Medically Reviewed by Norbert Gleicher, MD
As women, we are born with all the eggs we will ever have. But while the number of eggs we have left – our egg count – is part of our fertility equation, the true driver of fertility is egg quality, and the decline in egg quality is an inevitable result of age. Unfortunately, egg quality makes up approximately 95% of embryo quality – the key driver of lower pregnancy chances as women age.
How does age affect egg quality?
As we age, our ovaries change at the biological level. For example, key substances, such as levels of androgen hormones (male hormones, like DHEA and testosterone) start falling at around age 35, and precipitously after age 38-40 years. Follicles, however, need good androgen levels in order to grow and support the eggs they nurture in their maturation process. Consequently, as women grow older, their follicles produce fewer eggs and those they produce are of poorer quality.
Eggs also need lots of energy as they mature, which is provided by the batteries of eggs, so-called mitochondria, in the cytoplasm of egg cells. CoQ10 is a key fuel for the 600K+ mitochondria found in a woman’s egg cell (the most of any cell in the human body!) Levels of CoQ10 also fall with age, negatively impacting mitochondrial function, and therefore egg development and maturation.
What is DHEA?
DHEA, also known as also known as dehydroepiandrosterone, is a natural hormone precursor for testosterone, produced by adrenals and ovaries, which we all constantly produce. Unfortunately, our DHEA levels peak in our 20’s. The hormone mostly converts into testosterone and then, to much smaller degrees, to estrogen. Both are key hormones for the reproductive process which, therefore, also decline with age. Because good testosterone levels in ovaries are essential for early developmental stages of follicles (the so-called small-follicle growing stages) DHEA is critical for early development of ovarian follicles– and therefore egg development. Without enough DHEA, fewer eggs will go through the early stages of development and their quality will be poorer– which may negatively impact your functional ovarian reserve (number of eggs available in a cycle) and egg quality.
What is CoQ10?
CoQ10 is found in almost every cell in our bodies. It is critical for energy production in the cell’s powerhouse, the mitochondria. CoQ10 is, therefore, widely prescribed in medicine, but especially among cardiologists and female as well as male fertility specialists. The mature egg is the largest cell in a woman’s body and, therefore, requires more energy than any other bodily cell. CoQ10 supplementation, therefore, helps in maturing high-quality eggs.
What does the research say? Research shows the benefits of DHEA and CoQ10 supplementation may include:
Get pregnant quickly
Supplementation with DHEA may help you get pregnant more quickly, both spontaneously on your own or with IUI/IVF for women with low (or diminished) functional ovarian reserve. DHEA supplementation improves your testosterone levels which quickly decline after age 38-40 or, even earlier, in women with premature ovarian aging (POA). Your ovaries, however, need good testosterone levels to make good eggs, both in quantity and quality.
Reduce miscarriage rates
A 2007 study demonstrated that DHEA decreases the miscarriage rate of women, starting at age 35. The older a patient is, the bigger the impact on miscarriages will be. The same study also demonstrated that the reduction was likely due to a decrease in chromosomal abnormalities, which are the cause of about half of all miscarriages.
Protect the DNA of eggs and mitochondria
Mitochondria are the batteries of our cells. Research has suggested that having well-functioning mitochondria could be an indication of egg quality. One of the functions of CoQ10 is to protect mitochondria from damage and is an essential ingredient needed for energy production in egg cells.
The mature egg is the largest single cell in a woman’s body and, therefore, requires the most energy of any cell. If cells run out of energy, more mistakes happen in the maturation process, which can lead to chromosomal abnormalities in eggs and embryos and, as noted above, miscarriages.
Higher quality eggs and a higher pregnancy rate
A 2017 study showed higher levels of CoQ10 in follicular fluid to be associated with optimal embryo parameters (higher quality eggs) and higher pregnancy rates. Studies also show DHEA treatment resulted in significantly higher cumulative pregnancy rates in women with diminished ovarian function.
Improves Response to IVF-ICSI stimulation
A 2018 study showed that low-prognosis young women who supplemented with CoQ10 for 60 days prior to an IVF-ICSI cycle had increased number of retrieved oocytes, higher fertilization rate, and more high-quality embryos.
How to select a DHEA and CoQ10 supplement:
Look for DHEA that is:
- 100% plant-derived, pharmaceutical-grade DHEA, micronized to the same levels as used in clinical studies on DHEA for female fertility
- Has been independently tested at a third-party lab (and the company will share this with you)
- Follows recommended dosage schedule of 25 mg 3 times daily
- Developed by fertility experts, tested with fertility patients and used at fertility clinics globally
Look for CoQ10 that is:
- A mega-dose (999 mg/day) of CoQ10, following the supplementation schedule recommended by experts in CoQ10 and female fertility
- Pharmaceutical-grade CoQ10 in oil-suspended soft gel for best absorption
- Is batch tested at independent labs for potency (and the company will share this with you)
It Starts with the Egg – Biochemist Rebecca Fett is author of “It Starts with the Egg” – an Amazon Best-Selling book on egg quality. She has spent years studying the science of egg quality and presents the latest studies in an approachable way, including chapters on DHEA and CoQ10.
Improving Egg Quality in Women over 40: Read more on the above in our blog on improving egg quality in women over 40.
Contact Us directly with any specific questions on Fertinatal DHEA or Ovoenergen CoQ10.
We were born from research. Read more below:
DHEA Critical for Early Development in Ovarian Follicles. Harper AJ, Buster JE, Casson PR. Changes in adrenocortical function with aging and therapeutic implications. Semin Reprod Endocrinol. 1999;17(4):327-38.
Supplementation with CoQ10 helps enhance the energy available for the egg to preform key functions during maturation. Interview with Dr. Bentov, published May 16, 2011, http://www.chatelaine.com/health/what-every-woman-over-30-should-know-about-fertility/
Supplementation with DHEA may help you get pregnant more quickly, spontaneously or with IUI/IVF. Barad DH, et al, Update on the use of dehydroepiandrosterone supplementation among women with diminished ovarian reserve. J Assist Reprod Genet 2007;24(12):629-34.
A 2007 study showed a decrease in miscarriage rates after DHEA supplementation in women with diminished ovarian reserve. Gleicher N, Ryan E, Weghofer A, Blanco‐Meija S, Barad DH. Miscarriage rates after dehydroepiandrosterone (DHEA) supplementation in women with diminished ovarian reserve: a case control study. Reprod Biol Endocrinol 2009;7:108.
Research shows a link between chromosomal errors in eggs and lower levels of DHEA and testosterone in ovarian follicles. Grunwald, K., Feldmann, K., Melsheimer, P., Rabe, T., Neulen, J., & Runnebaum, B. (1998). Aneuploidy in human granulosa lutein cells obtained from gonadotrophin-stimulated follicles and its relation to intrafollicular hormone concentrations. Human reproduction (Oxford, England), 13(10), 2679-2687.
Research shows that having high-functioning mitochondria is an indication of egg quality. Dumollard R, Carroll J, Duchen MR, Campbell K, Swann K. Mitochondrial function and redox state in mammalian embryos. Semin Cell Dev Biol. 2009 May;20(3):346-53.
CoQ10 protects mitochondria from damage and is an essential ingredient needed for energy production in egg cells. Perez-Sanchez C, Ruiz-Limon P, Aguirre MA, Bertolaccini ML, Khamashta MA, Rodriguez-Ariza A, Segui P, Collantes-Estevez E, Barbarroja N, Khraiwesh H, Gonzalez-Reyes JA, Villalba JM, Velasco F, Cuadrado MJ, Lopez-Pedrera C. Mitochondrial dysfunction in antiphospholipid syndrome: implications in the pathogenesis of the disease and effects of coenzyme Q(10) treatment. Blood. 2012 Jun 14;119(24):5859-70
A 2017 study showed higher levels of CoQ10 in follicular fluid is associated with optimal embryo parameters (higher quality eggs) and higher pregnancy rates. Akarsu S, Gode F, Isik AZ, Dikmen ZG, Tekindal MA. The association between coenzyme Q10 concentrations in follicular fluid with embryo morphokinetics and pregnancy rate in assisted reproductive techniques [published correction appears in J Assist Reprod Genet. 2017 May;34(5):607]. J Assist Reprod Genet. 2017;34(5):599–605. doi:10.1007/s10815-017-0882-x
Studies also show DHEA treatment resulted in significantly higher cumulative pregnancy rates in women with diminished ovarian function. Barad D, Brill H, Gleicher N. Update on the use of dehydroepiandrosterone supplementation among women with diminished ovarian function. J Assist Reprod Genet. 2007;24(12):629–634. doi:10.1007/s10815-007-9178-x
A 2018 study showed that low-prognosis young women who supplemented with CoQ10 for 60 days prior to an IVF-ICSI cycle had increased number of retrieved oocytes, higher fertilization rate, and more high-quality embryos. Xu Y, Nisenblat V, Lu C, et al. Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial. Reprod Biol Endocrinol. 2018;16(1):29. Published 2018 Mar 27. doi:10.1186/s12958-018-0343-0