CoQ10 for Fertility
CoQ10 supplementation has been recommended for some time in reproductive medicine settings for infertile men whose semen analysis shows that they have low sperm count, low sperm motility and other sperm-related problems. Today, there are preliminary studies suggesting that this supplement could have important potential benefits in addressing female infertility as well. This is an area that is actively being researched, with a specific focus on the effects of CoQ10 levels on egg quality and pregnancy rates. At our fertility center, we have been using this antioxidant for women with egg quality issues for some time now, paired with ovarian stimulation and IVF. And we are actively conducting additional clinical research in this area as part of the CHR’s in-house research program.
What is the CoQ10-Fertility Connection?
What does Coenzyme Q10 do?
Coenzyme Q10, also known as CoQ10, is a powerful antioxidant that is naturally found in the body. It can also come from food sources like fish, meat (especially organ meats), certain oils (like canola and soybean oils), and certain nuts and seeds (like peanuts and sesame seeds). CoQ10 can also be taken as a dietary supplement, which offers much higher concentrations than food sources. The form of CoQ10 in supplements is either ubiquinol or ubiquinone; ubiquinol is the form that is more readily absorbed.
Coenzyme Q10 is produced and used in all cells in the human body. All cells require energy to function properly, and this energy is produced by mitochondria. Found inside all cells in the body, mitochondria are tiny structures, called organelles, with their own DNA that is separate from the DNA in the cell nucleus.
CoQ10 plays an essential role in energy production as part of the electron transport chain, where it is responsible for moving electrons through the mitochondrial cell membrane to make ATP. The electron transport chain is the third stage of energy production, which occurs after glycolysis and the Krebs cycle.
In addition to acting as an enzyme, CoQ10 is also an antioxidant. Antioxidants act against free radicals to reduce oxidative stress that negatively affects cellular DNA. This is valuable in any cell, but it may be especially important in protecting the DNA of oocytes, or egg cells, in a woman’s ovaries.
Fertility, Egg Quality & Coenzyme Q10
There are two main theories about the effects of CoQ10 on female fertility. Both of these proposed mechanisms relate to the molecule’s potential role in egg quality. The important thing to note, first, is that the amount of CoQ10 that the body produces declines with age. As a result, as a woman gets older, all her cells -- including her oocyte cells -- have progressively less energy available. This can be problematic for several reasons, and it is where taking CoQ10 supplements can help.
How might coenzyme Q10 improve egg quality? Egg cells are very large (in fact, they are the largest cells in the body), and a lot of energy is required for egg maturation, fertilization, and embryonic cell division. One theory is that inefficient energy production can have a substantial impact on these large cells with high energy demands. If energy is generated inefficiently, this can result in lower egg quality and embryo quality. Less energy in the critical embryonic stage can cause mistakes in cell division. These mistakes can lead to failed IVF cycles or miscarriages.
When a woman takes CoQ10 supplements as prescribed by her fertility physician, her eggs have a better chance of getting sufficient energy from their mitochondria to propel healthy growth. Healthy egg cells are obviously essential for successful IVF cycles, as well as consequently higher pregnancy rates and live birth rates.
Another theory relates to coenzyme Q10’s role as an antioxidant. When there is insufficient antioxidant activity in any cell, free radicals can cause damage to DNA. When free radicals damage an egg cell’s DNA, this can lead to egg quality problems.
As a powerful antioxidant, CoQ10 has the potential to protect the DNA of egg cells from oxidative damage, which naturally tends to accumulate as we age. This is why supplementation is particularly important for older women trying to conceive. CoQ10 supplementation for IVF can protect those oocytes from oxidative damage, also conferring a greater opportunity for healthy maturation and growth.
In both of these scenarios, low levels of CoQ10 can lead to problems in fertilization or interfere with the viability of an embryo if genetic mutations occur due to DNA damage. Consequently, female fertility declines. In research studies, egg quality appears to be improved by CoQ10’s action in egg cells during in vitro fertilization. Therefore, used within well-designed protocols for IVF, CoQ10 has the potential to improve pregnancy chances, especially in older women.
CoQ10 Egg Quality Research
This is a promising research direction in reproductive medicine, and studies are being undertaken around the world. A study on a mouse model, published by a team of researchers in the United States and Canada, confirmed that mice treated with CoQ10 showed greater improvement in ovarian response than the placebo group.
In terms of human studies, a recent study in China that enrolled 186 women with poor ovarian response found that taking 200 mg of CoQ10 three times daily for 60 days improved ovarian response before IVF or ICSI. Women with polycystic ovary syndrome (PCOS) were excluded from this study. A different study of 101 women with clomiphene-resistant PCOS in Egypt found that prescribing both CoQ10 and clomiphene improved ovulation and clinical pregnancy rates.
Nevertheless, published research studies on CoQ10 fertility in women and the use of coenzyme Q10 for egg quality are still not numerous. However, CoQ10 is not a medication but a supplement with only mild potential side effects. Because of this, fertility doctors are able to administer it safely as a part of a tailored treatment plan -- and there are certainly potential benefits to doing so. Most research is focusing on pairing supplementation with IVF or IUI treatment for women with infertility, rather than using CoQ10 for pregnancy attempts naturally.
The use of the supplement for IVF is similar to how dehydroepiandrosterone (DHEA) is used in concert with IVF, a method that was first established here at CHR in 2005. DHEA is another supplement that is beneficial before and during fertility treatment with ovarian stimulation. The important part is to start supplementation early, at least 6-8 weeks before the planned IUI or IVF start, so that the eggs going through the multiple-months-long maturation process will gain the fertility benefits of supplementation. The same applies to CoQ10.
Even though published data is limited, especially for human studies, CHR physicians have been able to improve pregnancy chances in women with diminished ovarian reserve (whether due to attempting pregnancy after age 40 or due to premature ovarian aging) with supplementation with coenzyme Q10 before and during IVF. Diminished ovarian reserve, or DOR, affects about 10% of women even at a young age.
Are you interested in learning more about CoQ10, and whether it may be a suitable treatment option for your fertility? Contact us today to set up a consultation with a CHR physician.
Read more about Egg Quality
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.