DHEA Plus Coenzyme Q10 Verus Coenzyme Q10 Alone on Sperm Concentration in Subfertile Male With Oligospermia.

This Randomized controlled trial will be conducted in the Department of Reproductive Endocrinology & Infertility, BMU from the day of approval. Ethical clearance will be obtained from the Institutional Review Board. The study population will be the subfertile men with oligospermia according to WHO Laboratory manual 6 th Edition in 2021, fulfilling the inclusion and exclusion criteria.

A baseline semen analysis for the evaluation of male infertility will be done. Infertility will be determined by clinical history. A baseline semen sample will be collected in the laboratory of Reproductive Endocrinology & Infertility, BMU by masturbation in a sterile plastic container. The sperm parameter will be checked by Makler Counting Chamber. An aliquot (0.5 ml) of each well-mixed semen sample will be placed on the Makler counting chamber, and the coverslip will be applied. The spermatozoa will be allowed to sediment for 3 minutes. Recognizable spermatozoa will be counted in 10 squares with x20 objective of a light microscope and recorded as spermatozoa in millions/mL of semen.

A total of 52 patients will be included in the study according to the inclusion and exclusion criteria. Eligible men will be randomly allocated into either Group A or Group B. Group A will receive (DHEA 25mg and Coenzyme Q10 100mg) twice daily and Group B will receive (Coenzyme Q10 100mg) twice daily for 3 months. They will be informed not to take other medications that could affect spermatogenesis during the study period expect after counseling physician.

The side effects and the spontaneous pregnancies will also be recorded. There will be two hospital visits during the dosing period. During the initial visit after recruitment, the participants will be prescribed medicines by some designated prescribing form.

One week later, a telephone interview will be conducted to review for side effects and arrange an early appointment at the patient's request if needed. Patients will be advised for timed sexual intercourse and for urinary pregnancy test in case of missed period. After three months of intervention, a semen analysis and serum testosterone level will be performed.

Inclusion criteria

Age 20-50 years. Subfertile males with oligospermia (sperm concentration less than16 million/ml)

Exclusion criteria

Severe oligospermia (less than 5million/ml) Any medical and endocrine disorders like hypertension, diabetes mellitus, hypothyroidism, hyperprolactinemia, renal or liver disease. Any abnormality on genital examination and scrotal sonogram. History of chemotherapy or radiotherapy, genital infection, genital surgery. Antioxidants supplmentation in the last 3 months Drug, alcohol or substance abuse, psycho-sexual abnormalities.