Vitamin and mineral supplements are very popular. They can also be very expensive. It is important to know which vitamins are really necessary for good health before investing. According to a new article from the American Medical Association, 52 per cent of adults use at least one, and 10 per cent use four, different supplement products.
As a fertility doctor, I see a lot of patients who want to try everything possible to improve their odds of pregnancy. For many women, this involves taking extra vitamins and minerals. The standard recommendations for a woman preparing for pregnancy are: folic acid (at least 0.4mg per day) and vitamin D (at least 800 IU per day.) Women who do not get enough iron or calcium from their diet may also be advised to supplement these minerals.
Coenzyme Q10 is one of the newer, mainstream supplements on the market. It has been promoted as a treatment for heart disease, migraines, cancer, muscle soreness and infertility.
How does CoQ10 work?
Inside of (nearly) all cells, there are tiny organelles called mitochondria. Mitochondria have been dubbed the "power supply" of the cell because they make energy. But mitochondria also perform other important jobs, such as helping the cell divide and signaling to the cell when it is time to die.
Eggs are the largest cell in the human body. Research has suggested that the eggs of older women may not produce enough CoQ10, causing the eggs to fail when it comes time for fertilization. Inadequate mitochondria have been implicated in premature menopause, infertility and miscarriage.
CoQ10 (ubiquinone) has become trendy in the treatment of infertility. The popularity of CoQ10 rose after a study showed the eggs of older mice seemed to last longer and perform better when the mice were supplemented with CoQ10. However, since then, many other studies attempting to prove this theory have failed to show any benefit in humans.
One recent study that did show an effect of CoQ10 examined women undergoing in vitro fertilization (IVF.) The researchers measured the CoQ10 concentration in the fluid surrounding each individual egg as it was removed from the woman's ovary. Higher concentrations of CoQ10 were associated with better quality embryos and higher pregnancy rates. The study only included 60 women, however, so more research is required before we can make any strong conclusions.
It is important to note that CoQ10 is not approved as a drug. According to Health Canada, it is classified as a natural health product (NHP.) Natural health products are known to vary widely in their composition, depending on the manufacturer. This is because NHPs are not tightly regulated in the same way that medications are.
For the purpose of improving fertility, women usually take 300 – 600mg of CoQ10 per day. You should stop the supplement if you become pregnant, because the safety of high dose CoQ10 has not been studied in pregnancy. People taking Warfarin should not take CoQ10. Side effects of CoQ10 are generally mild and limited to stomach upset.
In summary, CoQ10 is a popular supplement for women seeking to improve their fertility. It may help to boost the function of eggs by helping their mitochondria to produce energy.
As a fertility doctor, I tell patients that CoQ10 appears to be safe, although it has not been proven to be effective with any rigorous scientific research. When reading about any NHP online, be aware of who is writing the article. Vendors and manufacturers of NHPs may aim to promote their supplements by citing medical benefits that are not supported by science.
According to the Society of Obstetricians and Gynecologists of Canada, a balanced diet, along with folic acid and vitamin D, are sufficient for most women who are trying to conceive.