2019 / 3 January

Coenzyme Q10 in patients with idiopathic male infertility


Today’s medical biochemistry note is about Coenzyme Q10 and idiopathic male infertility.

Worldwide 15% of reproductive-age couples suffer from infertility, and male infertility contributes to almost half of infertility cases [1-3]. Male infertility can be attributed to multifactorial heterogeneous conditions, including varicocele, cryptorchidism, hypogonadism, infection, systemic diseases, testicular cancer, genetic abnormalities, and oxidative stress-induced male infertility. In approximately 30% to 40% of cases, no known etiology is identified, and this condition has been termed as idiopathic male infertility [1,3-5].

The effect of reactive oxygen species (ROS) and free radical-mediated injury to spermatozoa has been identified as an important mediator of male infertility by causing damage to the sperm membrane and decreasing sperm motility. Studies have reported suppressed antioxidant capacity and increase levels of ROS in the seminal fluid of infertile men in comparison to their controls [1, 2, 6-7].

Coenzyme Q10 (CoQ10) is fat-soluble ubiquinone with bioenergetic and the antioxidant role. It is a crucial component of the mitochondrial respiratory chain and is present in well-measurable levels in seminal fluid, where it probably exerts an essential function in energy metabolism and antioxidant properties [1, 8] Concentration in seminal fluid of CoQ10 is correlated with sperm count and motility and alterations of CoQ10 content are associated with male infertility, such as asthenozoospermia and varicocele [9, 10] Furthermore, the damage of oxidative stress on seminal fluid is considered responsible for 30% to 80% of male subfertility cases [11].

CoQ10 is a non-enzymatic antioxidant and free radical scavenging found in human mitochondria. Approximately half of the body’s CoQ10 is endogenously synthesized via the cholesterol metabolic pathway, and the remainder is obtained through diet in organic meats, beef, soy oil, sardines, and peanut [1, 2, 8, 9, 12]. Supplementation with CoQ10 enhances sperm parameters in infertile men such as motility, morphology, and concentration according to several clinical trials and a meta-analysis published by Lafuente et al. [13-15]. However, whether these improvements in sperm parameters translate to higher rates of conception or live birth is still unclear.

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References

  1. Majzoub A, Agarwal A. Systematic review of antioxidant types and doses in male infertility: Benefits on semen parameters, advanced sperm function, assisted reproduction and live-birth rate. Arab J Urol. 2018;16(1):113-124. Published 2018 Jan 2. doi:10.1016/j.aju.2017.11.013
  2. Alahmar AT. The effects of oral antioxidants on the semen of men with idiopathic oligoasthenoteratozoospermia. Clin Exp Reprod Med. 2018;45(2):57-66.
  3. Kothandaraman N, Agarwal A, Abu-Elmagd M, Al-Qahtani MH. Pathogenic landscape of idiopathic male infertility: new insight towards its regulatory networks. NPJ Genom Med. 2016;1:16023. Published 2016 Aug 17. doi:10.1038/npjgenmed.2016.23.
  4. Agarwal A, Durairajanayagam D, Halabi J, Peng J, Vazquez-Levin M. Proteomics, oxidative stress and male infertility. Reprod Biomed Online. 2014 Jul;29(1):32-58. doi: 10.1016/j.rbmo.2014.02.013.
  5. Yu B, Huang Z. Variations in Antioxidant Genes and Male Infertility. Biomed Res Int. 2015;2015:513196. doi: 10.1155/2015/513196.
  6. Bisht S, Faiq M, Tolahunase M, Dada R. Oxidative stress and male infertility. Nat Rev Urol. 2017 Aug;14(8):470-485. doi: 10.1038/nrurol.2017.69.
  7. Agarwal A, Virk G, Ong C, du Plessis SS. Effect of oxidative stress on male reproduction. World J Mens Health. 2014;32(1):1-17.
  8. Mancini A, De Marinis L, Littarru GP, Balercia G. An update of Coenzyme Q10 implications in male infertility: biochemical and therapeutic aspects. Biofactors. 2005;25(1-4):165-74.
  9. Tiseo BC, Gaskins AJ, Hauser R, Chavarro JE, Tanrikut C, EARTH Study Team. Coenzyme Q10 Intake From Food and Semen Parameters in a Subfertile Population. Urology. 2016;102:100-105.
  10. Balercia G, Mancini A, Paggi F, Tiano L, Pontecorvi A, Boscaro M, Lenzi A, Littarru GP. Coenzyme Q10 and male infertility. J Endocrinol Invest. 2009 Jul;32(7):626-32. doi: 10.3275/6301.
  11. Showell MG, Brown J, Yazdani A, Stankiewicz MT, Hart RJ. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2011 Jan 19;(1):CD007411. doi:10.1002/14651858.CD007411.pub2.
  12. Mancini A, Balercia G. Coenzyme Q(10) in male infertility: physiopathology and therapy. Biofactors. 2011 Sep-Oct;37(5):374-80. doi: 10.1002/biof.164.
  13. Lafuente R, González-Comadrán M, Solà I, et al. Coenzyme Q10 and male infertility: a meta-analysis. J Assist Reprod Genet. 2013;30(9):1147-56.
  14. Nadjarzadeh A, et al. Effect of Coenzyme Q10 supplementation on antioxidant enzymes activity and oxidative stress of seminal plasma: a double-blind randomised clinical trial. Andrologia. 2014 Mar;46(2):177-83. doi:10.1111/and.12062.
  15. 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.

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