SAN FRANCISCO – Two months of pre-IVF supplementation with coenzyme Q10 was associated with a 41% rate of aneuploidies in 9 oocytes, compared with aneuploidies in 51% of 13 oocytes from women randomized to placebo, a small prospective study found.
"This difference didn’t reach significance because of the small numbers, but at least it’s trending in the right direction," Dr. Robert F. Casper said at the UCLA annual in vitro fertilization and embryo transfer update 2013.
The study took 2-3 years to enroll and randomize 39 women aged 38 years or older who were undergoing IVF at his institution, a lengthy process because of patient reluctance to enter the study.
He said the investigators didn’t really know how long to pretreat with coenzyme Q10 (CoQ10) in hopes of rejuvenating the mitochondria of aging oocytes, so they settled on 2 months because they didn’t think these older women would agree to a longer time frame. Even with that compromise, most eligible patients still were unwilling to risk being randomized to placebo and so refused enrollment, said Dr. Casper, professor of ob.gyn. and of medicine (division of endocrinology) at the University of Toronto and the Camille Dan Family research chair in translational cell biology at the Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto.
The encouraging trend in reduced risk of aneuploidy suggests that a much larger prospective study should be conducted, perhaps with younger IVF patients who "wouldn’t be so stressed about being randomized to placebo for a few months," he said.
Patients took six capsules per day that gave them either placebo or 600 mg/day of CoQ10 in the form of ubiquinone.
The study originally randomized 39 women, 27 of whom completed 2 months of pretreatment. Twenty-two oocytes were available for aneuploidy analysis after IVF and embryo transfer: 9 in the CoQ10 group and 13 in the placebo group.
Although the average estradiol level on the day of human chorionic gonadotropin (HCG) was higher in the CoQ10 group and the average progesterone level was lower on the day of HCG than in the placebo group, these differences did not reach statistical significance. The groups also did not differ significantly in average age, follicle-stimulating hormone level on cycle day 3, the day of HCG, or total international units of Menopur (menotropins) used.
No major side effects were seen. Most women in the CoQ10 group reported feeling more energetic, Dr. Casper said. Some who complained of insomnia were instructed to take all six capsules in the morning.
The study was inspired by two previous studies in mice by the same investigators. One found that CoQ10 supplementation in old mice improved ovarian response to stimulation, increased the number of cumulus cells and oocyte mitochondrial function, restored normal nuclear spindles, and delayed ovarian follicle loss due to aging. The second study showed that disrupting CoQ10 production in mice oocytes mimicked reproductive aging. Disrupting CoQ10 production accelerated oocyte loss and premature ovarian failure, impaired mitochondrial function with reduced energy production, and increased chromosomal abnormalities, all of which were bypassed with CoQ10 supplementation.
Dr. Casper has been a consultant for Fertility Nutraceuticals, which is making a brand of CoQ10, and he disclosed financial relationships with multiple other companies unrelated to this topic.
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