CoQ10 Supplementation to Improve Fertility in Women

Storch bringing baby
Three meta-analyses show beneficial effects of CoQ10 supplementation on semen quality, semen quantity, and semen mobility. Here, a meta-analysis of studies of CoQ10 supplementation of women with infertility shows a significant effect on clinical pregnancy rates.

A meta-analysis of five randomized controlled clinical studies (n=449 infertile women) has shown that CoQ10 supplementation increases clinical pregnancy rates compared with placebo treatment or no treatment. The CoQ10 supplementation significantly increases clinical pregnancy rates both overall and in infertility subgroups such as the poor ovarian response subgroup (n=286) and the polycystic ovarian syndrome subgroup (n=163) [Florou 2020].

All study participants were women of reproductive age (mean age 33 years) diagnosed with either poor ovarian response or polycystic ovary syndrome. All were attending an assisted reproductive technology clinic [Florou 2020].

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Testing CoQ10 Products for Quality

Lab scientist
CoQ10 products are not equally well absorbed. They do not give equally good health benefits. The bioavailability and the efficacy of the CoQ10 product varies considerably according to the formulation of the product. Consumers of CoQ10 products should seek out documentation for bioavailability and health benefits.

The CoQ10 Association has announced plans to test every Coenzyme Q10 product on the market in the US for potency and purity [Schultz 2020, August 13]. If all goes according to plan, the project will be completed by the end of 2020. We look forward to seeing the results of the testing.

Potency of CoQ10 Products

Testing for potency means ensuring that the capsule contains the quantity of Coenzyme Q10 specified on the label.

Earlier this year, in May, 2020, the NOW nutritional supplements company headquartered in Illinois, revealed that its in-house laboratory had tested 10 CoQ10 products purchased on amazon.com.

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CoQ10 for Women with Poor Ovarian Response

Pregnant woman
The reasons for a poor ovarian response to stimulation with gonadotropins are not clear. Mitochondrial dysfunction and oxidative stress are possible explanations for the diminished ovarian response. Coenzyme Q10 is essential for energy production in the mitochondria of oocytes and is important for antioxidant protection in oocytes.

Coenzyme Q10 pre-treatment of young low-prognosis patients with diminished ovarian reserve or poor ovarian response increased the patients’ ovarian response to stimulation and improved oocyte and embryo quality.

The CoQ10 pre-treatment was associated with improved pregnancy and live birth rates.

After one completed assisted reproductive technique treatment cycle, the women treated with Coenzyme Q10 had a 32% pregnancy rate and a 29% live birth rate. The women in the control group had a pregnancy rate of 17% and a 16% live birth rate.

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CoQ10 Supplements: What You Need To Know

Coenzyme Q10 capsules
The thing is, there are considerable differences in the absorption and bioavailability of the many commercial CoQ10 supplements.  An inexpensive CoQ10 supplement is not inexpensive if it gives only negligible absorption and bioavailability.  It is a waste of money.  It is important to choose a CoQ10 supplement with documented absorption and efficacy.

The active substance in the best Coenzyme Q10 nutritional supplements is a natural substance that is extracted in a yeast fermentation process; the Coenzyme Q10 is not a synthetic substance.

The CoQ10 molecules in the best nutritional supplements are the same molecules as the CoQ10 molecules synthesized inside the mitochondria in human cells.

As we get older, our cells’ ability to synthesize Coenzyme Q10 declines. Furthermore, the use of some drugs such as statin medications inhibits the cells’ synthesis of Coenzyme Q10.  We need a good supplement to make up for the loss.

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A Pharmacist Looks at CoQ10 Supplements

Dr. Ross Pelton
Dr. Ross Pelton brands himself as The Natural Pharmacist; he is also a certified clinical nutritionist. He is currently the Scientific Director for Essential Formulas. Dr. Pelton is the author of The Drug-Induced Nutrient Depletion Handbook. For a FREE copy of Dr. Pelton’s Quick Reference Guide to Drug-Induced Nutrient Depletions, go to naturalpharmacist.net/dind.

In the April/May 2020 issue of the journal IMCJ: Integrative Medicine: A Clinician’s Journal, pharmacist Dr. Ross Pelton reviews the most important developments in Coenzyme Q10 clinical research:

• The Q-Symbio Study in which researchers gave chronic heart failure patients 3 x 100 mg of Coenzyme Q10 or placebo daily as an adjuvant treatment together with conventional heart failure medications for two years. The outcome was significantly improved symptoms, quality of life, and survival in the CoQ10 treatment group compared to the placebo group [Mortensen 2014].

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Coenzyme Q10 for Adjunctive Treatment of Heart Failure

Blood circulation
Heart failure does not mean that the heart has stopped working. It means that the heart is not pumping as much blood out to the rest of the body as it should. The consequence is that the body organs and tissues do not get as much oxygen and as many nutrients as they need. Clinical trials show that treatment with Coenzyme Q10 in addition to conventional heart failure medication is beneficial.

Adjunctive treatment of chronic heart failure patients with 3 times 100 milligrams of Coenzyme Q10 daily for two years gave the following significant results compared with placebo treatment [Mortensen 2014]:

  • reduced number of deaths from heart disease
  • reduced number of deaths from all causes
  • reduced number of heart failure related hospitalizations
  • improved NYHA class

Absorption and Bioavailability of the CoQ10 Supplement

CoQ10 supplements are very different from one another. The CoQ10 supplement that gave the beneficial heart health outcomes listed above is a specially formulated CoQ10 preparation, specially formulated with respect to the carrier oils in which the Coenzyme Q10 raw material is dispersed and with respect to the heating and cooling process used in the manufacture of the supplement. It has documented absorption and bioavailability.

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Coenzyme Q10: Clinical Applications

Picture of Dr. WilliamV. Judy
In the February and March 2019 issues of WholeFoods magazine, the long-time Coenzyme Q10 clinical researcher, Dr. William V. Judy, warns: Buyer beware. CoQ10 supplements do not give equal absorption. It is important to buy a CoQ10 supplement that has documented absorption and bioavailability and that has documented beneficial heart health effects.

Coenzyme Q10 is an essential bio-nutrient that has vitamin-like properties.

  • It is a vital co-factor in the cellular process of ATP energy generation.
  • It is an important lipid-soluble antioxidant. It has anti-inflammatory effects.
  • Substantial reduction of bio-markers for oxidative stress and inflammation has been seen in several randomized controlled trials [Martelli 2020].

Coenzyme Q10 is a redox molecule, having both an oxidized form (ubiquinone) and a reduced form (ubiquinol).

CoQ10 Supplementation and Heart Disease Risk Factors

Coenzyme Q10 and Heart Failure

In the Q-Symbio Study, researchers gave chronic heart failure patients 300 mg/day (3 x 100 mg in divided dosages) or matching placebos for two years.

Coenzyme Q10 and High Blood Pressure

Older meta-analyses of the effect of Coenzyme Q10 on hypertension showed significant reductions in both systolic and diastolic blood pressure [Rosenfeldt 2007; Ho 2009]. A more recent meta-analysis has shown that CoQ10 supplementation is associated with a significant reduction in systolic blood pressure but not in diastolic blood pressure in patients with metabolic syndrome [Tabrizi 2018].

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Testing the Potency of Coenzyme Q10 Supplements

CoQ10 capsules in blister pack
Yes, of course, the capsule must contain 100 mg of Coenzyme Q10 if that is what the label says. However, the absorption of Coenzyme Q10 is complex. The CoQ10 potency test results do not take important factors into consideration:  Dissolving the CoQ10 Crystals – Dividing the CoQ10 Daily Dosage – Deciding on the Form (ubiquinone or ubiquinol) and Formulation 

A US supplements manufacturer reports that its testing shows some of the CoQ10 supplements sold on amazon.com do not contain the quantity of Coenzyme Q10 indicated on the product label [Schultz, 2020, May 14].

The testing shows that seven of the ten tested products had less than 80% potency. These seven named products are not products from major sellers of CoQ10 supplements in the USA.

The other three tested products tested are labeled “X Brand” in the test report. These three products are said to contain 93%, 96.5%, and 86% of the declared active ingredient [NOW® Testing].

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Enzyme Systems Convert Ubiquinone to Ubiquinol

Dr. Judy COQ10 Insider's Guide book
Dr. William Judy in his 2018 book, Coenzyme Q10: An Insider’s Guide, discusses the absorption and bioavailability of the ubiquinone and ubiquinol forms of Coenzyme Q10. The book is available from amazon.com. ISBN: 978-87-7776-186-7

There are numerous enzyme systems at work in the body to convert ubiquinone, the oxidized form of Coenzyme Q10, to ubiquinol, the reduced form of Coenzyme Q10.  Despite marketing claims to the contrary, it is not necessary to take a ubiquinol supplement to get sufficient ubiquinol in the body [Mantle & Dybring 2020].  No worries there.

This is the take-home message in a peer-reviewed journal article published on May 5, 2020, in the Antioxidants journal [Mantle & Dybring 2020].

Ubiquinone (Oxidized Form) and Ubiquinol (Reduced Form)

Coenzyme Q10 molecules are redox molecules. In the body, they convert back and forward between their oxidized form, ubiquinone, and their reduced form, ubiquinol.  What does that mean, oxidized and reduced?

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Facts About Coenzyme Q10 Absorption and Bio-Availability

Dr. Judy in lab coat
Dr. William V. Judy, SIBR Research Institute, explains: Absorption is the movement of the ingested Coenzyme Q10 through the stomach and small intestines into the lymph and then into the blood circulation. Bioavailability is the accumulation of the ingested Coenzyme Q10 in the blood over time in response to daily doses. It is the amount of Coenzyme Q10 that is available for transport into the tissue cells.

Fact: Without decent absorption and bio-availability of our CoQ10 supplement, we cannot hope to get good heart health effects.

Fact: There is much variability from one CoQ10 supplement to another. It is important to choose a CoQ10 supplement for which there is documented evidence of absorption and bio-availability as well as published evidence of improvement of heart health signs and symptoms.

Sadly, the claims for the absorption of many CoQ10 supplements have been greatly exaggerated in many cases.

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