{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:28:38Z","timestamp":1787840918546,"version":"build-2784847793"},"reference-count":40,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,5,30]],"date-time":"2021-05-30T00:00:00Z","timestamp":1622332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Infertility affects 15% of couples worldwide. A male factor is involved in 50% of cases. The etiology of male infertility is poorly understood, but there is evidence for a strong association between oxidative stress (OS) and poor seminal fluid quality. For this reason, therapy with antioxidants is one of the cornerstones of empirical treatment of male infertility. Coenzyme Q10 (CoQ10)\u2014an essential cofactor for energy production with major antioxidant properties\u2014is commonly used to support spermatogenesis in idiopathic male infertility. This systematic review aims to elucidate the usefulness of CoQ10 supplementation in the treatment of male infertility, particularly with regard to semen quality assessed by conventional and advanced methods, and pregnancy rates. All studies report a beneficial effect of CoQ10 supplementation on semen parameters, although randomized controlled trials are a minority. Moreover, the optimal dosage of CoQ10 or how it can be combined with other antioxidant molecules to maximize its effect is unknown. However, CoQ10 is still one of the most promising molecules to treat idiopathic male infertility and warrants further investigation.<\/jats:p>","DOI":"10.3390\/antiox10060874","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T00:22:15Z","timestamp":1622420535000},"page":"874","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Coenzyme Q10 and Male Infertility: A Systematic Review"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9290-5699","authenticated-orcid":false,"given":"Gianmaria","family":"Salvio","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolic Diseases, Umberto I Hospital, Via Conca 71, 60126 Ancona, Italy"},{"name":"Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Tronto 10\/A, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Cutini","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolic Diseases, Umberto I Hospital, Via Conca 71, 60126 Ancona, Italy"},{"name":"Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Tronto 10\/A, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Ciarloni","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolic Diseases, Umberto I Hospital, Via Conca 71, 60126 Ancona, Italy"},{"name":"Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Tronto 10\/A, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Giovannini","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolic Diseases, Umberto I Hospital, Via Conca 71, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Perrone","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolic Diseases, Umberto I Hospital, Via Conca 71, 60126 Ancona, Italy"},{"name":"Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Tronto 10\/A, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Balercia","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolic Diseases, Umberto I Hospital, Via Conca 71, 60126 Ancona, Italy"},{"name":"Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Tronto 10\/A, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,30]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2010). WHO Laboratory Manual for the Examination and Processing of Human Semen, World Health Organization."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1111\/andr.12748","article-title":"Use of follicle-stimulating hormone for the male partner of idiopathic infertile couples in Italy: Results from a multicentre, observational, clinical practice survey","volume":"8","author":"Santi","year":"2020","journal-title":"Andrology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"296","DOI":"10.5534\/wjmh.190055","article-title":"Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility","volume":"37","author":"Agarwal","year":"2019","journal-title":"World J. Mens. Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/and.13012","article-title":"Reactive oxygen species impact on sperm DNA and its role in male infertility","volume":"50","author":"Bui","year":"2018","journal-title":"Andrologia"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.mce.2005.12.027","article-title":"The antioxidant glutathione peroxidase family and spermatozoa: A complex story","volume":"16","author":"Drevet","year":"2006","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1007\/BF03346521","article-title":"Coenzyme Q10 and male infertility","volume":"32","author":"Balercia","year":"2009","journal-title":"J. Endocrinol. Investig."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.rbmo.2019.03.099","article-title":"Influence of oral vitamin and mineral supplementation on male infertility: A meta-analysis and systematic review","volume":"39","author":"Buhling","year":"2019","journal-title":"Reprod. Biomed. Online"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jclinepi.2009.06.006","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration","volume":"62","author":"Liberati","year":"2009","journal-title":"J. Clin. Epidemiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3","DOI":"10.5812\/numonthly.16870","article-title":"Ubiquinol effect on sperm parameters in subfertile men who have astheno-teratozoospermia with normal sperm concentration","volume":"6","author":"Cakiroglu","year":"2014","journal-title":"Nephrourol. Mon."},{"key":"ref_10","first-page":"137","article-title":"Prospective open-label study on the efficacy and tolerability of a combination of nutritional supplements in primary infertile patients with idiopathic astenoteratozoospermia","volume":"84","author":"Busetto","year":"2012","journal-title":"Arch. Ital. Urol. E Androl."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1111\/and.12003","article-title":"Effects of oral antioxidant treatment upon the dynamics of human sperm DNA fragmentation and subpopulations of sperm with highly degraded DNA","volume":"45","author":"Abad","year":"2013","journal-title":"Andrologia"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1111\/andr.12547","article-title":"Impact of antioxidant treatment on DNA fragmentation index: A double-blind placebo-controlled randomized trial","volume":"6","author":"Stenqvist","year":"2018","journal-title":"Andrology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"112","DOI":"10.5653\/cerm.2019.00136","article-title":"The impact of two doses of coenzyme Q10 on semen parameters and antioxidant status in men with idiopathic oligoasthenoteratozoospermia","volume":"46","author":"Alahmar","year":"2019","journal-title":"Clin. Exp. Reprod. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.fertnstert.2003.05.009","article-title":"Coenzyme Q10 supplementation in infertile men with idiopathic asthenozoospermia: An open, uncontrolled pilot study","volume":"81","author":"Balercia","year":"2004","journal-title":"Fertil. Steril."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1016\/j.fertnstert.2008.02.119","article-title":"Coenzyme Q10 treatment in infertile men with idiopathic asthenozoospermia: A placebo-controlled, double-blind randomized trial","volume":"91","author":"Balercia","year":"2009","journal-title":"Fertil. Steril."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.juro.2009.02.121","article-title":"Efficacy of Coenzyme Q10 on Semen Parameters, Sperm Function and Reproductive Hormones in Infertile Men","volume":"182","author":"Safarinejad","year":"2009","journal-title":"J. Urol."},{"key":"ref_17","first-page":"224","article-title":"Coenzyme Q 10 improves seminal oxidative defense but does not affect on semen parameters in idiopathic oligoasthenoteratozoospermia: A randomized double-blind, placebo controlled trial","volume":"34","author":"Nadjarzadeh","year":"2011","journal-title":"J. Endocrinol. Investig."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.juro.2012.03.131","article-title":"Effects of the reduced form of coenzyme Q10 (ubiquinol) on semen parameters in men with idiopathic infertility: A double-blind, placebo controlled, randomized study","volume":"188","author":"Safarinejad","year":"2012","journal-title":"J. Urol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1007\/s11255-011-0081-0","article-title":"The effect of coenzyme Q 10 supplementation on partner pregnancy rate in infertile men with idiopathic oligoasthenoteratozoospermia: An open-label prospective study","volume":"44","author":"Safarinejad","year":"2012","journal-title":"Int. Urol. Nephrol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1111\/and.12152","article-title":"Coenzyme Q10 supplementation in infertile men with low-grade varicocele: An open, uncontrolled pilot study","volume":"46","author":"Festa","year":"2014","journal-title":"Andrologia"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/and.12062","article-title":"Effect of Coenzyme Q10 supplementation on antioxidant enzymes activity and oxidative stress of seminal plasma: A double-blind randomised clinical trial","volume":"46","author":"Nadjarzadeh","year":"2014","journal-title":"Andrologia"},{"key":"ref_22","first-page":"11","article-title":"Effect of ubiquinol therapy on sperm parameters and serum testosterone levels in oligoasthenozoospermic infertile men","volume":"9","author":"Thakur","year":"2015","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_23","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":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4081\/aiua.2014.1.1","article-title":"Antioxidant cosupplementation therapy with vitamin C, vitamin E, and coenzyme Q10 in patients with oligoasthenozoospermia","volume":"86","author":"Kobori","year":"2014","journal-title":"Arch. Ital. Urol. E Androl."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1007\/s12020-014-0432-6","article-title":"Protective effects of coenzyme Q10 and aspartic acid on oxidative stress and DNA damage in subjects affected by idiopathic asthenozoospermia","volume":"49","author":"Tirabassi","year":"2015","journal-title":"Endocrine"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Gvozdj\u00e1kov\u00e1, A., Kucharsk\u00e1, J., Dubravicky, J., Mojto, V., and Singh, R.B. (2015). Coenzyme Q10, \u03b1-tocopherol, and oxidative stress could be important metabolic biomarkers of male infertility. Dis. Markers, 2015.","DOI":"10.1155\/2015\/827941"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12958-016-0219-0","article-title":"Comparison of the effect of a combination of eight micronutrients versus a standard mono preparation on sperm parameters","volume":"14","author":"Lipovac","year":"2016","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1002\/rmb2.12308","article-title":"Combination therapy with antioxidants improves total motile sperm counts: A Preliminary Study","volume":"19","author":"Terai","year":"2020","journal-title":"Reprod. Med. Biol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Arafa, M., Agarwal, A., Majzoub, A., Selvam, M.K.P., Baskaran, S., Henkel, R., and Elbardisi, H. (2020). Efficacy of antioxidant supplementation on conventional and advanced sperm function tests in patients with idiopathic male infertility. Antioxidants, 9.","DOI":"10.3390\/antiox9030219"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"92","DOI":"10.3934\/publichealth.2020009","article-title":"Effect of antioxidant supplements on sperm parameters in infertile male smokers: A single-blinded clinical trial","volume":"7","author":"Sadaghiani","year":"2020","journal-title":"AIMS Public Health"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1111\/andr.12805","article-title":"Dietary supplementation with a novel l-carnitine multi-micronutrient in idiopathic male subfertility involving oligo-, astheno-, teratozoospermia: A randomized clinical study","volume":"8","author":"Kopets","year":"2020","journal-title":"Andrology"},{"key":"ref_32","first-page":"76","article-title":"Effect of antioxidant supplementation containing l-carnitine on semen parameters: A prospective interventional study","volume":"25","author":"Nazari","year":"2021","journal-title":"J. Bras. Reprod. Assist."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Lei, L., and Liu, Y. (2017). Efficacy of coenzyme Q10 in patients with cardiac failure: A meta-analysis of clinical trials. BMC Cardiovasc. Disord., 17.","DOI":"10.1186\/s12872-017-0628-9"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1186\/s12944-018-0876-4","article-title":"The effects of coenzyme Q10 supplementation on lipid profiles among patients with coronary artery disease: A systematic review and meta-analysis of randomized controlled trials","volume":"17","author":"Jorat","year":"2018","journal-title":"Lipids Health Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"6484839","DOI":"10.1155\/2018\/6484839","article-title":"Effectiveness of coenzyme Q10 supplementation for Type 2 diabetes mellitus: A systematic review and meta-analysis","volume":"2018","author":"Zhang","year":"2018","journal-title":"Int. J. Endocrinol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Zhai, J., Bo, Y., Lu, Y., Liu, C., and Zhang, L. (2017). Effects of coenzyme Q10 on markers of inflammation: A systematic review and meta-analysis. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0170172"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1007\/s10815-013-0047-5","article-title":"Coenzyme Q10 and male infertility: A meta-analysis","volume":"30","author":"Lafuente","year":"2013","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s10815-014-0374-1","article-title":"Sperm DNA fragmentation index and pregnancy outcome after IVF or ICSI: A meta-analysis","volume":"32","author":"Zhang","year":"2015","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1530\/eje.0.1450561","article-title":"Inhibin B in male reproduction: Pathophysiology and clinical relevance","volume":"145","author":"Meachem","year":"2001","journal-title":"Eur. J. Endocrinol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s12958-018-0436-9","article-title":"Lifestyle and fertility: The influence of stress and quality of life on male fertility","volume":"16","author":"Ilacqua","year":"2018","journal-title":"Reprod. Biol. Endocrinol."}],"container-title":["Antioxidants"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3921\/10\/6\/874\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:09:02Z","timestamp":1760162942000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3921\/10\/6\/874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,30]]},"references-count":40,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["antiox10060874"],"URL":"https:\/\/doi.org\/10.3390\/antiox10060874","relation":{},"ISSN":["2076-3921"],"issn-type":[{"value":"2076-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,30]]}}}