The use of coenzyme Q10 and DHEA during IUI and IVF cycles in patients with decreased ovarian reserve

Abstract

Objective: The objective of this study is to compare the combination of dehydroepiandrosterone (DHEA) and coenzyme Q10 (CoQ10) (D + C) with DHEA alone (D) in intrauterine insemination (IUI) and in vitro fertilization (IVF) cycles among patients with decreased ovarian reserve.

Methods: We retrospectively extracted data from patients charts treated by DHEA with/without CoQ10 during IUI or IVF between February 2006 and June 2014. Prestimulation parameters included age, BMI, day 3 FSH and antral follicular count (AFC). Ovarian response parameters included total gonadotropins dosage, peak serum estradiol, number of follicles > 16 mm and fertilization rate. Clinical outcomes included clinical and ongoing pregnancy rates.

Results: Three hundred and thirty IUI cycles involved D + C compared with 467 cycles of D; 78 IVF cycles involved D + C and 175 D. In both IUI and IVF, AFC was higher with D + C compared with D (7.4 ± 5.7 versus 5.9 ± 4.7, 8.2 ± 6.3 versus 5.2 ± 5, respectively, p < 0.05). D + C resulted in a more follicles > 16 mm during IUI cycles (3.3 ± 2.3 versus 2.9 ± 2.2, respectively, p = 0.01), while lower mean total gonadotropin dosage was administered after D + C supplementation compared with D (3414 ± 1141 IUs versus 3877 ± 1143 IUs respectively, p = 0.032) in IVF cycles. Pregnancy and delivery rates were similar for both IUI and IVF.

Conclusion: D + C significantly increases AFC and improves ovarian responsiveness during IUI and IVF without a difference in clinical outcome.

Chinese abstract

目的：本研究目的是比较卵巢功能储备低下患者宫腔内人工受精（IUI）和体外受精（IVF）过程中应用脱氢表雄酮（DHEA）联合辅酶Q10（CoQ10）（D+C）与单用DHEA（D）

的情况。方法：回顾性抽取2006年2月至2014年6月接受DHEA联合/不联合CoQ10的IUI或IVF患者。刺激前参数包括年龄、BMI、月经第3天卵泡刺激素（FSH）和窦卵泡数（AFC）。卵巢反应参数包括促性腺激素总剂量、血清雌二醇峰值、直径>16mm卵泡数和受精率。临床结局包括临床妊娠率和持续妊娠率。结果：IUI周期中330例接受D+C治疗，467例接受D治疗；IVF周期中78例接受D+C治疗，175例D治疗。在IUI和IVF周期中，D+C组AFC高于D组(分别为7.4 ± 5.7和 5.9 ± 4.7,8.2 ± 6.3 和 5.2 ± 5, p < 0.05)。IUI周期中，与D组相比，D+C组直径>16mm的卵泡数较多(3.3 ± 2.3 和2.9 ± 2.2, p < 0.01)，而在IVF周期中，与D组相比，接受D+C治疗组患者促性腺激素总平均剂量较低(分别为3414 ± 1141 Ius与3877 ± 1143 IUs, p = 0.032) 。IUI和IVF周期中两组临床妊娠率和分娩率相似。结论：IUI和IVF周期中应用D+C可以明显降低窦卵泡数，提高卵巢反应性同时不影响临床结局。

• Antral follicle count
• controlled ovarian hyper stimulation
• DHEA
• CoQ10
• IVF

Declaration of interest

The authors report no conflicts of interest.