A Case Control Study of Melatonin with or Without Coenzyme Q10 in Improving Oocyte Quality and Outcomes in In vitro Fertilization

Abstract

Antioxidant therapy is thought to improve oocyte quality through the reduction of oxidative stress. Melatonin and coenzyme Q10 (CoQ10) are known antioxidants. We aimed to investigate the clinical efficacy of exogenous melatonin supplementation with or without CoQ10 in improving oocyte quantity and quality. Fifty-three women undergoing cycles at Monash IVF were supplemented with melatonin 4 mg daily, with 19 of those additionally supplemented with 150 mg of CoQ10. Controls were matched at a 2:1 ratio to cases. Data were taken from an index (pretherapy) cycle and from a therapeutic (posttherapy) cycle for both cases and controls. Comparisons were made directly between cases and controls in the therapeutic cycle and by comparing the median differences of the change in outcomes from the index to therapeutic cycle. Primary outcomes included follicle, oocyte, and metaphase II oocytes (MII) counts. Results showed higher median absolute oocyte numbers (6.00 vs. 4.00, P = 0.049) in the case group. Cases and controls were significantly different when comparing median change between cycles in oocyte number (0.00 vs. -1.00, P = 0.028) and MII count (0.00 vs. -1.00, P = 0.034). However, this was the result of poorer outcomes in the control group rather than improvements in the case group, and it cannot be concluded that treatment improved oocyte quality.

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

“…In 2019, an RCT in women with PCOS found no difference in ovulation rate and CPR when CoQ 10 was compared with vitamin D [36]. Oral supplementation of melatonin with CoQ 10 achieved an increase in oocyte quality in comparison with melatonin alone [37]. Similarly, a combination of dehydroepiandrosterone (DHEA) with CoQ 10 reduced the total dose of gonadotropins needed for ovarian stimulation and increased the number of AFC and mature follicles in comparison to DHEA alone [38].…”