Skip to main content
Springer Nature Link
Log in

Coenzyme Q10 and male infertility: a meta-analysis

  • Gonadal Physiology and Disease
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Objective

To evaluate the effect of coenzyme Q10 treatments in male infertility, specifically in these parameters: live birth and pregnancy rates, CoQ10 seminal concentration, sperm concentration, and sperm motility.

Materials and methods

Systematic review and meta-analysis in male infertility patients with CoQ10 oral treatments. Three trials were included: 149 males in CoQ10 group and 147 males in placebo group.

Results

None of the included trials provided any data regarding live births. The results of this meta-analysis show that supplementing infertile men with CoQ10 does not increase pregnancy rates. The analysis showed, among patients receiving CoQ10 treatment, a statistically significant increase in: CoQ10 seminal concentration (RR 49.55, 95 % CI 46.44 to 52.66, I2 = 17 %), sperm concentration (RR 5.33, 95 % CI 4.18 to 6.47, I2 = 58 %), and sperm motility (RR 4.50, 95 % CI 3.92 to 5.08, I2 = 0 %)

Conclusion

There is no evidence in the literature that CoQ10 increases either live birth or pregnancy rates, but there is a global improvement in sperm parameters. Adequately powered, robust trials of individual and combination antioxidant therapies are required to guide clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Agarwal A, Saleh RA, Bedaiwy MA. Role of reactive oxygen species in the pathophysiology of human reproduction. Fertil Steril. 2003;79:829–43.

    Article  PubMed  Google Scholar 

  2. Agarwal A, Said TM. Carnitines and male infertility. Reprod Biomed Online. 2004;8(4):376–84. Review.

    Article  PubMed  CAS  Google Scholar 

  3. Aitken RJ, Clarkson JS, Fishel S. Generation of reactive oxygen species, lipid peroxidation and human sperm function. Biol Reprod. 1989;40:183–97.

    Article  Google Scholar 

  4. Alleva R, Scararmucci A, Mantero F, Bompadre S, Leoni L, Littarru GP. The protective role of ubiquinol-10 against formation of lipid hydroperoxides in human seminal fluid. Mol Aspects Med. 1997;18(Suppl):S221–8.

    Article  PubMed  CAS  Google Scholar 

  5. Auger J, Eustache F, Andersen AG, Irvine DS, Jorgensen N, Skakkebaek NE, et al. Sperm morphological defects related to environment, lifestyle and medical history of 1001 male partners of pregnant women from four European cities. Hum Reprod. 2001;16:2710–7.

    Article  PubMed  CAS  Google Scholar 

  6. Balercia G, Armeni T, Mantero F, Principato G, Regoli F. Total oxyradical scavenging capacity toward different reactive oxygen species in seminal plasma and sperm cells. Clin Chem Lab Med. 2003;41(1):13–9.

    Article  PubMed  CAS  Google Scholar 

  7. Balercia G, Buldreghini E, Vignini A, Tiano L, Paggi F, Amoroso S, et al. Coenzyme Q10 treatment in infertile men with idiopathic asthenozoospermia: a placebo-controlled, double-blind randomized trial. Fertil Steril. 2009;91(5):1785–92.

    Article  PubMed  CAS  Google Scholar 

  8. Balercia G, Mancini A, Paggi F, Tiano L, Pontecorvi A, Boscaro M, et al. Coenzyme Q10 and male infertility. J Endocrinol Invest. 2009;32(7):626–32. Review.

    PubMed  CAS  Google Scholar 

  9. Cavallini G, Ferraretti AP, Gianaroli L, Biagiotti G, Vitali G. Cinnoxicam and L-carnitine/acetyl-L-carnitine treatment for idiopathic and varicocele-associated oligoasthenospermia. J Androl. 2004;25(5):761–70.

    PubMed  CAS  Google Scholar 

  10. Comhaire FH, Christophe AB, Zalata AA, Dhooge WS, Mahmoud AM, Depuydt CE. The effects of combined conventional treatment, oral antioxidants and essential fatty acids on sperm biology in subfertile men. Prostaglandins Leukot Essent Fat Acids. 2000;63(3):159–65.

    Article  CAS  Google Scholar 

  11. Comhaire FH, El Garem Y, Mahmoud A, Eertmans F, Schoonjans F. Combined conventional/antioxidant “Astaxanthin” treatment for male infertility: a double blind, randomized trial. Asian J Androl. 2005;7(3):257–62.

    Article  PubMed  CAS  Google Scholar 

  12. Dawson EB, Harris WA, Teter MC, Powell LC. Effect of ascorbic acid supplementation on the sperm quality of smokers. Fertil Steril. 1992;58(5):1034–9.

    PubMed  CAS  Google Scholar 

  13. Eskenazi B, Kidd SA, Marks AR, Sloter E, Block G, Wyrobek AJ. Antioxidant intake is associated with semen quality in healthy men. Hum Reprod. 2005;20(4):1006–12.

    Article  PubMed  CAS  Google Scholar 

  14. Farquharson RG, Jauniaux E, Exalto N, ESHRE Special Interest Group for Early Pregnancy (SIGEP). Updated and revised nomenclature for description of early pregnancy events. Hum Reprod. 2005;20(11):3008–11.

    Article  PubMed  Google Scholar 

  15. Fleiss JL. The statistical basis of meta-analysis. Stat Methods Med Res. 1993;2(2):121–45. Review.

    Article  PubMed  CAS  Google Scholar 

  16. Fraga CG, Motchnik PA, Shigenaga MK, Helbock HJ, Jacob RA, Ames BN. Ascorbic acid protects against endogenous oxidative DNA damage in human sperm. Proc Natl Acad Sci U S A. 1991;88(24):11003–6.

    Article  PubMed  CAS  Google Scholar 

  17. Fraga CG, Motchnik PA, Wyrobek AJ, Rempel DM, Ames BN. Smoking and low antioxidant levels increase oxidative damage to sperm DNA. Mutat Res. 1996;351(2):199–203.

    Article  PubMed  Google Scholar 

  18. Ford WC, Whittington K. Antioxidant treatment for male subfertility: a promise that remains unfulfilled. Hum Reprod. 1998;13(6):1416–9.

    Article  PubMed  CAS  Google Scholar 

  19. Geva E, Bartoov B, Zabludovsky N, Lessing JB, Lerner-Geva L, Amit A. The effect of antioxidant treatment on human spermatozoa and fertilization rate in an in vitro fertilization program. Fertil Steril. 1996;66(3):430–4.

    PubMed  CAS  Google Scholar 

  20. Groneberg DA, Kindermann B, Althammer M, Klapper M, Vormann J, Littarru GP, et al. Coenzyme Q10 affects expression of genes involved in cell signalling, metabolism and transport in human CaCo-2 cells. Int J Biochem Cell Biol. 2005;37(6):1208–18.

    Article  PubMed  CAS  Google Scholar 

  21. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–60.

    Article  PubMed  Google Scholar 

  22. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Versio 5.1.0. The Cochrane Collaboration, 2011. Available from http://handbook.cochrane.org

  23. Johnson L, Varner DD. Effect of daily spermatozoan production but not age on transit time of spermatozoa through the human epididymis. Biol Reprod. 1988;39(4):812–7.

    Article  PubMed  CAS  Google Scholar 

  24. Kessopoulou E, Powers HJ, Sharma KK, Pearson MJ, Russell JM, Cooke ID, et al. A double-blind randomized placebo cross-over controlled trial using the antioxidant vitamin E to treat reactive oxygen species associated male infertility. Fertil Steril. 1995;64(4):825–31.

    PubMed  CAS  Google Scholar 

  25. Lanzafame FM, La Vignera S, Vicari E, Calogero AE. Oxidative stress and medical antioxidant treatment in male infertility. Reprod Biomed Online. 2009;19(5):638–59. Review.

    Article  PubMed  CAS  Google Scholar 

  26. Lenzi A, Picardo M, Gandini L, Dondero F. Lipids of the sperm plasma membrane: from polyunsaturated fatty acids considered as markers of sperm function to possible scavenger therapy. Hum Reprod Update. 1996;2(3):246–56. Review.

    Article  PubMed  CAS  Google Scholar 

  27. Lenzi A, Lombardo F, Sgrò P, Salacone P, Caponecchia L, Dondero F, et al. Use of carnitine therapy in selected cases of male factor infertility: a double-blind crossover trial. Fertil Steril. 2003;79(2):292–300.

    Article  PubMed  Google Scholar 

  28. Lenzi A, Sgrò P, Salacone P, Paoli D, Gilio B, Lombardo F, et al. A placebo-controlled double-blind randomized trial of the use of combined l-carnitine and l-acetyl-carnitine treatment in men with asthenozoospermia. Fertil Steril. 2004;81(6):1578–84.

    Article  PubMed  CAS  Google Scholar 

  29. Littarru GP, Tiano L. Bioenergetic and antioxidant properties of coenzyme Q10: recent developments. Mol Biotechnol. 2007;37(1):31–7. Review.

    Article  PubMed  CAS  Google Scholar 

  30. Littarru GP, Tiano L. Clinical aspects of coenzyme Q10: an update review. Nutrition. 2010;26(3):250–4.

    Article  PubMed  CAS  Google Scholar 

  31. López G, Lafuente R, Checa MA, Monqaut A, Brassesco M. Effect of a treatment with vitamins, L-carnitine and coenzyme Q10 on sperm head vacuolization and DNA fragmentation on in vitro fertilization patients. Rev Int Androl. 2011;09(4):154–9.

    Google Scholar 

  32. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.

    Article  PubMed  Google Scholar 

  33. Nadjarzadeh A, Sadeghi MR, Amirjannati N, Vafa MR, Motevalian SA, Gohari MR, et al. Coenzyme Q10 improves seminal oxidative defense but does not affect on semen parameters in Idiopathic Oligoasthenoteratozoospermia: a Randomized Double-blind, placebo Controlled Trial. J Endocrinol Invest 2011; e224-e228.

  34. Rao B, Soufir JC, Martin M, David G. Lipid peroxidation in human spermatozoa as related to midpiece abnormalities and motility. Gamete Res. 1989;24:127–34.

    Article  PubMed  CAS  Google Scholar 

  35. Ross C, Morriss A, Khairy M, Khalaf Y, Braude P, Coomarasamy A, et al. A systematic review of the effect of oral antioxidants on male infertility. Reprod Biomed Online. 2010;20(6):711–23.

    Article  PubMed  CAS  Google Scholar 

  36. Safarinejad MR. Efficacy of coenzyme Q10 on semen parameters, sperm function and reproductive hormones in infertile men. J Urol. 2009;182:237–48.

    Article  PubMed  CAS  Google Scholar 

  37. Sheweita S, Tilmisany A, Al-Sawaf H. Mechanisms of male infertility: role of antioxidants. Curr Drug Metab. 2005;6(5):495–501.

    Article  PubMed  CAS  Google Scholar 

  38. Showell MG, Brown J, Yazdani A, Stankiewicz MT, Hart RJ. Antioxidants for male subfertility. Cochrane Database Syst Rev 2011, Issue 1. Art. No.: CD007411. DOI: 10.1002/14651858.CD007411.pub2

  39. Tremellen K, Miari G, Froiland D, Thompson J. A randomised control trial examining the effect of an antioxidant (Menevit) on pregnancy outcome during IVF-ICSI treatment. Aust N Z J Obstet Gynaecol. 2007;47(3):216–21.

    Article  PubMed  Google Scholar 

  40. Tulsiani DR. Carbohydrates mediate sperm-ovum adhesion and triggering of the acrosome reaction. Asian J Androl. 2000;2:87–97.

    PubMed  CAS  Google Scholar 

  41. Wathes DC, Abayasekara DR, Aitken RJ. Polyunsaturated fatty acids in male and female reproduction. Biol Reprod. 2007;77(2):190–201.

    Article  PubMed  CAS  Google Scholar 

  42. WHO laboratory manual for the examination and processing of human semen. Fourth edition. 1999.

  43. Wolff H, Politch JA, Martinez A, Haimovici F, Hill JA, Anderson DJ. Leukocytospermia is associated with poor semen quality. Fertil Steril. 1990;53(3):528–36.

    PubMed  CAS  Google Scholar 

  44. Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009.

Download references

Conflict of interest

The authors declare no conflict of interest.

Financial support

None

Author information

Authors and Affiliations

  1. Andrology Laboratory, CIRH. Clínica Corachan. ANACER, Eguilaz, 14, bajos, 08017, Barcelona, Spain

    Rafael Lafuente & Gemma López

  2. Medical Department, CIRH. Clínica Corachan. ANACER, Eguilaz, 14, bajos, 08017, Barcelona, Spain

    Mario Brassesco

  3. Department of Obstetrics and Gynecology, Hospital del Mar, Barcelona, Spain

    Mireia González-Comadrán, Ramón Carreras & Miguel A. Checa

  4. Iberoamerican Cochrane Centre, Institute of Biomedical Research, IIB Sant Pau, Barcelona, Spain

    Ivan Solà

  5. CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain

    Ivan Solà

Authors
  1. Rafael Lafuente
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Mireia González-Comadrán
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Ivan Solà
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Gemma López
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Mario Brassesco
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Ramón Carreras
    View author publications

    You can also search for this author inPubMed Google Scholar

  7. Miguel A. Checa
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Rafael Lafuente.

Additional information

Capsule Oral treatment with Coenzyme Q10 improves sperm concentration and sperm motility, but there is no evidence that increases either live birth or pregnancy rates.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lafuente, R., González-Comadrán, M., Solà, I. et al. Coenzyme Q10 and male infertility: a meta-analysis. J Assist Reprod Genet 30, 1147–1156 (2013). https://doi.org/10.1007/s10815-013-0047-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-013-0047-5

Keywords