Dietary supplementation with coenzyme Q10 in poor responder patients undergoing IVF-ICSI Treatment

Abstract

Ovarian aging and age-related reduction in live birth rate reflects a decline in response to ovarian stimulation, reduced embryo quality and pregnancy rate (PR), and an increased incidence of miscarriages and fetal aneuploidy. This is attributed to a high rate of aneuploidy and follicle depletion, probably due to energy-dependent mechanism as mitocondrial mutations in follicular cells increase with age and oxidative phosphorylation an ATP production in the follicle is also impaired in older women. Coenzyme Q10 (CoQ10) is a crucial substrate in the electron transport chain of mitochondria., and has been shown to decrease in several tissues with aging. The aim of this study was to asses if dietary supplementation of mitochondrial nutrients such as C0Q10 may improve mitochondrial energy production for the maturing oocyte and developing embryo, thereby improving ovarian response and reproductive outcome in poor responders. Prospective randomized controlled study. Seventy eight poor responders (36-40 years of age) in a previous IVF cycle according to Bologna criteria were randomized to Group 1 : 600 mg Co Q10 twice a day for 12 weeks and Group 2: no treatment for 12 weeks. Mean age was 37.8 yrs. in Group 1 and 37.2 yrs in group 2. Anti-Mullerian hormone (AMH) (0.67 +- 0.26vs 0.7 +-0.28) and FSH values (12 +- 2.11 vs 11.6 +- 1.89) were comparable. The primary outcomes were number of oocytes retrieved, number of good quality embryos obtained, pregnancy rate and live birth. Both groups were comparable in terms of age, BMI, ovarian reserve (AMH and FSH) and length of treatment. There were no significant differences in the number of MII oocytes retrieved (1.82 ± 0.82 vs. 1.87 ± 0.76; p=0.77), implantation rate (26.2% vs. 21.4%; p=0.75) and clinical pregnancy rate (fetal heartbeat at 7 weeks) (15.4% vs. 12.8%; p=0.64) No significant differences in outcome were detected between the CoQ10 and no treatment groups. However, the sample size of this study may be underpowered to detect a significant difference.