Maximizing Egg Quality: The Truth About CoQ10 and DHEA

Written by
Dr. Mahasin Suna Qasim, MD, FACOG

Walk down any pharmacy aisle, and you will see dozens of expensive “fertility vitamins” promising to improve your chances of conception. For IVF patients looking to maximize their egg quality, the supplement market can be overwhelming and misleading. From a clinical perspective, most over-the-counter fertility supplements lack strong scientific backing. However, there are two specific supplements—Coenzyme Q10 (CoQ10) and DHEA—that have demonstrated some measurable physiological benefits in clinical trials. Here is the clinical breakdown of how they work.

Coenzyme Q10 (CoQ10): Fueling the Egg’s Mitochondria

CoQ10 is a naturally occurring antioxidant found in almost every cell of the human body. Its primary role is to assist in the production of ATP, the biochemical energy source for cellular function.

• The Biological Mechanism: A developing egg requires a massive amount of cellular energy to mature, divide, and successfully fertilize. This energy is generated by the egg’s mitochondria. As women age, mitochondrial function naturally declines, leading to lower energy reserves within the egg. By supplementing with CoQ10, we hope to actively support mitochondrial function and increase the egg’s available energy.
• Clinical Application: We may recommend CoQ10 (specifically the highly bioavailable ubiquinol form) for patients with Diminished Ovarian Reserve (DOR), those who have demonstrated a poor ovarian response, or those of Advanced Maternal Age (AMA) to help mitigate age-related cellular fatigue and reduce oxidative stress.
• Pregnancy Rates: While CoQ10 therapy has been associated with higher clinical pregnancy rates, the reality is that there are no prospective randomized double-blinded clinical studies (the “gold standard” of research) that demonstrate higher live birth rates in patients receiving CoQ10. We always keep this in mind when counseling our patients about its true benefits.

DHEA: The Controversial Androgen

Dehydroepiandrosterone (DHEA) is a mild androgen (male steroid hormone) naturally produced by the adrenal glands. Unlike CoQ10, which is generally safe for everyone, DHEA is a powerful hormone that must be used with clinical precision.

• The Biological Mechanism: In the ovaries, androgens play a critical role in the early stages of follicle development. Some clinical data suggests that in patients with severe ovarian aging, the ovaries become starved of androgens. Supplementing with DHEA for 8 to 12 weeks before an IVF cycle can theoretically increase the androgen levels in the follicular fluid, potentially stimulating dormant follicles and improving overall egg yield.
• Clinical Application: If used, DHEA is strictly recommended for a very specific subset of patients—typically older patients or poor responders with clinically verified low androgen levels. It is contraindicated for patients with Polycystic Ovary Syndrome (PCOS), as their androgen levels are usually already elevated.

The Bottom Line on Over-the-Counter Supplements

You cannot out-supplement significant genetic or anatomical fertility barriers. A high-quality prenatal vitamin with folic acid (or methylfolate) is the only universally recommended supplement for all IVF patients. CoQ10 may offer some benefit in cases of low oocyte yield or markedly diminished egg reserve; however, the jury is still out on whether it truly increases the likelihood of a successful pregnancy. Before adding any hormonal supplement like DHEA to your regimen, it is critical to consult with your reproductive endocrinologist to ensure it is both indicated and shown to have a positive impact in your specific case.