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

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.