Systematic Review and Meta-analysis on Effect of Carnitine, Coenzyme Q10 and Selenium on Pregnancy and Semen Parameters in Couples With Idiopathic Male Infertility.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 34871624 · doi:10.1016/j.urology.2021.10.041
What was done
A systematic review and meta-analysis following PRISMA guidelines (PROSPERO CRD42020210284) of randomized controlled trials from PubMed, Scopus, EMBASE, and Web of Science comparing selenium, carnitine, or coenzyme Q10 (alone or combined) against placebo in couples with idiopathic male factor infertility, evaluating pregnancy and semen outcomes.
What was found
Twenty randomized studies were included from 3,304 screened records. - Pregnancy rates did not significantly differ between the treatment and placebo groups: 16.2% (69/426) vs. 11.2% (45/401) (P = .05). - Antioxidant treatment showed small but statistically significant improvements in semen parameters compared with placebo: - Sperm motility: mean difference 5.05 (95% CI 2.77 to 7.34, P < .0001) - Progressive motility: mean difference 5.72 (95% CI 2.77 to 8.66, P = .0001) - Sperm concentration: mean difference 6.58 (95% CI 3.22 to 9.93, P = .0001)
Why it matters
While antioxidant supplementation yields small improvements in surrogate sperm parameters, these changes do not translate into a statistically significant benefit for clinical pregnancy rates.
Limits
The primary studies were identified as poor quality. The pregnancy analysis included only 827 couples total. The abstract does not report live birth rates, adverse effects, or outcomes stratified by specific antioxidant regimen or dosage.