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In-vitro (Latin: in glass) refers to studies conducted outside of a living organism

191 In one randomized controlled trial that included 175 men with infertility, taking a supplement providing 1 gram L-carnitine and 0.5 grams acetyl-L-carnitine, as well as 725 mg fumarate, 1 gram fructose, 50 mg citric acid, 10 mg zinc, 20 mg CoQ10, 50 mcg selenium, 90 mg vitamin C, 200 mcg folic acid, and 1.5 mcg B12, twice daily improved sperm motility, semen volume, and DNA fragmentation compared with placebo after six months

(2015) 10:e0123088

Vitamin C metabolism produces oxalate and some studies have linked vitamin C to increased risk for kidney stone formation (24)

Cell lines offer the advantages of immortality and high reproducibility, facilitating long-term, continuous experimentation without needing to maintain low passage numbers

Acknowledgements We thank the patients for their diligent and active participation