Serum anti-Müllerian hormone response to pyrroloquinoline quinone supplementation in healthy women: no overall change and exploratory subgroup findings.

INTRODUCTION

Oocyte maturation requires substantial ATP, and the resulting oxidative stress may impair follicular development. Pyrroloquinoline quinone (PQQ), an antioxidant compound, protects mitochondria and promotes follicular development in animal models; however, its effects on human ovarian function remain unclear.

METHODS

This single-arm, open-label study prospectively evaluated the effects of oral PQQ supplementation on ovarian reserve and related clinical and biochemical outcomes. The primary outcome was serum anti-Müllerian hormone (AMH). Secondary outcomes included luteinizing hormone, follicle-stimulating hormone, estradiol, biological antioxidant potential, reactive oxygen metabolites-derived compounds (d-ROMs), and Menstrual Distress Questionnaire (MDQ) scores. Fifty healthy women aged 25-42 years with regular menstrual cycles and baseline serum AMH levels of 0.5 ≤ AMH < 3.0 ng/mL received 20 mg/day of PQQ for 90 ± 10 days. Blood samples were collected on menstrual cycle days 1-7 before and after supplementation. Exploratory subgroup analyses were performed using combined stratification by age and baseline AMH.

RESULTS

Analyses were conducted in the per-protocol set (n = 35). AMH did not change significantly overall (1.561 ± 0.689 vs. 1.439 ± 0.772 ng/mL, p = 0.182). In younger participants with lower baseline AMH (n = 7), AMH showed a non-significant increase (1.121 ± 0.379 vs. 1.361 ± 0.604 ng/mL, p = 0.056), accompanied by a significant decrease in d-ROMs (351.3 ± 43.5 vs. 305.3 ± 34.3 U. CARR, p = 0.027). In contrast, older participants with lower baseline AMH (n = 13) showed a significant decrease in AMH (1.066 ± 0.296 vs. 0.852 ± 0.312 ng/mL, p = 0.033), while d-ROMs remained unchanged. Across the overall cohort, d-ROMs showed a non-significant reduction (334.2 ± 59.7 vs. 321.5 ± 63.9 U. CARR, p = 0.090).

CONCLUSION

PQQ supplementation did not alter AMH levels in the overall cohort. Subgroup findings were inconsistent and should be interpreted cautiously given the small sample sizes and absence of a control group. These exploratory results do not permit conclusions regarding clinical efficacy. Larger, placebo-controlled trials with imaging-based and clinical reproductive endpoints are needed to determine whether PQQ has measurable effects on ovarian biology.

CLINICAL TRIAL REGISTRATION: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000056669, identifier UMIN000049793.