Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 29587861 · doi:10.1186/s12958-018-0343-0
What was done
A prospective randomized controlled trial evaluated 60 days of coenzyme Q10 (CoQ10) pretreatment versus no pretreatment before an IVF-ICSI cycle in 186 young women (age < 35) with poor ovarian reserve (POSEIDON group 3). The primary outcome was the number of high-quality embryos. A total of 169 participants were evaluated (76 in the CoQ10 group, 93 in the control group; 17 were excluded due to low compliance).
What was found
CoQ10 pretreatment resulted in significantly lower gonadotrophin requirements and higher peak estradiol levels. Women in the CoQ10 group had an increased number of retrieved oocytes (4, IQR 2-5), higher fertilization rate (67.49%), and more high-quality embryos (1, IQR 0-2; p < 0.05 for each). Cancelled embryo transfers due to poor embryo development were significantly lower with CoQ10 (8.33% vs. 22.89%, p = 0.04) and more women in the treatment group had cryopreserved embryos (18.42% vs. 4.3%, p = 0.012). Clinical pregnancy and live birth rates trended higher in the CoQ10 group but did not achieve statistical significance.
Why it matters
This trial demonstrates that antioxidant pretreatment with CoQ10 can improve ovarian responsiveness and embryological parameters in young women with diminished ovarian reserve. However, confirmatory trials are required to establish whether these intermediate improvements translate into higher live birth rates.
Limits
The control group received no pretreatment rather than a placebo, introducing potential performance bias. Seventeen randomized participants were excluded post-randomization due to low compliance. The study was underpowered to detect statistically significant differences in clinical pregnancy and live birth rates, and findings are restricted to women under 35 meeting POSEIDON group 3 criteria.
Cited by
- supports Published scientific literature suggests that coenzyme Q10 and L-carnitine improve oocyte quality.