Does coenzyme Q 10 supplementation improve fertility outcomes in women undergoing assisted reproductive technology proce
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REVIEW
Does coenzyme Q10 supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials Panagiota Florou 1 & Panagiotis Anagnostis 1,2 Dimitrios G. Goulis 2
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Patroklos Theocharis 1 & Michail Chourdakis 3
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Received: 4 April 2020 / Accepted: 28 July 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
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. Keywords Coenzyme Q10 . CoQ10 . Female infertility . Assisted reproduction . Pregnancy outcomes . Meta-analysis
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10815-020-01906-3) contains supplementary material, which is available to authorized users. * Michail Chourdakis [email protected] 1
Department of Endocrinology, Police Medical Center of Thessaloniki, 326 Monastiriou Street, 54121 Thessaloniki, Greece
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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
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Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
Abbreviations IVF In vitro fertilization ICSI Intracytoplasmic sperm inject
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