The effect of coenzyme Q10 supplementation on in vitro fertilization outcomes in infertile patients with polycystic ovary syndrome.

BackgroundPolycystic ovary syndrome (PCOS) is a leading cause of anovulatory infertility, but evidence regarding coenzyme Q10 (CoQ10) supplementation remains limited and inconsistent.AimTo evaluate associations between pre-IVF CoQ10 supplementation and embryological and reproductive outcomes in women with PCOS.MethodsThis retrospective cohort included 154 women receiving CoQ10 (100 mg/day for four weeks before IVF; n = 75) or no CoQ10 (n = 79), as documented in medical records. Embryological and reproductive outcomes were compared, and logistic regression analyses adjusted for age and BMI.SummaryMedian age was 27 years (IQR, 24-30) in both groups. Body weight was higher with CoQ10 [74 (64-86) vs. 68 (60-80) kg; p = 0.029], whereas BMI did not differ. CoQ10 recipients had higher median MII oocyte counts [18 (12-22) vs. 12 (10-16)], and 2PN oocyte counts [15 (11-20) vs. 10 (8-13); both p < 0.001]. Both medians were 50.0% higher with CoQ10. Pregnancy occurrence was 56.0% versus 30.4% (OR = 2.92, 95% CI: 1.50-5.65), clinical pregnancy was 46.7% versus 16.5% (OR = 4.44, 95% CI: 2.10-9.39), and live birth was 30.7% versus 6.3% (OR = 6.55, 95% CI: 2.34-18.34). Absolute between-group differences were 25.6, 30.2, and 24.4 percentage points, respectively. After adjustment, CoQ10 remained associated with pregnancy occurrence (aOR = 3.01, 95% CI: 1.54-5.90), clinical pregnancy (aOR = 4.82, 95% CI: 2.24-10.36), and live birth (aOR = 6.86, 95% CI: 2.42-19.47; all p ≤ 0.001). Pre-IVF CoQ10 supplementation was associated with better embryological and reproductive outcomes in this cohort. Given the retrospective, non-randomized design, prospective randomized trials are required to confirm efficacy and mechanisms. Selection bias, confounding by indication, and residual confounding therefore cannot be excluded.