CoQ10 improved sperm count and motility and was linked to more pregnancies in men with unexplained infertility

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Male fertility Systematic review and meta-analysis of randomised trials · 2026

Key finding

Nine trials with 781 men with unexplained (idiopathic) infertility were pooled. Compared with control, CoQ10 raised sperm concentration by an average of 10.22 million/mL and total motility by 4.95 percentage points, and increased seminal volume and CoQ10 levels in semen. The odds of clinical pregnancy were about six times higher (OR 6.02, 95% CI 1.97 to 18.41). Sperm shape only improved when treatment ran for more than 3 months.

What it means for practice

For men with unexplained low semen quality, CoQ10 (ubiquinone or ubiquinol) is a reasonable add-on to standard care. Plan for at least 3 months, which is roughly one full sperm production cycle, before rechecking a semen analysis. The trials were small and the confidence interval for pregnancy is wide, so it should be presented as supportive rather than a guarantee.

Reference

Bakri S, Saleh R, Cayan S, Birowo P, Atmoko W, Zainal ATF, Makkaraka MAG, Agarwal A. Efficacy and safety of coenzyme Q10 in idiopathic male infertility: a systematic review and meta-analysis of randomized trials. World J Mens Health. 2026;44(4):829-843.

Read the original paper

Summarised by the Draxer Clinical Advisory Department for health professionals. It supports, and does not replace, clinical judgement.

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