The Fertility Talk

In case you missed that biology lesson…..

What are Mitochondria?

They're the “engine” of your eggs. Most cells in your body have hundreds of mitochondria in them. As your egg cells mature, going from a tiny microscopic primordial follicle cell to a visible egg cell (barely visible to the naked eye), mitochondria multiply exponentially to 100,000–500,000 (or more) mitochondria in fully mature eggs.

Let’s put that into perspective….

Approximately **50-75 mitochondria** are present in a **single sperm**. The **sperm's** midpiece contains a smaller amount of mitochondria so that a supply of energy is available for the sperm to perform its function of traveling to and later fertilizing the egg.
Let’s be real, the sperm needs energy to make the arduous journey up through the uterus and into the fallopian tubes however the egg needs a much larger energy supply for all the incredible work that’s required to make a baby. Fertilization of the egg to produce an embryo, cell division to produce a blastocyst and all of the energy required after that.

This energy supply is so important for fertility and pregnancy and with age naturally there is a decline. Certain environmental toxins such as smoking, drug use and poor diet can all have detrimental affects on egg quality and speed up this decline. We cannot do much to prevent the natural decline that occurs with age however we can take control of the environment we provide for our eggs.

What Causes Damage?

Oxidative stress and mitochondrial dysfunction are among the most investigated possible mechanisms for poor egg quality. Mitochondria are the most abundant organelles in our eggs and early embryos that generate approximately 90% of reactive oxygen species (ROS), the end products of oxygen metabolism, and convert ROS into an inactive state via antioxidant defense mechanisms. Higher levels of ROS accumulating in mitochondria during multiple physiological conditions contribute to mitochondrial dysfunction and increase in oxidative stress. Oxidative stress is bad. This, in turn, leads to oxidative damage to DNA and other intra-cellular defects, which are similar to the age-related changes. Therefore, improving mitochondrial function by supplementing antioxidants has been proposed as one of the important strategies to enhance reproductive performance.

Can Antioxidants Help?

In short. Yes.

Coenzyme Q10, also known as CoQ10, is an antioxidant that is naturally found in the body. It can also be taken as a dietary supplement, and it has been recommended for some time as a supplement for men with low sperm count, low motility and other sperm-related problems. Today, there are preliminary studies that suggest that the CoQ10-fertility association could be important for female infertility as well. CoQ10 for pregnancy in women is an area that is actively being researched, with a specific focus on CoQ10 and egg quality.

What’s The Data?

Published research studies on CoQ10 fertility in women and the use of coenzyme Q10 for egg quality are still somewhat limited. Most research is focusing on pairing supplementation with CoQ10 and IVF or IUI treatment for women with infertility, rather than using CoQ10 for pregnancy attempts naturally. One randomised controlled trial in 2018 showed that pretreatment with coenzyme Q10 improved ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve.

In summary, the study showed that pretreatment with CoQ10 (200 mg three times daily)

increased ovarian response to stimulation
improved egg and embryo quality in young low prognosis patients with diminished ovarian reserve

There is a possible beneficial effect on clinical pregnancy and live birth rates, but this needs to be confirmed in larger randomized controlled studies. Further work is required to establish the optimal length, timing and dosage of treatment and to evaluate the therapeutic effect of CoQ10 supplementation in other subgroups of low prognosis women with poor ovarian reserve. However the data thus far is promising.

In short, it appears that supplementing with Co-Enzyme Q10 can improve response to hormonal medications given during ART. There is insufficient data to suggest that all women trying to conceive should take this supplement however as there is no evident of harm to a person when taking antioxidant supplementation (in the correct dose), it is up to the discretion of a woman if she would like to make use of this supplement if trying to optimise her chances. I would always advise to consult with your doctor before commencing supplementation.

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