The central conclusion
A small pilot reported improvements in selected semen and biochemical measures after 60 days of vitamins and coenzyme Q10. Without randomization, placebo or an untreated group, the change cannot be attributed confidently to the supplements. Pregnancy and live birth were not assessed. The findings should not be used to market a personalized fertility protocol.
What the researchers did
Twenty-six infertile men were allocated to one of three combinations according to their baseline seminal-plasma metabolite profile. Six received vitamin E plus coenzyme Q10. Twelve received vitamin E, coenzyme Q10, B-complex vitamins and vitamin C. Eight received B-complex vitamins and vitamin C.
Semen analysis and high-performance liquid-chromatography profiling were performed before and after treatment. Some semen measures and metabolites improved in two groups, while another group mainly showed a change in vitamin E. These observations can generate a hypothesis for a larger trial.
Why before-and-after improvement is insufficient
Without a comparison group, we do not know what would have happened to similar men over the same 60 days without supplementation. Semen measures fluctuate between samples. Abstinence interval, fever, infection, medication, heat exposure, alcohol, smoking, weight, stress, collection conditions and laboratory variability can all contribute.
Regression to the mean is also relevant. If patients are selected after an unusually poor result, a later result may look better even without an effective intervention.
Groups of 6, 12 and 8 participants are too small for stable conclusions. Multiple biochemical and semen endpoints increase the risk that apparently favourable results are chance findings or exaggerated estimates.
Personalized allocation is not personalized evidence
The word personalized describes how one of three combinations was selected. It does not establish that biomarker-guided allocation works better than placebo, no supplement, a standard formulation or ordinary clinical care.
A convincing test would randomize participants, standardize semen collection, obtain repeated baseline samples, prespecify one or a few primary outcomes, control multiplicity, document adherence and adverse effects, and include reproductive outcomes meaningful to couples.
Surrogate outcomes and patient-important outcomes
Concentration, motility and morphology can inform diagnosis, but an improvement does not guarantee conception. Couples need to know whether an intervention increases clinical pregnancy or live birth, shortens time to pregnancy and remains safe. The pilot did not answer those questions.
This does not prove that every antioxidant is ineffective. It means that the efficacy of a specific product and selection algorithm must be demonstrated in an appropriate controlled study.
What should happen before buying a supplement package
The priority is to assess potentially treatable causes of male infertility. A proper pathway includes a full history, an andrological examination, correctly performed and usually repeated semen analysis, and targeted hormonal, genetic or imaging tests when indicated. Varicocele, medication, infection, endocrine disorders, genetic factors and lifestyle exposures may require specific management.
Supplements should not delay diagnosis, treatment of a cause or evaluation of both partners.
A responsible interpretation
The study supports a hypothesis that metabolite-guided antioxidant combinations may influence selected semen measures. It does not establish clinical efficacy, the value of personalization or an increased chance of having a child. A changed semen result is not automatically a treatment effect.
Source: International Journal of Food Sciences and Nutrition. 2026. PMID 42683831. https://doi.org/10.1080/09637486.2026.2726352
This educational information does not replace an individual andrology assessment.