Clinical evidence of coenzyme Q10 pretreatment for women with diminished ovarian reserve undergoing IVF/ICSI: a systematic review and meta-analysis.

BACKGROUND

To quantitatively evaluate the effect of coenzyme Q10 (CoQ10) pretreatment on outcomes of IVF or ICSI in women with diminished ovarian reserve (DOR) based on the existing randomized controlled trials (RCTs).

METHODS

Nine databases were comprehensively searched from database inception to November 01, 2023, to identify eligible RCTs. Reproductive outcomes of interest consisted of three primary outcomes and six secondary outcomes. The sensitivity analysis was adopted to verify the robustness of pooled results.

RESULTS

There were six RCTs in total, which collectively involved 1529 participants with DOR receiving infertility treatment with IVF/ICSI. The review of available evidence suggested that CoQ10 pretreatment was significantly correlated with elevated clinical pregnancy rate (OR = 1.84, 95%CI [1.33, 2.53],  = 0.0002), number of optimal embryos (OR = 0.59, 95%CI [0.21, 0.96],  = 0.002), number of oocytes retrieved (MD = 1.30, 95%CI [1.21, 1.40],  < 0.00001), and E levels on the day of hCG (SMD = 0.37, 95%CI [0.07, 0.66],  = 0.01), along with a reduction in cycle cancellation rate (OR = 0.60, 95%CI [0.44, 0.83],  = 0.002), miscarriage rate (OR = 0.38, 95%CI [0.15, 0.98],  = 0.05), total days of Gn applied (MD = -0.89, 95%CI [-1.37, -0.41],  = 0.0003), and total dose of Gn used (MD = -330.44, 95%CI [-373.93, -286.96],  < 0.00001). The sensitivity analysis indicated that our pooled results were robust.

CONCLUSIONS

These findings suggested that CoQ10 pretreatment is an effective intervention in improving IVF/ICSI outcomes for women with DOR. Still, this meta-analysis included relatively limited sample sizes with poor descriptions of their methodologies. Rigorously conducted trials are needed in the future.