Clinical evidence of coenzyme Q10 pretreatment for women with diminished ovarian reserve undergoing IVF/ICSI: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 39129455 · doi:10.1080/07853890.2024.2389469
What was done
Systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the effect of coenzyme Q10 (CoQ10) pretreatment on IVF or ICSI outcomes in women with diminished ovarian reserve (DOR). Nine databases were searched from inception to November 1, 2023. Assessed outcomes included three primary and six secondary reproductive measures, with sensitivity analysis used to verify result robustness.
What was found
Across 6 RCTs comprising 1,529 women with DOR undergoing IVF/ICSI, CoQ10 pretreatment significantly increased: - Clinical pregnancy rate (OR = 1.84, 95% CI [1.33, 2.53], p = 0.0002) - Number of optimal embryos (OR = 0.59, 95% CI [0.21, 0.96], p = 0.002) - Number of oocytes retrieved (MD = 1.30, 95% CI [1.21, 1.40], p < 0.00001) - Estradiol (E2) levels on the day of hCG trigger (SMD = 0.37, 95% CI [0.07, 0.66], p = 0.01) CoQ10 pretreatment also significantly decreased: - Cycle cancellation rate (OR = 0.60, 95% CI [0.44, 0.83], p = 0.002) - Miscarriage rate (OR = 0.38, 95% CI [0.15, 0.98], p = 0.05) - Total days of gonadotropin (Gn) stimulation (MD = -0.89 days, 95% CI [-1.37, -0.41], p = 0.0003) - Total dose of Gn used (MD = -330.44, 95% CI [-373.93, -286.96], p < 0.00001)
Why it matters
CoQ10 pretreatment appears to improve ovarian response and pregnancy rates while lowering gonadotropin requirements and cycle cancellations in a challenging clinical population.
Limits
The meta-analysis included only six trials with relatively limited individual sample sizes. Included RCTs suffered from poor methodological reporting. Live birth rate, long-term safety, and specific optimal dosing or duration protocols for CoQ10 were not detailed in the abstract.