Essa Bahauldeen Fadhil, Mohammed Mahmood Mohammed, Ula M Alkawaz
Journal: F1000Research 2024;12():1093
PMID: 38957201
Infertility affects around 15% of couples of reproductive age, and while some cases cannot be treated, new therapies are being explored. This study aimed to assess the effects of adding coenzyme Q10 (CoQ10), a substance that helps produce energy in cells and acts as an antioxidant, protecting cells from damage, to letrozole, a hormone-modulating medication used off-label in male infertility to lower oestrogen levels and raise testosterone, on sperm quality and hormone levels in men with low sperm count, poor sperm movement, and abnormal sperm shape. This randomised control trial recruited 67 adult men aged 18–60. As an open-label study, both participants and researchers were aware of which treatment was received. Group A (n=29) received letrozole 2.5 mg twice weekly, while Group B (n=38) received letrozole 2.5 mg twice weekly plus CoQ10 400 mg daily. Both groups were treated for three months.
The results showed that both groups experienced significant improvements across most sperm and hormone parameters after three months of treatment, including increased sperm concentration, normal morphology, total sperm count, motility, testosterone, and follicle-stimulating hormone levels, alongside a decrease in oestradiol. However, when the two groups were compared directly, Group B produced significantly greater improvements than Group A in sperm concentration, normal morphology, total sperm count, testosterone levels, oestradiol levels, and the testosterone-to-oestradiol ratio.
In conclusion, adding CoQ10 to letrozole therapy may help improve most sperm parameters and hormonal markers in Iraqi men with poor sperm quality. Healthcare professionals may find these results useful when considering adjuvant treatments for men with infertility.
Worldwide, infertility affects about 15% of reproductive-age couples. In many cases, infertility can't be treated, however new treatment options with promising value have been involved in recent clinical trials. The aim of this clinical trial was to evaluate the impacts of adding coenzyme Q10 (CoQ10) to letrozole on the results of spermiogram and sex hormone tests in men diagnosed with idiopathic oligoasthenoteratozoospermia (iOAT) syndrome, which is a type of male defective spermatogenesis of unknown etiology. This randomized, open-label, parallel two-arm interventional study included 67 adult male patients aged 18-60 years with a confirmed diagnosis of iOAT syndrome recruited from The High Institute for Infertility Diagnosis & Assisted Reproduction Technologies/Nahrain University. Patients were randomly separated into two groups, Group A included 29 patients treated with letrozole 2.5 mg tablet orally twice a week, Group B included 38 patients treated with a combination of letrozole 2.5 mg tablet orally twice a week plus CoQ10 400 mg per day. Both groups completed treatment for three months. Semen samples, serum follicle-stimulating hormone (FSH), estradiol (E ), and testosterone (T) were analyzed at day one, and at the end of month one, two and three. Both groups showed that sperm concentration, normal morphology, total sperm count and motility, serum testosterone and FSH levels, and T/E ratio were significantly increased, while estradiol levels significantly decreased after three months of treatment. Seminal fluid volume changed significantly in group A only. In comparing between the two groups, all measured parameters, apart from sperm motility and FSH level, demonstrated a significant difference after three months of treatment, while sperm volume reached significant value after only two months of therapy. CoQ10 as adjuvant treatment to letrozole effectively improved most of the tested sperm parameters in Iraqi men with iOAT. ClinicalTrials.gov ( NCT05847257, May 6, 2023).
Copyright: © 2024 Fadhil EB et al.
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