Embryos classified as low-grade mosaic (<50%) after preimplantation genetic screening (PGS) can have the same competence of producing healthy newborns as euploid embryos

Abstract

OBJECTIVE: CoQ10 is a necessary component in the electron transport chain and its role in the generation of ATP is well documented in human oocytes. ATP is needed during embryonic development specifically for chromosome segregation. Thus, the oral supplementation of CoQ10 has been suggested to help reduce aneuploidy in preimplantation embryos. In this pilot study, we test the hypothesis that the supplementation of CoQ10 prior to an IVF cycle can possibly decrease chromosomal aneuploidy in AMA patients.DESIGN: Double blinded, randomized control trial, pilot study. MATERIALS AND METHODS: Inclusion criteria consisted of patients that were 36-42 years old, AMH %2.0 ng/mL, 1 st cycle of IVF treatment, and an antral follicle count (AFC) between R6 and %19. A total of 21 patients were randomized between placebo (twice daily; Group 1) or oral supplement with CoQ10 (125 mg/twice daily; Group 2) for 3 months prior to IVF. Patients had plasma drawn three months prior to oocyte retrieval for baseline CoQ10 levels, at start of stimulation, and at retrieval. A total of 9 and 12 patients were randomized to Group 1 and 2, respectively. Both groups underwent a microdose GnRH agonist stimulation (high dose Bravelle and Menopur) with retrieval. Due to the low number of embryos from this patient population, all usable, non-usable and arrested embryos were biopsied and analyzed for chromosome copy number with SNP array. Patient, doctor, embryologist, and PGS lab were all blinded to which supplement the patient received.RESULTS: There was no difference in maternal age, Day 3 FSH, AMH, and AFC between Group 1 and Group 2. Baseline CoQ10 levels were significantly lower in Group 1 (0.7AE0.5 ug/mL) compared to Group 2 (0.9AE0.2 ug/ mL; P<0.05). After three months of oral supplementation, Group 1 had a significantly lower plasma CoQ10 level compared to Group 2, 0.9AE0.6 ug/ mL and 2.6AE0.9 ug/ml, respectively (P<0.05). The CoQ10 levels were also significantly lower at retrieval between Group 1 and Group 2, 0.8AE0.3 ug/mL and 2.2AE1.2 ug/mL, respectively (P<0.05). The average number of eggs retrieved, maturity, and fertilization was not significant between Groups 1 and 2. In terms of ploidy, 10/17 (58.8%) and 11/34 (32.4%) embryos were euploid from Group 1 and Group 2, respectively (NS).CONCLUSIONS: Our data suggest that oral supplementation of CoQ10 can increase plasma levels of CoQ10; however, CoQ10 did not affect chromosomal aneuploidy.