Impact of coenzyme Q10 as an adjuvant therapy to letrozole on spermiogram results and sex hormone levels in Iraqi men with infertility; randomized open label comparative study

Background: Worldwide, infertility affects about 15% of reproductive-age couples. In many cases, can't be treated, however new treatment options with promising value have been involved in recent clinical trials. The aim this trial was to evaluate the impacts adding coenzyme Q10 (CoQ10) to letrozole on results spermiogram and sex hormone tests men diagnosed idiopathic oligoasthenoteratozoospermia (iOAT) syndrome, which is a type male defective spermatogenesis unknown etiology. Methods: This randomized, open-label, parallel two-arm interventional study included 67 adult patients aged 18-60 years confirmed diagnosis iOAT syndrome recruited from High Institute for Infertility Diagnosis & Assisted Reproduction Technologies/Nahrain University. Patients were randomly separated into two groups, Group A 29 treated 2.5 mg tablet orally twice week, B 38 combination week plus CoQ10 400 per day. Both groups completed three months. Semen samples, serum follicle-stimulating (FSH), estradiol (E2), and testosterone (T) analyzed at day one, and end month three. Results: Both showed that sperm concentration, normal morphology, total count motility, FSH levels, T/E2 ratio significantly increased, while levels decreased after months treatment. Seminal fluid volume changed group only. comparing between all measured parameters, apart motility level, demonstrated significant difference treatment, reached only therapy. Conclusions: as adjuvant effectively improved most tested parameters Iraqi iOAT. Registration: ClinicalTrials.gov (NCT05847257, May 6, 2023).