{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T11:41:49Z","timestamp":1769341309622,"version":"3.49.0"},"reference-count":28,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T00:00:00Z","timestamp":1686009600000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National\n                                    Key Research and Development Program of\n                                    China","doi-asserted-by":"publisher","award":["2017YFC1311103"],"award-info":[{"award-number":["2017YFC1311103"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>Infertility is a focal issue in public health and affects human\n                            reproduction and survival. Notably, an increasing number of studies in\n                            recent decades have found that sperm DNA integrity plays a critical role\n                            in the development of healthy embryos. Among the multiple pathogenic\n                            factors of sperm DNA fragmentation, oxidative stress has proven to be\n                            predominant. Coenzyme Q10 supplementation, which has been used for the\n                            treatment of male infertility, has shown good clinical efficacy due to\n                            its oxidation resistance, but its efficacy as measured by the sperm DNA\n                            fragmentation index remains controversial. To address this issue, we\n                            will perform a systematic review and meta-analysis to evaluate the\n                            efficacy of coenzyme Q10 for male infertility patients with a high sperm\n                            DNA fragmentation index.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Methods and analysis<\/jats:title>\n                        <jats:p>The PubMed, Embase, Cochrane Central Register of Studies and Web of\n                            Science databases will be comprehensively searched from inception to 31\n                            December 2022 to identify relevant studies published in the English\n                            language using appropriate search strategies. The search terms will be\n                            derived from the following concepts: sperm DNA fragmentation, coenzyme\n                            Q10 and randomised controlled trials. Two review stages, that is, title\n                            and abstract screening and full-text screening, will be performed by two\n                            reviewers. The risk of bias, publication bias and evidence grade of the\n                            included studies will be assessed using a standardised protocol. Data\n                            will be used to calculate effect sizes. Heterogeneity among the studies\n                            will be evaluated graphically. Subgroup analysis and sensitivity\n                            analysis will be performed if necessary to validate the\n                            results.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Ethics and dissemination<\/jats:title>\n                        <jats:p>No ethical approval will be needed, as there will be no participants\n                            in this study. We will follow the Preferred Reporting Items for\n                            Systematic Reviews and Meta-Analyses guidelines to disseminate the\n                            findings through publication and conference presentation.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>PROSPERO registration number<\/jats:title>\n                        <jats:p>CRD42022293340.<\/jats:p>\n                    <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-068368","type":"journal-article","created":{"date-parts":[[2023,7,30]],"date-time":"2023-07-30T11:02:54Z","timestamp":1690714974000},"page":"e068368","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy of coenzyme Q10 supplementation for male infertility with high\n                        sperm DNA fragmentation index: a protocol for a systematic review and\n                        meta-analysis"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3975-155X","authenticated-orcid":false,"given":"Yu","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoli","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangyin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruihong","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiang","family":"Geng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Ouyang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tian","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,6,6]]},"reference":[{"key":"2023073003443248000_13.6.e068368.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2009.10.046"},{"key":"2023073003443248000_13.6.e068368.2","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/and.12056","article-title":"Sperm DNA fragmentation in couples with unexplained recurrent spontaneous abortions","volume":"46","author":"Khadem","year":"2014","journal-title":"Andrologia"},{"key":"2023073003443248000_13.6.e068368.3","doi-asserted-by":"publisher","DOI":"10.2164\/jandrol.106.000703"},{"key":"2023073003443248000_13.6.e068368.4","doi-asserted-by":"crossref","unstructured":"Khalafalla K , Majzoub A , Elbardisi H , et al . The\n                            effect of Sperm DNA fragmentation on intracytoplasmic Sperm injection\n                            outcome. Andrologia 2021;53:e14180.\n                            doi:10.1111\/and.14180","DOI":"10.1111\/and.14180"},{"key":"2023073003443248000_13.6.e068368.5","doi-asserted-by":"crossref","unstructured":"Yifu P , Lei Y , Shaoming L , et al . Sperm DNA\n                            fragmentation index with unexplained recurrent spontaneous abortion: A\n                            systematic review and meta-analysis. J Gynecol Obstet Hum Reprod\n                            2020;2020:101740.\n                            doi:10.1016\/j.jogoh.2020.101740","DOI":"10.1016\/j.jogoh.2020.101740"},{"key":"2023073003443248000_13.6.e068368.6","doi-asserted-by":"crossref","unstructured":"Li MW , Lloyd KCK . DNA fragmentation index (DFI) as\n                            a measure of Sperm quality and fertility in mice. Sci Rep 2020;10:3833.\n                            doi:10.1038\/s41598-020-60876-9","DOI":"10.1038\/s41598-020-60876-9"},{"key":"2023073003443248000_13.6.e068368.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2014.10.021"},{"key":"2023073003443248000_13.6.e068368.8","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.bpobgyn.2017.07.003","article-title":"Review: diagnosis and impact of Sperm DNA alterations in assisted reproduction","volume":"44","author":"Simon","year":"2017","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"2023073003443248000_13.6.e068368.9","doi-asserted-by":"crossref","unstructured":"Yifu P , Lei Y , Shaoming L , et al . Sperm DNA\n                            fragmentation index with unexplained recurrent spontaneous abortion: A\n                            systematic review and meta-analysis. J Gynecol Obstet Hum Reprod\n                            2020:101740. doi:10.1016\/j.jogoh.2020.101740","DOI":"10.1016\/j.jogoh.2020.101740"},{"key":"2023073003443248000_13.6.e068368.10","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.redox.2015.01.002","article-title":"Oxidative stress: a concept in redox biology and medicine","volume":"4","author":"Sies","year":"2015","journal-title":"Redox Biol"},{"key":"2023073003443248000_13.6.e068368.11","doi-asserted-by":"crossref","unstructured":"Tamagno E , Guglielmotto M , Vasciaveo V , et al .\n                            Oxidative stress and beta Amyloid in Alzheimer\u2019s disease. Antioxidants\n                            (Basel) 2021;10:1479. doi:10.3390\/antiox10091479","DOI":"10.3390\/antiox10091479"},{"key":"2023073003443248000_13.6.e068368.12","doi-asserted-by":"publisher","DOI":"10.1093\/advances\/nmab049"},{"key":"2023073003443248000_13.6.e068368.13","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1016\/j.freeradbiomed.2015.10.419","article-title":"Oxidative DNA damage in mouse Sperm Chromosomes: size matters","volume":"89","author":"Kocer","year":"2015","journal-title":"Free Radic Biol Med"},{"key":"2023073003443248000_13.6.e068368.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2014.02.004"},{"key":"2023073003443248000_13.6.e068368.15","doi-asserted-by":"crossref","unstructured":"Beharry KD , Cai CL , Henry MM , et al . Co-enzyme\n                            Q10 and N-3 polyunsaturated fatty acid supplementation reverse\n                            intermittent hypoxia-induced growth restriction and improved antioxidant\n                            profiles in neonatal rats. Antioxidants (Basel) 2017;6:103.\n                            doi:10.3390\/antiox6040103","DOI":"10.3390\/antiox6040103"},{"key":"2023073003443248000_13.6.e068368.16","doi-asserted-by":"crossref","first-page":"345","DOI":"10.2174\/1389200216666151103115654","article-title":"Coenzyme Q10 supplementation and exercise in healthy humans: a systematic review","volume":"17","author":"Sarmiento","year":"2016","journal-title":"Curr Drug Metab"},{"key":"2023073003443248000_13.6.e068368.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.02.121"},{"key":"2023073003443248000_13.6.e068368.18","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1007\/s12011-020-02251-3","article-title":"Impact of coenzyme Q10 and selenium on seminal fluid parameters and antioxidant status in men with idiopathic infertility","volume":"199","author":"Alahmar","year":"2021","journal-title":"Biol Trace Elem Res"},{"key":"2023073003443248000_13.6.e068368.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.02.119"},{"key":"2023073003443248000_13.6.e068368.20","unstructured":"Higgins J , Thomas J . Cochrane Handbook for\n                            systematic reviews of interventions version 6.2.0. Cochrane\n                            Collaboration 2021. Available:\n                            http:\/\/handbook.cochrane.org\/"},{"key":"2023073003443248000_13.6.e068368.21","doi-asserted-by":"crossref","unstructured":"Page MJ , McKenzie JE , Bossuyt PM , et al . The\n                            PRISMA 2020 statement: an updated guideline for reporting systematic\n                            reviews. BMJ 2021;372:n71. doi:10.1136\/bmj.n71","DOI":"10.1136\/bmj.n71"},{"key":"2023073003443248000_13.6.e068368.22","doi-asserted-by":"crossref","unstructured":"Shamseer L , Moher D , Clarke M , et al . Preferred\n                            reporting items for systematic review and meta-analysis protocols\n                            (PRISMA-P) 2015: elaboration and explanation. 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