Aneuploidy Rates in Advanced Maternal Age Patients Supplemented With Coenzyme Q10 (CoQ10) Versus Those That Are Not: a Pilot Study
Condition: Mitochondrial DNA; Aneuploidy
MeSH terms: Aneuploidy
Study type: Interventional

Summary: 
      Pregnancy rates for women over 35 years old are significantly lower when compared to younger
      women. One of the causes for this decrease is believed to be chromosomal aneuploidy.
      Chromosomal aneuploidy is a natural phenomena and occurs in women of every age and has been
      implicated in spontaneous miscarriages, and preimplantation embryo wastage (Hassold and Hunt,
      2001).

      As maternal age increases, so too does the incidence of chromosomal aneuploidy. Embryo
      quality from older patients undergoing IVF tends to be reduced and associated with higher
      rates of chromosomal abnormalities when compared to good quality embryos (Munne et al.,
      1995).

      Chromosomal aneuploidy derives from the improper segregation of chromosomes during
      preimplantation development. The process of segregation, or mitosis, includes synthesis of
      the complete genome, equal division of chromosomes to opposite poles by the spindle
      apparatus, and separation of the two cells by cytokinesis, yielding two chromosomally
      identical cells. The entire process of cellular and genetic replication requires energy in
      the form of adenosine tri phosphate (ATP). ATP is mainly produced in mitochondria in the
      process known as the electron transport chain (ETC). There are many important molecules
      required for ATP production, CoQ10 can act as the appropriate carrier of electrons through
      the ETC. When a deficiency in CoQ10 is present, ATP production is decreased resulting in
      aneuploidy (Bentov et al., 2013). Similarly, research has shown that chromosome alignment and
      spindle formation are affected by mtDNA copy number (Ge et al., 2012). It has also been shown
      that the transfer of ooplasm from young, healthy oocyte donors into oocytes of women with
      repeated embryonic failure has result in children with subsequent mitochondrial heteroplasmy
      (Cohen et al., 1998).

      CoQ10 concentrations have been shown to decrease as age increases (Bentov et al., 2011).
      Consequently, the decrease in CoQ10 concentrations seen in older women may cause an increase
      in chromosomal aneuploidy in subsequent embryos (Bentov et al., 2013). In this pilot study,
      we test the hypothesis that the supplementation of CoQ10 prior to an IVF cycle can increase
      mitochondrial DNA activity and possibly decrease chromosomal aneuploidy in AMA patients.
    

Detailed description: 
      Brief Summary
    

Intervention name(s): CoQ10; Placebo
Intervention type(s): Dietary Supplement; Dietary Supplement
Intervention description(s): This is a dietary supplement which will be administered daily to the patient for 3 months prior to IVF; This is a placebo which will be administered daily to the patient for 3 months prior to IVF.
Intervention MeSH terms: Coenzyme Q10
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Basic Science
Keywords: mtDNA; aneuploidy; IVF; blastocyst; COQ10