Ubiquinol: The Key to Male Fertility?

Ubiquinol: The Key to Male Fertility?

Safe, cost-effective and discrete treatment of reduced sperm motility:
New study shows a significant improvement in sperm quality with
Ubiquinol supplementation.

Iranian Professor of Urology Mohammad Reza Safarinejad has
executed a series of clinical studies looking at idiopathic male
factor infertility. Firstly, the clinical usefulness of coenzyme Q10
in the improvement of semen parameters was scientifically
documented1 and then a direct increase in the pregnancy rate
was shown2. Now a new study3 shows even more promising
results for the intake of Ubiquinol, the advanced active form of
coenzyme Q10 that is more easily utilized and absorbed in the
body.
Socio-cultural dimensions
Male infertility is a worldwide health issue with a serious
socio-cultural dimension for those concerned. It is estimated
that in 30 per cent of infertile couples, the infertility can be
traced back to the male partner. Around 8 per cent of men of
reproductive age seek help for infertility problems. But despite
great advances in the field of infertility, many cases of male
infertility are diagnosed as idiopathic (i.e. of unknown cause)
and remain untreated.
Most couples with severe male factor infertility will achieve
successful pregnancy with the aid of advanced assisted
reproduction technology (ART). However, ART has drawbacks.
Firstly, it is costly and the probability of becoming pregnant per
reproductive cycle is only about 20 to 25 per cent. Secondly,
most insurance companies don’t cover the cost of ART.
In low income communities where health service resources
are restricted and basic health needs are unmet, health
resources are not used to provide expensive technologies
for the treatment of infertility. However, the social and family
consequences of infertility, especially in developing and underdeveloped
communities, are devastating. In these countries,
the problem of infertility is often attributed to women and, as a
result, common scenarios include separation, divorce, infidelity,
polygamy and ostracism of women. In addition, infertile
couples experience depression, guilt, grief, shame, and social
isolation.
First results for the efficacy of Q10
The basic aim of Professor Safarinejad’s studies was to find
a safe, efficacious and cost-effective treatment for idiopathic
male factor infertility. Coenzyme Q10 had already been
discussed with regard to this indication, but further verification
was needed.
Coenzyme Q10 is an essential electron carrier in the body’s
mitochondrial respiratory chain. Also known as ubiquinone, it
is endogenously synthesized and lipid-soluble. It has vitaminlike
properties, acts as a powerful antioxidant, and protects
membrane phospholipids from lipid peroxidation. In addition,
Q10 is able to recycle and regenerate other antioxidants, such
as tocopherol and ascorbate. In the Iranian study, Kaneka
Q10™ was used. This is a natural form of coenzyme Q10 and is
the only Q10 in the world to be derived by yeast fermentation.
Coenzyme Q10 can be classified as a nutrient, and dietary
supplementation is safe and free from unwanted side-effects.
In his sequential studies, Professor Safarinejad used a two-way
approach to describe the problem of idiopathic male infertility
in its totality and to cover both of its “determinants” – i.e.
sperm quality and the corresponding desired outcome, namely
the pregnancy rate.
A placebo-controlled, randomized clinical trial was used
to assess the effects of Q10 on three semen parameters
– sperm density, sperm motility, and sperm morphology.
Study participants (212 infertile men with idiopathic
oligoasthenoteratozoospermia (OAT)) were treated for 26
weeks, followed by a 30-week washout period. The trial
showed that 300 mg/day coenzyme Q10 significantly improved
all three semen parameters, whereas they remained unchanged
in the placebo group.
It would appear, however, that study outcomes based only
on improvement in semen values cannot cover the issue in
its entirety. It is likely that a more accurate outcome measure
would be the pregnancy rate, since that is the ultimate goal
of infertility treatment. Yet while using the pregnancy rate as
the principal goal of therapy end points, it is imperative to
take into account the spontaneous pregnancy rate in infertile
couples on no treatment. In light of these observations,
another prospective open label study analyzed the impact
of Q10 therapy on spontaneous pregnancy rates in couples
with idiopathic male factor infertility. This study achieved
a pregnancy rate of 34.1 per cent. Compared to the crude
12-month cumulative spontaneous pregnancy rate of 6.4
per cent on the waiting list for male subfertility patients, this

is a remarkable increase and might not have been achieved
if these patients had been left untreated. The study even
showed a trend towards higher pregnancy rates when the Q10
administration time was extended beyond the initial 6-month
period.
Further investigations with Ubiquinol
After the significant results of the first two studies in the
improvement of semen parameters and pregnancy rates, there
seemed an obvious need for further research into the effects
of administration of Ubiquinol, the reduced and active form of
coenzyme Q10.
More than 96 per cent of CoQ10 in the blood is available in
its reduced form, Ubiquinol. Used as a supplement, Ubiquinol
has a more rapid and better effect than Q10 since it does not
have to be converted into its active form. Until recently, it was
impossible to isolate Ubiquinol for use in supplements, as
it reacts very quickly with oxygen. When exposed to air, the
white powder immediately turns into the orange Q10. However,
considering the important role of oxidative stress in semen
parameters, it is precisely this redox property that makes
Ubiquinol so valuable, as it also reacts similarly with reactive
oxygen species in the body and is therefore an extremely
powerful antioxidant.
In the double-blind, placebo controlled, randomized study,
a total of 228 men with unexplained infertility were randomly
assigned into one of two groups. The first group received 200
mg Ubiquinol for 26 weeks, while the second group received
a similar regimen of placebo. A 12-week off-treatment period
followed for both groups. The Ubiquinol supplementation
resulted in 81.6 per cent, 31.7 per cent and 24 per cent
improvements in sperm density, sperm motility and sperm
morphology respectively.
Compared with the previous study, Ubiquinol was more
effective than Q10 in improving sperm count and motility.
Sperm density increased more than 2.5-fold with Ubiquinol
compared to conventional Q10.
Huge demand worldwide
For the first time, the clinical usefulness of Ubiquinol
administration in the treatment of idiopathic male factor
infertility has been documented. The benefits of the study
results for people affected by this problem are obvious:
treatment with Ubiquinol can improve semen quality, and it
is safe, cost-effective and discrete. This is a great advance,
especially for resource-poor communities.
Manufacturers can harness the potential of this indication for
Ubiquinol quite easily, and on a large scale. Ubiquinol can be
used in a wide range of nutraceuticals, as well as in functional
foods, either alone or in combination with other substances to
create “all-round” fertility products. Infertility is such a serious
issue that people are generally very open to safe treatments
that carry no risk of side-effects but which promise positive
outcomes while being low in cost. This, along with the sheer
number of people affected worldwide, demonstrates that the
market potential is enormous.
1 Mohammad Reza Safarinejad: Efficacy of coenzyme Q10 on
semen parameters, sperm function and reproductive hormones
in infertile men: The Journal of Urology, Vol. 182, 237-248, July
2009.
2 Mohammad Reza Safarinejad: The effect of coenzyme Q10
supplementation on partner pregnancy rate in infertile men
with idiopathic oligoasthenoteratozoospermia: an openlabel
prospective study: Springer Science+Business Media,
published online, 13th Nov 2011.
3 Mohammad Reza Safarinejad (et al): Effects of the Reduced
Form of Coenzyme Q10 (Ubiquinol) on Semen Parameters
in Men with Idiopathic Infertility: a Double-Blind, Placebo
Controlled, Randomized Study: The Journal of Urology, Vol.
188, August 2012.