Plain English Summary
Background and study aims
A couple's inability to conceive after 1 year of regular unprotected intercourse clinically defines infertility, a condition which affects approximately 15% of the reproductive-aged population. Over half of all cases are at least partly due to make fertility problems and up to 40% is due to male fertility problems alone. Male infertility is often linked to abnormalities apparent when the semen is examined. About one third of infertile men are affected by a condition called idiopathic (oligo)±(atheno)±(terato) spermia (iOAT): which occurs despite no evidence of any clinical, instrumental and biochemical sign. iOAT does not respond to therapy and affected men often require assistance if they are to reproduce. This study is investigating a new therapy for iOAT.
Who can participate?
Infertile men, aged 20-50 years with iOAT.
What does the study involve?
Participants are randomly allocated to one of two groups. Those in group 1 are given the drug Flortec-Bracco once a day for three months. Participants in group 2 are given a placebo (starch) tablet once a day for three months. Each participant provides two sperm samples before and then again after the treatment period. The samples are then analysed for sperm count and mobility (how well they move).
What are the possible benefits and risks of participating?
The only benefit for participating will be the fact that patients treated with the active drug might have their problem cured. No side effect s are expected.
Where is the study run from?
Gynepro Medical (Italy)
When is the study starting and how long is it expected to run for?
January 2015 to December 2016
Who is funding the study?
Gynepro Medical (Italy)
Who is the main contact?
Dr Carlo Maretti
Oral administration of a placebo (starch) or of an active drug (L. paracasei B21060 + arabinogalattan and fruttoligosaccarides (Flortec-Bracco)) to two distinct populations of (oligo)±(atheno)±(terato) spermic infertile patients. Comparison of efficacy and of safety between placebo and active drug for the treatment of (Oligo)±(atheno)±(terato) spermia associated to idiopathic male infertility.
EPA (Evidence for Pregnancy Achievement)
The aim of this study is to assess whether oral administration of probiotics and prebiotics (L. paracasei B21060 + arabinogalattan and fruttoligosaccarides (Flortec-Bracco)) improves sperm count and fertility of dyspermic infertile patients.
Bioethics Committee, GynePro Medical, 29/06/2016, ref: CdB 0112016
Interventional double-blind placebo-controlled study
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
Not available in web format, please use the contact details to request a participant information sheet
Idiopathic (Oligo)±(atheno)±(terato) spermia associated to male infertility.
This study consists of two arms. Participants will be randomly allocated to one of these arms.
The patients of the first arm will be treated with active drug: L. paracasei B21060 + arabinogalattan and fruttoligosaccarides (Flortec-Bracco) one medicine sachet (containing L. paracasei B21060≥ 5 x 109 Colony Forming Units, Arabinogalattan 1.243 g, fructo-oligosaccarides 700 mg, L-glutammin 500 mg) once a day for six months.
The patients of the second arm will assume one 1 g starch tablet once a day for three months.
Three months after the suspension of the therapies the patients of both arms will be submitted to sperm analysis, hormonal assessment and bilateral scrotal echographic scan. Medical events occurred in this time will be recorded as well.
Primary outcome measure
Sperm concentration, sperm motility and percentage of typical sperm forms, measured at baseline and at 3 months
Secondary outcome measures
1. The number of biochemical pregnancies (detected by measuring serum β-hCG on at least two occasions 14 days after the last expected menstruation)
2. The numbers of clinical pregnancies (defined as detectable heart activity)
The differences between active drug or placebo group were assessed using the Mann–Whitney U test.
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
1. Infertile (oligo)±(atheno)±(terato) spermic infertile males aged 20-50
2. Normal sperm appearance, consistency, liquefaction, volume, and pH
Target number of participants
This is a prospective blind placebo controlled trial. Active drug has no side effect thus a power analysis will be performed to estimate the number of observations we need to have a reliable chance of detecting the effect we are looking for. Since there are no formal standards for power (π), we have assessed the power of our tests using π = 0.90 as a standard for adequacy. This convention implies a ten-to-one trade off between β-risk and α-risk. Beta is the probability of a type-II error (not detecting a difference between the patients groups when one actually exists: false negative) this research used a 10% cut-off; α is the probability of a type-I error (finding a difference betwenn the patient groups when a difference does not exist: false positive), this research used a 1% cut-off (Mc Donald et al. 2009). The power calculations were performed with G*Power 3 statistical power analysis program (Faul et al. 2007). At worst 40 patients for each cluster will be studied. (Faul et al. 2007). References Faul, F, Erdfelder E, Lang, AG, & Buchner, A. (2007) G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Meth. 39, 175-191. McDonald JH (2009) Handbook of Biological Statistics (2nd Edition), Sparky House Publishing, Baltimore MD.
Participant exclusion criteria
2. Seminal white blood cell concentration greater than 1 million/ml and/or a positive seminal cultural analysis or 3. Positive urethral swab chlamydia test
4. Drug, tobacco, or alcohol abuse
5. Ongoing medical treatment
6. Previous cancer radiotherapy or chemotherapy
7. Palpable varicocele
8. X-ray exposure in the previous 8 months
9.Y chromosome microdeletion
10. Karyotype alterations
11. Presence of female factors for infertility
12. Female partner age > 35 years
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
via Tanquillo Cremona 8
via Tranquillo Cremona 8
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
To be confirmed at a later date
IPD sharing statement
The datasets generated during and/or analysed during the current study are/will be available upon request from Dr Giorgio Cavallini
Intention to publish date
Participant level data
Available on request
Basic results (scientific)
2017 results in: https://www.ncbi.nlm.nih.gov/pubmed/28245352