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Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial

Yangying Xu, Victoria Nisenblat, Cuiling Lu, Rong Li, Jie Qiao, Xiumei Zhen, Shuyu Wang
Reproductive Biology and Endocrinology 2018 16(1):29

Bibliography

PubMed
PMID 29587861
PubMed Central
PMC5870379
DOI
10.1186/s12958-018-0343-0
Trial registry
View on ClinicalTrials.gov Registered trial — results not yet published in a peer-reviewed journal.
Funding
National Key Research and Development Project (2016YFC1000302) and Scientific Research Foundation for Returned Overseas Scholars of the Ministry of Education (A70538-3).
Competing interests
The authors declared no competing interests.

Study snapshot

DesignProspective randomized controlled trial; CoQ10 pretreatment versus no pretreatment before IVF/ICSI.
ModelWomen <35 years with diminished ovarian reserve / poor ovarian response, POSEIDON group 3, undergoing IVF/ICSI.
Sample186 randomized; 169 evaluated after 17 exclusions for low compliance: 76 CoQ10 and 93 control.
InterventionCoQ10 600 mg/day for 60 days before IVF/ICSI versus no pretreatment.
Duration60-day pretreatment followed by IVF/ICSI stimulation.
EndpointsPrimary: number of high-quality embryos; Gonadotropin requirement; Peak estradiol; Oocytes retrieved; Fertilization rate; Embryo-transfer cancellation for poor embryo development; Cryopreserved embryos; Clinical pregnancy; Live birth

What the study showed, in plain terms

This randomized study tested 600 mg/day of CoQ10 for 60 days before IVF/ICSI in women under 35 with diminished ovarian reserve. Of 186 randomized participants, 169 were evaluated after 17 women were excluded for low compliance.

CoQ10 pretreatment reduced gonadotropin requirements and increased peak estradiol, oocyte retrieval, fertilization and high-quality-embryo measures. The treated group had a median 4 retrieved oocytes (IQR 2–5), a fertilization rate of 67.49%, and a median 1 high-quality embryo (IQR 0–2). Embryo-transfer cancellation for poor embryo development was 8.33% versus 22.89% in controls (p=0.04), and cryopreserved embryos were available in 18.42% versus 4.3% (p=0.012).

Clinical-pregnancy and live-birth rates trended higher but did not reach statistical significance. The strongest evidence from this trial is improved ovarian-response and embryology endpoints, not a proven live-birth benefit.

Key findings

  • Dose: 600 mg/day for 60 days before IVF/ICSI.
  • Retrieved oocytes: median 4 (IQR 2–5) in the CoQ10 group; ovarian-response measures significantly favored pretreatment.
  • Fertilization rate 67.49%; high-quality embryos median 1 (IQR 0–2).
  • Embryo-transfer cancellation for poor embryo development: 8.33% vs 22.89% control (p=0.04).
  • Available cryopreserved embryos: 18.42% vs 4.3% (p=0.012).
  • Clinical pregnancy and live birth tended to favor CoQ10 but were not statistically significant.

What this study can and cannot tell us

  • No-treatment control rather than placebo prevented full participant blinding.
  • Seventeen randomized women were excluded for low compliance; this was not a strict intention-to-treat analysis.
  • Population was narrowly defined: women <35 years with POSEIDON group 3 diminished ovarian reserve.
  • The study was not powered to establish a definitive live-birth benefit.

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