Infertility affects many women, particularly over the age of 35. Doctors blame poor egg quality and quantity, and researchers feel that the mitochondria (the energy generators) of eggs are largely responsible. While women can’t change the age of their mitochondria, they may be able to maximize mitochondrial health by providing the right nutrients. Several supplements have been studied in animals, but most have not yet shown efficacy in human fertility studies. Two, however, really stand out: CoQ10 and L-Carnitine.
Infertility and age:
According to the CDC, infertility impacts up to 12% of women in the United States aged 15–44; 7.3 million women will seek out infertility services at some point in their lifetime.
Fertility rates in women begin to decline at age 32, and rates of miscarriage start to rise. At age 37, things take a dramatic turn for the worst. The American College of Obstetricians and Gynecologists recommends that women 35 and older receive particular attention. Women who do manage to get pregnant over 35 have the distinct pleasure of being labeled with “geriatric pregnancy” or “advanced maternal age,” due to the added risk of complications and pregnancy loss.
A primary cause of this phenomenon is that egg quality and quantity decline in older women. Unlike men, who produce sperm on a daily basis, women are born with all of their eggs. A woman who is 35 years-old has eggs that are 35 years-old.
One of the key factors in egg quality — and consequently, embryo quality once the egg is fertilized — is the health of the mitochondria. Mitochondria are the powerplants in our cells. They house the machinery that provides energy to cells and make cell function possible. Without healthy mitochondria, cells cannot grow or multiply normally.
Mitochondria are transferred to the embryo by the mother alone. A mature egg contains more mitochondria than any other cell in the human body. Sperm are compact and only bring enough mitochondria to make it to the egg and fertilize it. After that, their mitochondria disappear. Once an egg is fertilized, the mother’s mitochondria power everything else, and are the blueprint for the baby’s mitochondria for life.
Nutrients for your mitochondria:
Several studies have examined the role of CoQ10 in infertility. CoQ10 improves the activity, size, and energy production of mitochondria. It also improves the number of eggs in the ovaries, the quality of the genetic material in the eggs, and the ability of the eggs to resist damage.
One study in mice showed that supplementing older mice with CoQ10 made them produce more eggs, have egg quality comparable to younger mice, and improved the function of the mitochondria. Egg quality was not improved for younger mice, indicating that dietary CoQ10 is distinctly beneficial to older eggs.
CoQ10 is so essential that body tissues that have a high need for energy production, like ovaries, produce their own. Researchers believe that older women’s ovaries are less able to produce CoQ10. Also, whole body levels of CoQ10 decline as we age, particularly over the age of 30, and contribute to the aging process.
While no specific dose or duration of CoQ10 supplementation is universally agreed upon for women, evidence suggests that taking up to 600 mg a day (200 mg three times a day), for 60 days prior to conception, is well tolerated and improves pregnancy rates.
Data about the safety of CoQ10 during pregnancy is limited, so many doctors recommend discontinuing it once pregnant.
L-Carnitine is also essential to mitochondrial energy production. While it is more commonly known as a workout supplement, several studies in animals suggest that L-Carnitine improves fertility. L-Carnitine seems to improve ovulation (release of eggs from the ovaries), egg quality and quantity, health of the endometrium (lining of the womb where the embryo attaches), and growth of the embryo.
L-Carnitine is so essential that in-vitro fertilization labs grow embryos in L-Carnitine supplemented cultures. At the right concentrations, L-Carnitine improves embryo growth, hatching, and attachment to the lining of the womb. However, at high doses, it has toxic effects.
Researchers seem to have a preference for a particular form, acetyl-L-carnitine, because the body absorbs it better. Though no ideal dose recommendation exists, 500 mg daily has been studied in pregnant women and is well tolerated. L-Carnitine is a Class B drug in pregnancy: generally considered to be safe. Researchers have given up to 3,000 mg daily of L-carnitine during the first week of the menstrual cycle to improve pregnancy rates. Though in mice, even low dose L-carnitine has shown a positive effect.
Out of all the supplements touted to help with infertility, these two may be the most reliable for women over 35. And by the way, CoQ10 and L-Carnitine have also been shown to improve sperm quality in men.
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