In the last few years, coenzyme Q10 (CoQ10) has become a popular dietary supplement for couples struggling with infertility. If you are working with a fertility specialist, you may be aware of the potential benefits CoQ10 has on fertility.
A lot of the research looking at CoQ10 and fertility is relatively new, and therefore there are many myths about this powerful nutrient. In this article, we hope to dispel many of the myths surrounding CoQ10 and fertility.
Myth 1: There is no link between CoQ10 and fertility.
Fact: CoQ10 and fertility go hand-in-hand.
Ovulation is an energy-intense process. A woman’s eggs (oocytes) are cells, and the mitochondria are responsible for energy production within the cell. Therefore, the human egg contains more mitochondria than any other cell.
CoQ10 plays a crucial role in energy production inside the mitochondria. As people age, production of CoQ10 decreases. Therefore, an older woman’s eggs are less efficient at producing energy. CoQ10 levels are highest during the first 20 years of life, after which, they begin to decline.
As noted in this study in Fertility and Sterility, mitochondrial nutrients such as CoQ10 can increase energy production. In turn, this may have a positive impact on pregnancy outcomes in women over 35. Other studies have supported the conclusion that CoQ10 supplementation in women of advanced maternal age may improve pregnancy success rates.
Enrolling participants in fertility studies is difficult. Therefore, there has only been one human study looking at CoQ10 supplementation for female fertility. This 2014 study administered 600 mg of CoQ10 in women (age 35-43) undergoing IVF. While it was underpowered (meaning not enough women enrolled for the results to be statistically significant), the results were promising.
The rate of aneuploidy (the presence of an abnormal number of chromosomes in a cell) was 46.5% in the CoQ10 group compared to 62.8% in the control group. Aneuploidy is a common cause of miscarriage, and conditions such as Down’s Syndrome.
Clinical pregnancy rate was higher CoQ10 group (33%) than the control group (26.7%).
Myth 2: CoQ10 only helps female fertility.
Fact: There’s a connection between CoQ10 and male fertility, too.
There are a number of factors that contribute to male infertility. Perhaps one of the most damaging can be the presence of free radicals. In fact, roughly 30-80% of infertile males have high levels of free radicals in their semen.
It takes approximately three months for fully mature sperm to form. During that time, free radicals can cause damage to the sperm by attacking and destroying the membrane that surrounds sperm cells. They can also severely damage DNA, causing errors in the genetic information carried by the sperm.
CoQ10 is a powerful antioxidant. Antioxidants like CoQ10 work by protecting cells from damaging oxidative reactions caused by free radicals.
A 2009 study demonstrated that three to six months of CoQ10 supplementation may improve sperm motility (the ability for sperm to swim). In a more recent study, CoQ10 supplementation increased sperm density, motility, and morphology.
Myth 3. CoQ10 is only good for heart health.
Fact: CoQ10 works for all cells your body.
The benefits of CoQ10 for heart health and for those people taking statin medications are well-documented. However, if you know a bit about how CoQ10 works in general, you can see that it may be beneficial for almost every cell in your body.
Cells are the building blocks of life, and CoQ10 plays a significant role in cell function. When we eat food, those nutrients must be converted into a form of energy that cells can use. This conversion process is called cellular respiration. A majority of cellular respiration happens within the mitochondria, an organelle often called the “powerhouse” of the cell.
Cellular respiration involves a number of different complex processes to extract energy from nutrients. One of these processes is called the electron transport chain (ETC). The ETC relies heavily on CoQ10 to help carry electrons through its different stages. If CoQ10 levels are low, cells produce energy in a less efficient way.
In addition to helping in the ETC, CoQ10 is a powerful antioxidant. Antioxidants are substances that protect cells from damaging reactions. Highly reactive molecules, or free radicals, can cause lots of damage to the cell.
As an antioxidant, CoQ10 can help neutralize free radicals and possibly reduce any damage they may cause.
Myth 4: The best form of CoQ10 for fertility is ubiquinol.
Fact: It’s not the form of CoQ10 that matters, it’s the way it’s prepared.
Because there is a lot of conflicting information available, many people want to know which is the preferred form of CoQ10 for fertility – ubiquinone or ubiquinol?
Coenzyme Q10 supplements are available in both forms. Ubiquinone is the oxidized form, while ubiquinol is the reduced form. Both forms exist within our bodies, and we can convert between the two depending on our body’s needs.
CoQ10 supplements are available in many forms, including softgels, capsules, tablets and oral sprays. However, most CoQ10 supplements (standard ubiquinone or ubiquinol) are not very well absorbed in the body, even when taken with food.
Enhanced Absorption Technology
Fortunately, there are some CoQ10 supplements available that use an enhanced absorption delivery system. This type formulation improves the bioavailability of CoQ10 by up to 600%.
In a 2009 study conducted by Liu, et al., participants received a single dose of 125 mg of ubiquinone formulated with VESIsorb® (an enhanced absorption delivery system). These participants demonstrated CoQ10 blood levels that were 3-6 times higher than those taking the same dose of other oil-based ubiquinone products.
Those taking ubiquinone with VESIsorb achieved peak CoQ10 blood levels of 7.0 mcg/mL. Participants taking other oil-based/solubilized products only reached peak blood levels of roughly 2 – 3.5 mcg/mL.
In a 2014 study, standard oil-based ubiquinol was compared to standard oil-based ubiqinone. Participants who took the standard ubiquinol had an average total CoQ10 blood level of 4.3 mcg/mL after four weeks of 200 mg per day, compared to 2.5 mcg/mL in the oil-based ubiquinone group.
So, the absorption and bioavailability of oil-based ubiquinol is higher than that of oil-based ubiquinone.
Proponents of ubiquinol often cite this 2002 study comparing standard ubiquinol softgels to other standard ubiquinone preparations. This study showed lower peak CoQ10 blood levels for both forms (1.8 mcg/mL for ubiquinol versus 1.5 mcg/mL for ubiquinone).
The controversy between the two forms exists because there are no “apples to apples” comparisons. There have been no studies looking at enhanced absorption ubiquinone to either standard or enhanced absorption ubiquinol.
The key takeaway here is that the highest peak blood levels of CoQ10 have been seen in those taking enhanced absorption ubiquinone (7.0 mcg/mL). Ubiquinone with VESIsorb has been shown to be more bioavailable than standard, oil-based ubiquinol (4.3 mcg/mL) or ubiquinone (2.5 mcg/mL).
Myth 5: The CoQ10 fertility dosage is 600 mg for women.
Fact: Dosing varies depending on the type of CoQ10 you take and what you’re taking it for.
There is little human research looking at CoQ10 for egg quality. Therefore, the medical community has yet to reach a consensus about the recommended dosage for women.
The human study in women undergoing IVF used a dose of 600 mg, taken once a day for two months. Therefore, most fertility specialists will recommend this dose for their female patients.
However, this study used standard oil-based ubiquinone. Remember the pesky problem of CoQ10 being hard to absorb? That comes into play when calculating the amount you should take for egg quality.
If you are taking a product formulated with enhanced absorption technology you can take a lower dose since it results in a 3-6 times higher “absorbed dose.”
Dr. Richard Sherbahn of the Advanced Fertility Center of Chicago writes that the recommended dose of CoQ10 for female fertility varies between 50 mg and 600 mg a day, divided into multiple doses. However, he goes on to say that most women take anywhere between 100 and 300 mg a day and that up to 1,200 mg is considered safe.
For men, the picture is a little clearer. Studies showing benefit for male fertility used 200 mg a day for six months.
Myth 6: I have PCOS. CoQ10 won’t help me.
Fact: CoQ10 has benefits for women with PCOS.
Exciting new research has shown that CoQ10 may be particularly helpful for women with PCOS (polycystic ovarian syndrome). In a recent study, researchers compared the effect of taking CoQ10 along with clomiphine, to the effect of taking clomphine alone.
Researchers found that those who supplemented with 60 mg of CoQ10 three times a day, in addition to 150 mg of clomiphine-citrate, had more egg follicles, greater endometrial thickness, and experienced higher rates of ovulation (65.9% vs. 15.5%) than those in the control group. Even more exciting was that women in the CoQ10 plus clomiphine group had higher pregnancy rates (37.3% vs. 6.0%) than those taking only clomiphine.
A 2016 randomized controlled trial evaluated the effects of CoQ10 on glucose (sugar) metabolism and lipid (fat) profiles in 60 women with PCOS.
In this study, patients took either 100 mg of CoQ10 or a placebo daily for 12 weeks. Researchers measured markers of insulin metabolism and blood lipid levels at the beginning and end of the study.
The CoQ10 group had a significant decrease in fasting blood sugar and insulin levels. They also experienced decreases in total cholesterol and LDL (“bad cholesterol”) levels.
Myth 7: CoQ10 is a vitamin.
Fact: CoQ10 is “vitamin-like.”
CoQ10 is a member of the ubiquinone family of compounds. It is a fat-soluble, vitamin-like compound that is naturally produced by the human body. You can also consume CoQ10 in your diet or through dietary supplements.
Coenzyme Q10 is a “vitamin-like” compound because the body can make it on its own. Vitamins, by definition, cannot be made by the body. They must be obtained through the diet or nutritional supplements.
The name ubiquinone refers to the fact that ubiquinones, including CoQ10, have a “ubiquitous” presence in living organisms. In other words, virtually all cells in the human body contain CoQ10. Because it is so abundant in the body, CoQ10 is an essential compound for cell function.
Coenzyme Q10 concentrations are highest in organs with high rates of metabolism such as the heart, kidneys, and liver.
Myth 8. You can get all the CoQ10 you need through your diet.
Fact: You could, but you’d have to eat a lot of organ meat.
While our bodies naturally make CoQ10, you can also get it by eating certain foods. Food sources of coenzyme Q10 include fatty fish, organ meats such as liver, and whole grains.
Because CoQ10 concentrations are highest in the heart, kidneys, and liver, the best dietary sources of CoQ10 are organ meats. For example, pork heart contains approximately 127 micrograms of CoQ10 per gram of meat. Coming in second, beef heart contains about 113 micrograms of CoQ10 per gram of meat.
To compare that to other dietary sources of CoQ10, canned tuna contains only 16 micrograms of CoQ10 per gram of tuna. Wheat germ contains a mere 6 micrograms of CoQ10 per gram of wheat germ. To make matters worse, cooking coenzyme Q10 containing foods reduces the amount of CoQ10 by 14-32%.
Myth 9: I should continue taking CoQ10 throughout my pregnancy.
Fact: For most women, CoQ10 will not have additional benefit during pregnancy.
As explained earlier in this article, CoQ10 may improve egg quality and fertility. Although there is no reason to think that CoQ10 is unsafe during pregnancy, most women do not need to continue it once pregnant. However, one study showed that taking 200 mg of CoQ10 beginning at 20 weeks of pregnancy reduced the risk of pre-eclampsia (high blood pressure during pregnancy). If you are at risk for pre-eclampsia, please discuss taking CoQ10 and other ways to reduce your risk with your healthcare provider. Otherwise, there is not enough evidence to support the continuation of CoQ10 throughout pregnancy.
Therefore, it is best for most women to take it before pregnancy and then discontinue once you find out you are pregnant.
While research is still emerging, the association between CoQ10 and fertility is becoming clearer. Please discuss CoQ10 and fertility with your healthcare provider to see if it may be of benefit for you or your partner.
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