Bentov, Y., Hannam, T., Jurisicova, A., Esfandiari, N., & Casper, R. F. (2014). Coenzyme Q10 Supplementation and Oocyte Aneuploidy in Women Undergoing IVF-ICSI Treatment. Clinical medicine insights. Reproductive health, 8. https://doi.org/10.4137/CMRH.S14681
Bentov Y, Hannam T, Jurisicova A, Esfandiari N, Casper RF. Coenzyme Q10 Supplementation and Oocyte Aneuploidy in Women Undergoing IVF-ICSI Treatment. Clin Med Insights Reprod Health. 2014;8. doi:10.4137/CMRH.S14681
Bentov, Yaakov, et al. "Coenzyme Q10 Supplementation and Oocyte Aneuploidy in Women Undergoing IVF-ICSI Treatment." Clinical medicine insights. Reproductive health, vol. 8, 2014.
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CoQ10 Did Not Significantly Cut Egg Chromosome Errors in an IVF Trial
A randomized, double-blind trial of women aged 35 to 43 having IVF with ICSI found no significant difference in egg chromosome errors between coenzyme Q10 and placebo. About 5 out of 10 eggs analyzed in the CoQ10 group carried an error, against about 6 out of 10 in the placebo group.
Key Findings
Thirty-nine women were randomized (17 to CoQ10, 22 to placebo). Twenty-seven started the supplement and 24 completed a cycle with polar body biopsy and embryo transfer (10 CoQ10, 14 placebo).
The aneuploidy rate was 46.5% in the CoQ10 group and 62.8% in the placebo group. None of the results reached statistical significance.
The clinical pregnancy rate was 33.3% with CoQ10 and 26.7% with placebo. The live-birth rate was 25% with CoQ10 and 26.7% with placebo.
Average age was 39.0 in the CoQ10 group and 39.1 in the placebo group.
Interpretation
The study is a randomized, double-blind, placebo-controlled trial at two sites with one laboratory. The authors ended it in June 2012, after a report that polar body biopsy harms embryo quality, so enrollment fell short of the 27 women per group their power calculation required. They call the trial underpowered and give the small sample as one simple explanation for the lack of a significant difference. They also name the short two-month course as a possible reason. The two groups also used the stimulation protocols in different proportions. Results apply to women aged 35 to 43 who took one supplement for two months before retrieval.
RRM Context
The women in this trial had already entered IVF with ICSI, which bypasses the reproductive system without resolving why conception fails. Restorative reproductive medicine looks for the causes of reduced fertility in both partners and works with the cycle.
Our editorial summary of this paper, not the article's abstract.
Abstract
Background
The age-related reduction in live-birth rate is attributed to a high rate of aneuploidy and follicle depletion. We showed in an animal model that treatment with Coenzyme Q10 (CoQ10) markedly improved reproductive outcome. The aim of this study was to compare the post-meiotic oocyte aneuploidy rate in in vitro fertilization (IVF) and intra cytoplasmic sperm injection (ICSI) patients treated with CoQ10 or placebo.
Methods
We conducted a double blind placebo controlled randomized trial that included IVF-ICSI patients 35-43 years of age. The patients were treated with either 600 mg of CoQ10 or an equivalent number of placebo caps. We compared the post-meiotic aneuploidy rate using polar body biopsy (PBBX) and comparative genomic hybridization (CGH). According to the power calculation, 27 patients were needed for each arm.
Results
Owing to safety concerns regarding the effects of polar body biopsy on embryo quality and implantation, the study was terminated before reaching the target number of participants. A total of 39 patients were evaluated and randomized (17 CoQ10, 22 placebo), 27 were given the study medication (12 CoQ10, 15 placebo), and 24 completed an IVF-ICSI cycle including PBBX and embryo transfer (10 CoQ10, 14 placebo). Average age, base line follicle stimulating hormone (FSH), peak estradiol and progesterone serum level, as well as the total number of human menopausal gonadotropin (hMG) units-did not differ between the groups. The rate of aneuploidy was 46.5% in the CoQ10 group compared to 62.8% in the control. Clinical pregnancy rate was 33% for the CoQ10 group and 26.7% for the control group.
Conclusion
No significant differences in outcome were detected between the CoQ10 and placebo groups. However, the final study was underpowered to detect a difference in the rate of aneuploidy.
