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It is assumed that the level of acylcarnitines in blood mirrors the accumulating acyl-CoA species inside mitochondria which cause the carnitine shuttle to operate in the reverse fashion [32]

54 Li, Y., et al., Significant association between methylenetetrahydrofolate reductase gene C677T polymorphism with polycystic ovary syndrome risk: A meta-analysis update

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However, if low sperm count is caused by other factors like hormonal imbalances or structural issues, L carnitine alone may not be sufficient, and additional evaluation by a urologist or reproductive endocrinologist is recommended