Supplementing post-wash asthenozoospermic human spermatozoa with coenzyme Q10 for 1 hr in vitro improves sperm motility, but not oxidative stress

Does coenzyme Q10 improve semen quality and circulating testosterone level? a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Seminal oxidative stress has been shown to be a key factor in the development of male infertility. However, the benefits of infertility treatments with antioxidants such as coenzyme Q10 (CoQ10) remains controversial.

OBJECTIVES

The aim of the present study was to assess the effects of CoQ10 supplementation on semen quality, i.e., semen volume, total sperm number, sperm concentration, total sperm motility, percentage of progressive sperm motility and sperm morphology. In addition, the effects of CoQ10 supplementation on circulating testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and inhibin B levels were evaluated.

DESIGN

A systematic review and a meta-analysis of randomized controlled trials (RCTs) were performed to assess the effects of CoQ10 supplementation on semen quality and serum levels of male reproductive hormones.

METHODS

We conducted a strategic literature search in the Cochrane, EMBASE, PubMed/MEDLINE, Scopus, and Web of Science databases and collected only RCTs. The data in the collected RCTs were then meta-analyzed according to PRISMA guidelines.

RESULTS

Out of 2,144 collected studies, only eight were classified eligible. The studies included a total of 877 male subjects; 462 CoQ10-treated and 415 untreated/placebo-treated. We found significantly higher total sperm counts (SMD -13.38 [95% CI: -16.33, -10.43] P< 0.0001), total (SMD -7.26 [95% CI: -10.15, -4.36] P< 0.00001) and progressive motility (SMD -6.386 [95% CI: -10.04, -2.73] P= 0.0006), and normally formed sperm (SMD -1.96 [95% CI: -3.29, -0.62] P= 0.004) in CoQ10-treated male subjects compared with untreated/placebo-treated male subjects. Nonetheless, there was a significant inter-study heterogeneity in these studies. Moreover, significantly higher serum testosterone (SMD -0.59 [95% CI: -0.79, -0.40] P< 0.00001) and inhibin B levels (SMD -0.92 [95% CI: -1.47, -0.37] P= 0.001) were recorded in CoQ10-treated subjects compared to untreated/placebo-treated subjects. In addition, CoQ10 supplementation significantly lowered serum LH (SMD 1.77 [95% CI: 1.26, 2.28] P< 0.00001) and FSH concentrations (SMD 1.60 [95% CI: 1.38, 1.81] P< 0.00001). Interestingly, there was no significant inter-study heterogeneity in the hormonal studies. However, CoQ10 supplementation had no significant effect on semen volume (SMD 0.12 [95% CI: -0.13, 0.37] P= 0.34) and sperm concentration (SMD -6.69 [95% CI: -16.28, 2.90] P= 0.17).

CONCLUSION

Our study shows that CoQ10 supplementation increases total sperm count, total and progressive sperm motility, and the proportion of normally formed sperm in association with higher serum testosterone and inhibin B levels. Our study therefore supports the view in the literature of a beneficial use of CoQ10 in male infertility treatment. However, further well-designed RCTs with sufficiently large numbers of subjects are required to reach a final conclusion.

Identification of potential biomarkers and pathways for asthenozoospermia by bioinformatics analysis and experiments

Background

Asthenozoospermia, a type of male infertility, is primarily caused by dysfunctional sperm mitochondria. Despite previous bioinformatics analysis identifying potential key lncRNAs, miRNAs, hub genes, and pathways associated with asthenospermia, there is still a need to explore additional molecular mechanisms and potential biomarkers for this condition.

Methods

We integrated data from Gene Expression Omnibus (GEO) (GSE22331, GSE34514, and GSE160749) and performed bioinformatics analysis to identify differentially expressed genes (DEGs) between normozoospermia and asthenozoospermia. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were conducted to gain insights into biological processes and signaling pathways. Weighted Gene Co-expression Network Analysis (WGCNA) identified gene modules associated with asthenozoospermia. Expression levels of key genes were assessed using datasets and experimental data. Gene Set Enrichment Analysis (GSEA) and correlation analysis identified pathways associated with the hub gene and explore the relationship between the ZNF764 and COQ9 and mitochondrial autophagy-related genes. Competitive endogenous RNA (ceRNA) networks were constructed, and in vitro experiments using exosome samples were conducted to validate this finding.

Results

COQ9 was identified as a marker gene in asthenozoospermia, involved in autophagy, ATP-dependent chromatin remodeling, endocytosis, and cell cycle, etc. The ceRNA regulatory network (LINC00893/miR-125a-5p/COQ9) was constructed, and PCR demonstrated that LINC00893 and COQ9 were downregulated in asthenozoospermia, while miR-125a-5p and m6A methylation level of LINC00893 were upregulated in asthenozoospermia compared to normozoospermic individuals.

Conclusion

The ceRNA regulatory network (LINC00893/miR-125a-5p/COQ9) likely plays a crucial role in the mechanism of asthenozoospermia. However, further functional experiments are needed to fully understand its significance.

Human Sperm as an In Vitro Model to Assess the Efficacy of Antioxidant Supplements during Sperm Handling: A Narrative Review

Spermatozoa are highly differentiated cells that produce reactive oxygen species (ROS) due to aerobic metabolism. Below a certain threshold, ROS are important in signal transduction pathways and cellular physiological processes, whereas ROS overproduction damages spermatozoa. Sperm manipulation and preparation protocols during assisted reproductive procedures-for example, cryopreservation-can result in excessive ROS production, exposing these cells to oxidative damage. Thus, antioxidants are a relevant topic in sperm quality. This narrative review focuses on human spermatozoa as an in vitro model to study which antioxidants can be used to supplement media. The review comprises a brief presentation of the human sperm structure, a general overview of the main items of reduction-oxidation homeostasis and the ambivalent relationship between spermatozoa and ROS. The main body of the paper deals with studies in which human sperm have been used as an in vitro model to test antioxidant compounds, including natural extracts. The presence and the synergic effects of different antioxidant molecules could potentially lead to more effective products in vitro and, in the future, in vivo.

Studies on improving semen quality and increasing pregnancy chances through the in vitro addition of L-carnitine and coenzyme Q10 to semen in patients with asthenozoospermia

Background

At present, L-carnitine (LC) and coenzyme Q10 (CoQ10), as used clinically to treat male infertility caused by asthenozoospermia (ASZ) is still mainly administered orally, but some patients with ASZ still show no significant improvement in sperm motility and spouse pregnancy rate. Prodom is a device used to assist reproduction, which is temporarily fitted onto the penis to facilitate conception by helping the wife inject a certain drug into the vagina. This study used Prodom-assisted LC/CoQ10 in the treatment of patients with ASZ and evaluated the effect of this method on sperm motility and clinical pregnancy, with the goal of finding a comfortable, low-cost, effective method.

Results

During the trial period, 232 cases completed the trial, while 25 cases did not. During in vitro testing, the progressive sperm motility in the LC group, CoQ10 group, LC combined with CoQ10 group, and the semen blank control group was 24.3 ± 4.6% and 38.1 ± 5.1%, 23.0 ± 4.8% and 36.9 ± 4.4%, 28.4 ± 5.0% and 43.8 ± 5.4%, 19.7 ± 4.4% and 26.0 ± 4.9%, respectively. There were statistically significant differences in progressive sperm motility among the groups (all P values < 0.05). The pregnancy rates of the Prodom-assisted LC treatment group, Prodom-assisted CoQ10 treatment group, Prodom-assisted LC combined with CoQ10 treatment group, and oral LC combined with CoQ10 treatment group in the clinical treatment stage were 38.2, 35.4, 57.1, and 30.3%, respectively; the time to conception was 6.1 ± 1.8, 6.2 ± 1.8, 3.4 ± 0.9, and 7.9 ± 2.0, months respectively; and the treatment costs were $2350 ± 457, $2455 ± 434, $1348 ± 411, and $2684 ± 334, respectively. The differences in pregnancy rate, time to conception, and treatment costs among the groups were statistically significant (all P values < 0.05).

Conclusions

The supplementation of in vitro semen with LC/CoQ10 can improve sperm motility. LC/CoQ10 injected into the spouse’s vagina with the assistance of a Prodom can increase the pregnancy rate, shorten the time to conception, and reduce the cost of treatment in patients with ASZ.

Trial registration

ChiCTR2000040349 (registry: http://www.chictr.org.cn/).

Date of registration: November 28, 2020.

Progesterone activates the cyclic AMP-protein kinase A signalling pathway by upregulating ABHD2 in fertile men

Objective

This was a prospective study to investigate whether progesterone affects sperm activity by regulating the cyclic AMP-protein kinase A (cAMP-PKA) signalling pathway via α/β hydrolase domain-containing protein 2 (ABHD2).

Methods

Spermatozoa were collected from healthy and infertile men (with oligoasthenospermia or abnormal acrosome; n = 30/group). The expression of and mutations in ABHD2 were detected by quantitative PCR, western blot, and gene sequencing. The expression of ABHD2 in the presence of progesterone was detected in all groups, and cAMP and PKA levels were detected by ELISA in fertile men after treatment with ABHD2 antibody and PKA inhibitor H-89, respectively.

Results

Expression of ABHD2 mRNA and protein were reduced in spermatozoa from infertile compared with fertile men. Four gene mutation sites were detected in spermatozoa from the infertile groups. Progesterone increased mRNA and protein levels of ABHD2 in healthy spermatozoa but not in spermatozoa from infertile men. The levels of cAMP and PKA were increased by progesterone in healthy spermatozoa, and the progesterone-increased cAMP and PKA were decreased by ABHD2 antibody and H-89, respectively.

Conclusion

Progesterone regulates the ABHD2-mediated cAMP-PKA signalling pathway in healthy spermatozoa, which provides a new target for clinical diagnosis and treatment of infertility.