The Role of CoQ10 in Fertility
What is coenzyme Q10? Can it help me get pregnant? Dr. Mare dives into the research to help understand if CoQ10 is right for you.
What is coenzyme Q10?
Coenzyme Q10 (CoQ10) has been a popular topic of discussion in the medical infertility community for some time now. CoQ10, also known as ubiquinone, is a naturally occurring antioxidant found in every cell within the human body. It’s a component used by our cells for the energy production process in mitochondria. The main function of the mitochondrion is to produce energy for cellular activity—the “powerhouse of the cell” should be ringing some bells from middle school science class. The higher the energy needs of a cell, the higher its content of CoQ10. This means that organs with cells that have high energy requirements have more mitochondria and consequently, higher CoQ10 levels.
The oocyte (ovarian egg) is the largest cell in multicellular organisms and more mitochondria are found per egg than any other cellular organelle. As a result, eggs need a lot of mitochondria to produce the energy needed for cell division during egg maturation, fertilization, and development of an embryo. After fertilization, the mitochondria of the sperm quickly die so the mitochondria in an embryo comes entirely from the egg. As a result, the quality of an egg’s mitochondria exclusively determines the quality of the embryo.
Why does CoQ10 matter?
We know that as women age, both the quality and quantity of the eggs produced by the ovaries decreases (this is referred to as reduced ovarian reserve). Pregnancy rates decrease and genetic abnormalities in their embryos increase. Chromosome number errors lead to miscarriage and live-born genetic conditions like Down syndrome. This becomes more pronounced after age 35 in most women due to a rise in the number of chromosomal abnormalities. These then lead to a higher rate of miscarriages and genetic abnormalities in the fetus (i.e., aneuploidy).
There are two predominant theories about age-related decline in egg quality. The first one is pretty simple: essentially, the highest-quality eggs are used in the younger reproductive years, leaving the lower-quality eggs for later. The second one argues that the aging process itself might have a bad effect on the eggs that are laying dormant in the ovary. One of the main ways that this occurs is through higher numbers of mutations and deletions of mitochondrial DNA over time.
A 2005 study found lower numbers of mitochondrial DNA in the eggs of women with ovarian insufficiency when compared with women with a normal ovarian profile. Another study described a relationship between low numbers of mitochondrial DNA and how difficult it was to fertilize an egg.
What does the research say?
Given these theories, infertility research has focused quite a bit on figuring out how to improve egg quality and increase the number of eggs. Since we know CoQ10 is so integral to energy stored in all cells, it makes sense that supplementation could potentially help women with lower ovarian reserve to improve mitochondrial activity and energy production in the ovaries.
Much of the research in this area is still ongoing. Several studies have been conducted both in mice and human women. The studies in mice have shown that old mice given CoQ10 have improved outcomes more similar to young mice—meaning they have higher egg counts, more eggs ovulated after ovarian stimulation, and embryos had less chromosomal abnormalities.
In women with fertility issues because of a diminished ovarian reserve, rigorous studies using CoQ10 are still lacking. Despite the promising results in mice studies, a human study has yet to show a statistically significant benefit—mainly due to the fact that many of the human studies are simply too small.
- For example, one study from 2016 took patients who were poor responders in their previous IVF cycle and had half of them supplement with CoQ10 for 12 weeks while the other group did not supplement. No significant improvement in outcome (number of eggs retrieved) was found between the two groups. There were only 78 total patients in this study, however, which wasn’t enough subjects to detect a true difference.
- On the other hand, a study combined CoQ10 supplementation with clomiphene citrate (an ovulation induction agent) in PCOS patients who were resistant to clomiphene citrate alone. In these patients, the addition of CoQ10 did improve ovulation as well as clinical pregnancy rates (37% vs 6%).
- A recent study in 2018 found that pretreating young women who had poor ovarian reserve with CoQ10 prior to an IVF cycle improved ovarian response to stimulation. The clinical pregnancy and live birth rates per embryo transfer and per stimulation cycle were also noted to be higher in the CoQ10 group, but again, were not statistically significant because of the small study size.
These results are promising, but it’s important to note that so far, no study has shown evidence of improved live birth rates with women who have diminished ovarian reserve. There is plenty more research still underway that aims to look at this so hopefully we will have an answer to this question in the near future.
An additional benefit for CoQ10 in the male partners out there is that it has been shown to improve semen analysis parameters including sperm count, motility, and morphology.
CoQ10 may be of benefit to some infertility patients, but not all. How do you know if it’s right for you? Talk to your fertility doctor! Since CoQ10 is an antioxidant with no evidence of harm, it’s definitely worth discussing adding it to your supplementation when trying to conceive. If it’s a good option for you, your fertility doctor will also talk about specific dosing. Doses of up to 1200 mg per day appear to be safe, though divided doses two to three times daily tend to maximize absorption and maintain better levels.
If CoQ10 you decide to add to your fertility arsenal, make sure to check out our new CoQ10 supplement.
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