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Does coenzyme Q10 supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials

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Abstract

Objective

Increased oxidative stress has been identified as a pathogenetic mechanism in female infertility. However, the effect of specific antioxidants, such as coenzyme Q10 (CoQ10), on the outcomes after assisted reproductive technologies (ART) has not been clarified. The aim of this study was to systematically review and meta-analyze the best available evidence regarding the effect of CoQ10 supplementation on clinical pregnancy (CPR), live birth (LBR), and miscarriage rates (MR) compared with placebo or no-treatment in women with infertility undergoing ART.

Methods

A comprehensive literature search was conducted in PubMed (MEDLINE), Cochrane, and Scopus, from inception to March 2020. Data were expressed as odds ratio (OR) with 95% confidence intervals (CI). The I2 index was employed for heterogeneity.

Results

Five randomized-controlled trials fulfilled eligibility criteria (449 infertile women; 215 in CoQ10 group and 234 in placebo/no treatment group). Oral supplementation of CoQ10 resulted in an increase of CPR when compared with placebo or no-treatment (28.8% vs. 14.1%, respectively; OR 2.44, 95% CI 1.30–4.59, p = 0.006; I2 32%). This effect remained significant when women with poor ovarian response and polycystic ovarian syndrome were analyzed separately. No difference between groups was observed regarding LBR (OR 1.67, 95% CI 0.66–4.25, p = 0.28; I2 34%) and MR (OR 0.61, 95% CI 0.13–2.81, p = 0.52; I2 0%).

Conclusions

Oral supplementation of CoQ10 may increase CPR when compared with placebo or no-treatment, in women with infertility undergoing ART procedures, without an effect on LBR or MR.

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Data availability

Not applicable.

Abbreviations

IVF:

In vitro fertilization

ICSI:

Intracytoplasmic sperm injection

hCG:

Human chorionic gonadotropin

PCOS:

Polycystic ovary syndrome

POR:

Poor ovarian response

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Endocrinology, Police Medical Center of Thessaloniki, 326 Monastiriou Street, 54121, Thessaloniki, Greece

    Panagiota Florou, Panagiotis Anagnostis & Patroklos Theocharis

  2. Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, “Papageorgiou” General Hospital, Aristotle University of Thessaloniki, Ring Road, Nea Efkarpia, 54601, Thessaloniki, Greece

    Panagiotis Anagnostis & Dimitrios G. Goulis

  3. Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece

    Michail Chourdakis

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  1. Panagiota Florou
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Contributions

PF designed the research, searched the literature, extracted and analyzed the data, and wrote the first draft of the paper. PT searched the literature, extracted the data, and was responsible for the statistical analysis. PA and MC reviewed the manuscript and provided critical scientific input. DGG resolved discrepancies regarding the quality of the studies included in the meta-analysis, provided critical scientific input, and had the primary responsibility for the paper’s final content.

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Correspondence to Michail Chourdakis.

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Florou, P., Anagnostis, P., Theocharis, P. et al. Does coenzyme Q10 supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials. J Assist Reprod Genet 37, 2377–2387 (2020). https://doi.org/10.1007/s10815-020-01906-3

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