CoQ10 and Fertility

CoQ10 is most commonly known for its key role in ageing and combatting the damaging effects of free radicals (Quinzii et al., 2010). But low levels of CoQ10 are also implicated in diabetes, cancer, fibromyalgia, heart disease, mental decline and muscle conditions (Littarru & Tiano, 2010).

More recently, CoQ10 has been touted as an effective treatment and enhancement of fertility. Here is how...

What is CoQ10?

CoQ10 (short for Coenzyme Q10) is a fat-soluble antioxidant that protects cells from damage and plays an important part in the metabolism. It is naturally produced by the human body and exists in two forms: Ubiquinone (the oxidised form) and Ubiquinol (the bioactive, antioxidant form).

CoQ10 concentrations are highest in organs with high rates of metabolism such as the brain, heart, kidneys, and liver (Saini, 2011). Making them the best dietary sources.

It is also found in small amounts in fatty fish, whole grains and chlorophyll-rich vegetables. But cooking foods containing Coenzyme Q10 have shown a reduction of the latter by 14-32% (Weber, Bysted, & Hølmer, 1997).

The importance of CoQ10 in mitochondrial function...

Mitochondria are cellular organelles that are located outside the nucleus of a cell. They are the cell's source of power.

CoQ10 is found in the inner mitochondrial membrane, and is crucial for the production of adenosine triphosphate (ATP), which is the form of energy that our cells can use (Molyneux, Young, Florkowski, Lever, & George, 2008). The higher the energy a cell needs the more number of mitochondria it would have and the more it needs CoQ10 to do its job for optimal cell function (Khakh & Burnstock, 2009).

CoQ10 and the Egg Cell

Ovulation, fertilisation and embryo development are all energy-intense processes. Therefore, a woman’s egg cell (also known as Oocyte) contains more mitochondria than any other cell.

However, the ability to produce CoQ10 and use it in energy production decreases significantly with age. Recent research indicates that the decline in mitochondrial function in the oocyte may be responsible for this age-related decline in egg quality (Ben-Meir et al., 2015; Bentov & Casper, 2013).

Therefore, women of advanced maternal age (who would want to conceive) must regulate their CoQ10 levels to help repair free radicals, improve egg quality, enhance ovulation and boost pregnancy success rates.

One study has even found that women (age 35-43) undergoing IVF treatments and administered 600 mg of CoQ10 daily, showed very promising results (Bentov, Hannam, Jurisicova, Esfandiari, & Casper, 2014).

CoQ10 and The Sperm Cell

There are a number of factors that contribute to male infertility and one of the most damaging can be the presence of free radicals. Approximately 30-80% of infertile men have high levels of free radicals in their semen (Agarwal, Gupta, & Sikka, 2006).

Free radicals can destroy the membrane that surrounds sperm cells, severely impairing DNA and causing errors in the genetic information carried by the sperm.

CoQ10 has been shown to ameliorate fertility issues in men by

* Improving sperm motility and movement

* Increasing fertilisation rates

* Boosting sperm count

* Refining sperm morphology (size/form)

* Increasing antioxidants in seminal plasma

* Helping with asthenozoospermia

* Improving symptoms of Peyronie's disease

(Balercia et al., 2004; Littarru & Tiano, 2010; Nadjarzadeh et al., 2011; M. R. Safarinejad, 2010; Mohammad Reza Safarinejad, 2009)

Final Thoughts...

CoQ10 supplements are available in many forms, including soft gels, capsules, tablets and oral sprays. However, the majority is not well absorbed by the body.

Fortunately, there are a few CoQ10 supplements in the market that incorporate an enhanced absorption delivery system which has proved an increase of bioavailability by up to 600% compared to standard supplementation (Liu & Artmann, 2009).

But for some people that are either ingesting Statin drugs or have a deficiency in the enzyme coenzyme Q10 reductase (caused by a gene mutation), the conversion of CoQ10 to its active form Ubiquinol may be compromised greatly. The frequency of this polymorphism and mutation in the population varies with ethnic group: it is found in the homozygous state at a frequency of 4% in Caucasians, 5% in African–Americans, 16% in Mexican Hispanics, and 22% in Chinese populations (Kelsey et al., 1997).

Therefore, for these individuals there will be little benefit in taking CoQ10 and are better of supplementing with just Ubiquinol (Crane, 2001).

For women with PCOS (polycystic ovarian syndrome), an exciting study has shown that CoQ10 may be particularly helpful.

Women who were given a supplementation of 60 mg of CoQ10 three times a day, in addition to 150 mg of Clomiphine-citrate, had more egg follicles, greater endometrial thickness, experienced an enhancement in ovulation and higher pregnancy rates compared to those in the control group (El Refaeey, Selem, & Badawy, 2014).

Although supplementation with CoQ10 is considered safe, some people may experience a few rare side effects that include: Diarrhoea, nausea and heartburn. Therefore it is important to read the dosage labels on supplements, and stick to them unless instructed otherwise by your healthcare professional.

CoQ10 must also be avoided among pregnant and breastfeeding women given the lack of evidence on safety and efficiency. However, one study showed that taking 200 mg of CoQ10 at 20 weeks reduced the risk of pre-eclampsia (Teran et al., 2009).

In addition, CoQ10 is known to interact with some medications such as blood thinners, thyroid and chemotherapy medications. Therefore it is always important to consult your healthcare provider before taking any supplement.

+References

Agarwal, A., Gupta, S., & Sikka, S. (2006). The role of free radicals and antioxidants in reproduction. Current Opinion in Obstetrics and Gynecology. https://doi.org/10.1097/01.gco.0000193003.58158.4e

Balercia, G., Mosca, F., Mantero, F., Boscaro, M., Mancini, A., Ricciardo-Lamonica, G., & Littarru, G. P. (2004). Coenzyme Q 10 supplementation in infertile men with idiopathic asthenozoospermia: An open, uncontrolled pilot study. Fertility and Sterility. https://doi.org/10.1016/j.fertnstert.2003.05.009

Ben-Meir, A., Burstein, E., Borrego-Alvarez, A., Chong, J., Wong, E., Yavorska, T., … Jurisicova, A. (2015). Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging. Aging Cell. https://doi.org/10.1111/acel.12368

Bentov, Y., & Casper, R. F. (2013). The aging oocyte - Can mitochondrial function be improved? Fertility and Sterility. https://doi.org/10.1016/j.fertnstert.2012.11.031

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. https://doi.org/10.4137/cmrh.s14681

Crane, F. L. (2001). Biochemical Functions of Coenzyme Q10. Journal of the American College of Nutrition. https://doi.org/10.1080/07315724.2001.10719063

El Refaeey, A., Selem, A., & Badawy, A. (2014). Combined coenzyme Q10 and clomiphene citrate for ovulation induction in clomiphene-citrate-resistant polycystic ovary syndrome. Reproductive BioMedicine Online. https://doi.org/10.1016/j.rbmo.2014.03.011

Kelsey, K. T., Ross, D., Traver, R. D., Christiani, D. C., Zuo, Z. F., Spitz, M. R., … Wiencke, J. K. (1997). Ethnic variation in the prevalence of a common NAD(P)H quinone oxidoreductase polymorphism and its implications for anti-cancer chemotherapy. British Journal of Cancer. https://doi.org/10.1038/bjc.1997.474

Khakh, B. S., & Burnstock, G. (2009). The double life of ATP. Scientific American. https://doi.org/10.1038/scientificamerican1209-84

Littarru, G. P., & Tiano, L. (2010). Clinical aspects of coenzyme Q10: An update. Nutrition. https://doi.org/10.1016/j.nut.2009.08.008

Liu, Z. X., & Artmann, C. (2009). Relative bioavailability comparison of different coenzyme Q10 formulations with a novel delivery system. Alternative Therapies in Health and Medicine.

Molyneux, S. L., Young, J. M., Florkowski, C. M., Lever, M., & George, P. M. (2008). Coenzyme Q10: is there a clinical role and a case for measurement? The Clinical Biochemist. Reviews.

Nadjarzadeh, A., Sadeghi, M. R., Amirjannati, N., Vafa, M. R., Motevalian, S. A., Gohari, M. R., … Shidfar, F. (2011). Coenzyme Q 10 improves seminal oxidative defense but does not affect on semen parameters in idiopathic oligoasthenoteratozoospermia: A randomized double-blind, placebo controlled trial. Journal of Endocrinological Investigation. https://doi.org/10.3275/7572

Quinzii, C. M., López, L. C., Gilkerson, R. W., Dorado, B., Coku, J., Naini, A. B., … Hirano, M. (2010). Reactive oxygen species, oxidative stress, and cell death correlate with level of CoQ10 deficiency. FASEB Journal. https://doi.org/10.1096/fj.09-152728

Safarinejad, M. R. (2010). Safety and efficacy of coenzyme Q 10 supplementation in early chronic Peyronie’s disease: A double-blind, placebo-controlled randomized study. International Journal of Impotence Research. https://doi.org/10.1038/ijir.2010.20

Safarinejad, Mohammad Reza. (2009). Efficacy of Coenzyme Q10 on Semen Parameters, Sperm Function and Reproductive Hormones in Infertile Men. Journal of Urology. https://doi.org/10.1016/j.juro.2009.02.121

Saini, R. (2011). Coenzyme Q10: The essential nutrient. Journal of Pharmacy and Bioallied Sciences. https://doi.org/10.4103/0975-7406.84471

Teran, E., Hernandez, I., Nieto, B., Tavara, R., Ocampo, J. E., & Calle, A. (2009). Coenzyme Q10 supplementation during pregnancy reduces the risk of pre-eclampsia. International Journal of Gynecology and Obstetrics. https://doi.org/10.1016/j.ijgo.2008.11.033

Weber, C., Bysted, A., & Hølmer, G. (1997). Coenzyme q10 in the diet--daily intake and relative bioavailability. Molecular Aspects of Medicine. https://doi.org/10.1016/S0098-2997(97)00003-4

DR NAUF ALBENDAR

My name is Dr Nauf AlBendar and I am the founder of The Womb Effect. As a medical scientist with a BSc in Molecular Genetics and Genomics, an MSc in Nutrition & Food Science and a PHD in clinical medicine, I have developed a deep appreciation and understanding for the developmental origins of health and disease.