Efficacy and Safety of Coenzyme Q10 for Idiopathic Oligoasthenoteratozoospermia: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 YANGMing-gen , ZHENGZhou-da , XUZhen-qiang , LINHai-li , ZHUANGZhi-ming , ZHANGChao-xian ,  ZHENGYi-shu

Department of Urology, Zhangzhou Affiliated Hospital, Fujian Medical University, Zhangzhou 363000, China;

Corresponding author：

ZHENGYi-shu, Email: 597281365@qq.com

Keywords：

Coenzyme Q10; Antioxidant; Idiopathic oligoasthenoteratozoospermia; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.20160166

Video：

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Objective To systematically review the efficacy and safety of CoQ10 for idiopathic oligoasthenoteratozoospermia (iOAT). Methods We searched databases including PubMed, EMbase, MEDLINE, The Cochrane Library, CBM, CNKI, VIP and WanFang Data from inception to May 31^th 2016 for randomized controlled trials (RCTs) on CoQ10 in the treatment of iOAT. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results Seven RCTs involving 803 patients were included. The results of meta-analysis showed, compared with the control group, the CoQ10 group could significantly increase sperm concentration (MD=3.37, 95%CI 0.68 to 6.05, P=0.01), the number of A grade spermatozoa (MD=5.06, 95%CI 3.84 to 6.28, P < 0.000 01), the number of A+B grade spermatozoa (MD=7.72, 95%CI 4.19 to 11.26, P < 0.000 1), the rate of morphologically normal sperm (MD=1.89, 95%CI 0.63 to 3.16, P=0.003) and sperm coenzyme Q10 level (MD=40.02, 95%CI 24.73 to 55.31, P < 0.000 01), while not improve the levels of serum sex hormone (FSH: MD=–3.48, 95%CI –5.17 to –1.79, P < 0.000 1; LH: MD=–3.23, 95%CI –7.55 to 1.08, P=0.14; T: MD=0.45, 95%CI –3.31 to 4.20, P=0.82). No significant difference in adverse event was noted between two groups. Conclusion The evidence suggests that CoQ10 as empiric medical therapy for iOAT with low non-serious adverse event associated, may improve sperm concentration and percent sperm motility. However, the strength of evidence is low due to high risk of bias of the included studies. More rigorous studies are needed to verify the above conclusion.

Citation： YANGMing-gen, ZHENGZhou-da, XUZhen-qiang, LINHai-li, ZHUANGZhi-ming, ZHANGChao-xian, ZHENGYi-shu. Efficacy and Safety of Coenzyme Q10 for Idiopathic Oligoasthenoteratozoospermia: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(9): 1090-1096. doi: 10.7507/1672-2531.20160166 Copy

1.	Stahl PJ, Schlegel PN. Genetic evaluation of the azoospermic or severely oligozoospermic male. Curr Opin Obstet Gynecol, 2012, 24(4): 221-228.
2.	Kurpisz MK. New approaches to male infertility: Forum introduction. Reprod Biol Endocrinol, 2004, 2(3): 8-9.
3.	商学军, 郭军, 陈磊, 等.麒麟丸治疗少弱精子症的多中心临床疗效观察.中华男科学杂志, 2011, 17(12): 1139-1142.
4.	陈向锋, 李铮, 平萍, 等.天然维生素E辅助治疗特发性少弱精子症多中心前瞻性随机对照研究(附106例报告).中华男科学杂志, 2012, 18(5): 428-431.
5.	孙振高, 连芳, 姜鲲鹏, 等.生精片对男性少弱精子症患者精液参数的影响及其作用机制研究.中华男科学杂志, 2012, 18(8): 764-767.
6.	Ko EY, Siddiqi K, Brannigan RE, et al. Empirical medical therapy for idiopathic male infertility: a survey of the American Urological Association. J Urol, 2012, 187(3): 973-978.
7.	Chua ME, Escusa KG, Luna S, et al. Revisiting oestrogen antagonists (clomiphene or tamoxifen) as medical empiric therapy for idiopathic male infertility: a meta-analysis. Andrology, 2013, 1(5): 749-757.
8.	李伟, 李克, 黄宇烽.辅酶Q10的生物学功能及其对精子质量的影响.中华男科学杂志, 2006, 12(12): 1119-1122．.
9.	Agarwal A, Makker K, Sharma R. Clinical relevance of oxidative stress in male factor infertility: an update. Am J Reprod Immunol, 2008, 59(1): 2-11.
10.	Kefer JC, Agarwal A, Sabanegh E. Role of antioxidants in the treatment of male infertility. Int J Urol, 2009, 16(5): 449-57.
11.	Crane FL. Biochemical functions of coenzyme Q10. Am Coll Nutr, 2001, 20(6): 591-598.
12.	Watts G. Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J HumHypertens, 2007, 21(4): 297-306.
13.	Hamilton SJ, Chew GT, Watts GF. Coenzyme Q10 improves endothelial dysfunction in statin-treated type 2 diabetic patients. Diabetes Care, 2009, 32(5): 810-812.
14.	Balercia G, Buldreghini E, Vignini A, et al. Coenzyme Q10 treatment in infertile men with idiopathic asthenozoospermia: a placebo-controlled, double-blind randomized trial. Fertil Steril, 2009, 91(5): 1785-1792.
15.	Safarinejad MR. Efficacy of coenzyme Q10 on semen parameters, sperm function and reproductive hormones in infertile men. J Urol, 2009, 182(1): 237-248.
16.	Nadjarzadeh A, Sadeghi MR, Amirjannati N, et al. Coenzyme Q10 improves seminal oxidative defense but does not affect on semen parameters in idiopathicoligoasthenoteratozoospermia: a randomized double-blind, placebo controlled trial. J Endocrinol Invest, 2011, 34(8): e224-228.
17.	WHO. WHO Laboratory manual for the examination of human semen and sperm-cervical mucus interaction. 4^th ed. Cambridge: Cambridge University Press, 1999: 6-35.
18.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Chichester UK: Wiley and Sons, 2008.
19.	唐开发, 邢瑶, 仵春云, 等.他莫昔芬联合辅酶Q10治疗特发性少弱精子症临床疗效观察.中华男科学杂志, 2011, 17(7): 615-618.
20.	Safarinejad MR, Safarinejad S, Shafiei N, et al. Effects of the reduced form of coenzyme Q10 (ubiquinol) on semen parameters in men with idiopathic infertility: a double-blind, placebo controlled, randomized study. J Urol, 2012, 188(2): 526-531.
21.	Nadjarzadeh A, Shidfar F, Amirjannati N, 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, 46(2): 177-183.
22.	孙永.他莫西芬联合辅酶Q10治疗特发性少、弱、畸形精子症75例分析.中国优生与遗传杂志, 2014, 22(4): 121-122.
23.	Carlsen E, Giwercman A, Keiding N, et al. Evidence for decreasing quality of semen during past 50 years. BMJ, 1992, 305(6854): 609-613.
24.	黄春妍, 姚陈均, 王春, 等. 1985-2008年间我国正常男性精液质量变化分析.中华男科学, 2010, 16(8): 684-688.
25.	李克, 商学军, 陈爽, 等.高效液相色谱法检测精浆辅酶Q10水平及氧化应激研究.中华检验医学杂志, 2006, 29(3): 218-221.

1. Stahl PJ, Schlegel PN. Genetic evaluation of the azoospermic or severely oligozoospermic male. Curr Opin Obstet Gynecol, 2012, 24(4): 221-228.
2. Kurpisz MK. New approaches to male infertility: Forum introduction. Reprod Biol Endocrinol, 2004, 2(3): 8-9.
3. 商学军, 郭军, 陈磊, 等.麒麟丸治疗少弱精子症的多中心临床疗效观察.中华男科学杂志, 2011, 17(12): 1139-1142.
4. 陈向锋, 李铮, 平萍, 等.天然维生素E辅助治疗特发性少弱精子症多中心前瞻性随机对照研究(附106例报告).中华男科学杂志, 2012, 18(5): 428-431.
5. 孙振高, 连芳, 姜鲲鹏, 等.生精片对男性少弱精子症患者精液参数的影响及其作用机制研究.中华男科学杂志, 2012, 18(8): 764-767.
6. Ko EY, Siddiqi K, Brannigan RE, et al. Empirical medical therapy for idiopathic male infertility: a survey of the American Urological Association. J Urol, 2012, 187(3): 973-978.
7. Chua ME, Escusa KG, Luna S, et al. Revisiting oestrogen antagonists (clomiphene or tamoxifen) as medical empiric therapy for idiopathic male infertility: a meta-analysis. Andrology, 2013, 1(5): 749-757.
8. 李伟, 李克, 黄宇烽.辅酶Q10的生物学功能及其对精子质量的影响.中华男科学杂志, 2006, 12(12): 1119-1122．.
9. Agarwal A, Makker K, Sharma R. Clinical relevance of oxidative stress in male factor infertility: an update. Am J Reprod Immunol, 2008, 59(1): 2-11.
10. Kefer JC, Agarwal A, Sabanegh E. Role of antioxidants in the treatment of male infertility. Int J Urol, 2009, 16(5): 449-57.
11. Crane FL. Biochemical functions of coenzyme Q10. Am Coll Nutr, 2001, 20(6): 591-598.
12. Watts G. Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J HumHypertens, 2007, 21(4): 297-306.
13. Hamilton SJ, Chew GT, Watts GF. Coenzyme Q10 improves endothelial dysfunction in statin-treated type 2 diabetic patients. Diabetes Care, 2009, 32(5): 810-812.
14. Balercia G, Buldreghini E, Vignini A, et al. Coenzyme Q10 treatment in infertile men with idiopathic asthenozoospermia: a placebo-controlled, double-blind randomized trial. Fertil Steril, 2009, 91(5): 1785-1792.
15. Safarinejad MR. Efficacy of coenzyme Q10 on semen parameters, sperm function and reproductive hormones in infertile men. J Urol, 2009, 182(1): 237-248.
16. Nadjarzadeh A, Sadeghi MR, Amirjannati N, et al. Coenzyme Q10 improves seminal oxidative defense but does not affect on semen parameters in idiopathicoligoasthenoteratozoospermia: a randomized double-blind, placebo controlled trial. J Endocrinol Invest, 2011, 34(8): e224-228.
17. WHO. WHO Laboratory manual for the examination of human semen and sperm-cervical mucus interaction. 4^th ed. Cambridge: Cambridge University Press, 1999: 6-35.
18. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Chichester UK: Wiley and Sons, 2008.
19. 唐开发, 邢瑶, 仵春云, 等.他莫昔芬联合辅酶Q10治疗特发性少弱精子症临床疗效观察.中华男科学杂志, 2011, 17(7): 615-618.
20. Safarinejad MR, Safarinejad S, Shafiei N, et al. Effects of the reduced form of coenzyme Q10 (ubiquinol) on semen parameters in men with idiopathic infertility: a double-blind, placebo controlled, randomized study. J Urol, 2012, 188(2): 526-531.
21. Nadjarzadeh A, Shidfar F, Amirjannati N, 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, 46(2): 177-183.
22. 孙永.他莫西芬联合辅酶Q10治疗特发性少、弱、畸形精子症75例分析.中国优生与遗传杂志, 2014, 22(4): 121-122.
23. Carlsen E, Giwercman A, Keiding N, et al. Evidence for decreasing quality of semen during past 50 years. BMJ, 1992, 305(6854): 609-613.
24. 黄春妍, 姚陈均, 王春, 等. 1985-2008年间我国正常男性精液质量变化分析.中华男科学, 2010, 16(8): 684-688.
25. 李克, 商学军, 陈爽, 等.高效液相色谱法检测精浆辅酶Q10水平及氧化应激研究.中华检验医学杂志, 2006, 29(3): 218-221.

Chinese Journal of Evidence-Based Medicine

Efficacy and Safety of Coenzyme Q10 for Idiopathic Oligoasthenoteratozoospermia: A Meta-analysis

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