Background, aims, and objectives: Clomiphene citrate (CC) resistance remains one of the unsolved problems facing gynecologists during the stimulation of ovulation in polycystic ovarian syndrome (PCOS). This study was conducted to study the effect of coenzyme Q1O (Co-Q10) in reverting CC resistance in PCOS patients in improving ovulation and pregnancy rates.
Materials and methods: This cohort study involved 50 CC-resistant PCOS infertile patients. This study was conducted at Tanta and Benha Universities in the period from 1st May 2019 to 30th April 2021. All PCOS resistant to CC received initial pretreatment with CO-Q10 capsules in a dose of 100 mg twice daily after meals for 3 months. Induction of ovulation started after the initial pretreatment using CC in a dose of 150 mg twice daily for 5 days starting at day 3 in each cycle. At the same time, Co-Q10 supplementations were used as an adjuvant with CC for 5 days.
Results: The mean age of our patients was 27.46 ± 2.91 years, the mean BMI was 26.40 ± 2.67, and infertility duration was 3.92 ± 1.16 years. About 64% were overweight and obese and 36% were normal weight with BMI. Most cases (64%) had positive family history of infertility due to PCOS. After Co-Q10 supplementation, the serum estradiol was 171.66 ± 56.79 pg/mL, midluteal progesterone was 9.09 ± 1.79 pg/mL. Ovulation was present in 56%, representing significant improvement after use of Co-Q10. In addition, the rate of pregnancy was 28% and ongoing pregnancy rate was 16%.
Conclusion: Coenzyme Q10 (Co-Q10) pretreatment before induction of ovulation in CC-resistant PCOS improved ovulation and pregnancy rates. Ongoing pregnancy rates were improved after Co-Q10 supplementation in CC-resistant women.
Clinical significance: Co-Q10 could decrease CC resistance in most cases with improved ovulation and pregnancy rates. CO-Q10 could be an option for patient before shifting to second-line therapy.
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