Predictors of pregnancy and time to pregnancy in infertile men with idiopathic oligoasthenospermia pre‐ and post‐coenzyme Q10 therapy

Abstract

Different antioxidants including coenzyme Q10 (CoQ10) have been tried to treat idiopathic male infertility (IMI) with variable results. Therefore, this study aimed to determine the clinical and biochemical predictors of pregnancy outcome and time to pregnancy (TTP) in infertile men with idiopathic oligoasthenospermia (OA) pre-and post-CoQ10 therapy. This prospective controlled clinical study included 178 male patients with idiopathic OA and 84 fertile men (controls). Patients received 200 mg of oral CoQ10 once daily for 6 months. Demographics, semen parameters, seminal CoQ10 levels, reactive oxygen species (ROS) levels, total antioxidant capacity (TAC), catalase (CAT), glutathione peroxidase (GPx), sperm DNA fragmentation (SDF) and body mass index were measured and compared at baseline and after 6 months. All participants were followed up for another 18 months for pregnancy outcome and TTP. CoQ10 therapy for 6 months significantly improved semen parameters, antioxidant measures and reduced SDF. The pregnancy rate was 24.2% and TTP was 20.52 ± 6.72 months in patients as compared to 95.2% and 5.73 ± 6.65 months in fertile controls. After CoQ10 therapy, CoQ10 level, sperm concentration, motility and ROS were independent predictors of pregnancy outcome and CoQ10 level, male age, sperm concentration, motility, ROS and GPx were independent predictors of TTP in patients. In conclusion, CoQ10 therapy of 6 months is a potential treatment for men with idiopathic OA. CoQ10 level, male age, semen parameters, ROS and GPx could potentially be used as diagnostic biomarkers for male fertility and predictors for pregnancy outcome and TTP in these patients.

Coenzyme Q10 and Melatonin for the Treatment of Male Infertility: A Narrative Review

“…As previously reported, Alahmar et al [ 36 ] investigated the effect of 200 mg CoQ10 for 6 months in 78 iOA infertile men vs. controls. Treatment significantly improved semen parameters, antioxidant biomarkers and SDF.…”

“…More recently, a prospective study investigated 78 patients with idiopathic OA treated with 200 mg of CoQ10 for 6 months and 84 fertile men (controls) [ 36 ]. The authors found that treatment improved semen parameters and antioxidant measures and reduced SDF in infertile participants.…”

COVID-19 and Male Infertility: Is There a Role for Antioxidants?

“…Although some antioxidant combinations positively impacted semen quality, the differences were generally minor, and no significant change in pregnancy rates was detected, probably due to their small sample size. L-carnitine, N-acetylcysteine (NAC) [ 111 , 112 , 113 , 129 , 130 ], coenzyme Q10 [ 114 , 115 ], and vitamin D [ 116 ] were some of the antioxidant combinations used in these studies with a positive impact on semen quality.…”

Medical management of male infertility: now and future

“…These studies were small scale, and although some combinations did demonstrate an improvement in semen parameters, the differences tended to be small, and no studies demonstrated a significant difference in pregnancy rates. The antioxidant combinations, which showed improvement in sperm parameters include CoQ10 [11 ▪ ,12 ▪ ], l -carnitine, N-acetyl-cysteine [13 ▪ ,14 ▪ ,15 ▪ ,16 ▪ ,17], and vitamin D [18 ▪ ].…”