepidium meyenii (Maca), L-Carnitine, and Pentoxifylline

Background & Objective: Infertility is a widespread health issue, with male factors solely responsible in approximately 20% of cases and contributing to an additional 30-40%.In vitro sperm preparation using motility-enhancing agents prior to assist reproductive techniques (ART) has shown potential in improving semen quality and increasing pregnancy rates.This study aimed to evaluate the effects of a novel combination of motility stimulants-Maca, L-carnitine, and pentoxifylline-on sperm function, particularly the DNA fragmentation index (DFI), and to compare the effectiveness of the swim-up and density gradient (layering) techniques for sperm activation. Materials & Methods:Semen samples were collected from 90 asthenozoospermic men.Samples were divided into two groups: a control group using Ham's F-12 medium and a treatment group using medium supplemented with Maca powder (1 mg/mL), pentoxifylline (10 mg/mL), and L-carnitine (0.5 mg/mL).Sperm activation was performed using both the swim-up and Layering techniques.Sperm parameters were evaluated according to WHO guidelines (1999 and 2021).Data were analyzed using SPSS version 23.0 with Student's t-test, ANOVA, and the LSD post-hoc test.Results: The treatment group demonstrated significant improvements (P<0.05) in sperm concentration, motility (grades A and B), morphology, and reduced DNA fragmentation index.Both preparation techniques showed comparable improvements, although the Layering (density gradient) method yielded slightly better outcomes in DNA integrity. Conclusion:The combination of pentoxifylline, L-carnitine, and Maca significantly enhanced sperm function.The Layering technique was marginally more effective than swim-up in selecting spermatozoa with intact DNA.