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The cells were cultured in Eagles minimum essential medium (ThermoFisher Scientific) or DMEM F-12 (ThermoFisher Scientific) respectively, supplemented with 10% Fetal Bovine Serum (Gibco) and 1% penicillinstreptomycin (ThermoFisher Scientific), in a humidified incubator maintaining 5% CO 2 at 37 C

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[59] discovered that an extender containing l-carnitine could improve sperm quality and increase the number of sperm bound to the zona pellucida

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However, clinical practitioners often recommend a "start low and go slow" approach, particularly for patients with severe chronic illness who may be highly sensitive to new supplements or prone to detoxification reactions (Herxheimer reactions)