If you are trying to conceive through IVF, most supplements discussed in the book can be stopped the day before egg retrieval, because at that point they are no longer needed to support egg development. (Specifically: you can stop taking melatonin, N-acetyl cysteine, Alpha-lipoic acid, DHEA, myo-inositol and you may also decide to stop CoQ10/ubiquinol- further info on this below.)
After egg retrieval, the supplements that are helpful to continue taking in preparation for embryo transfer are:
- Prenatal
- Vitamin D
- Vitamin E
- Possibly CoQ10/Ubiquinol
(See the post on preparing for embryo transfer)
After embryo transfer, you can then stop vitamin E and CoQ10 and continue with your prenatal and vitamin D.
Yet there are no hard rules in this area. Your doctor may recommend that you continue taking CoQ10, antioxidants, and DHEA until you get a positive pregnancy test, so that these supplements are continuing to support egg development in case you need to do another cycle. (See excerpt from the upcoming 2nd edition below).
For much the same reason, if you are trying to conceive naturally or through IUI, you can continue taking egg quality supplements until you get a positive pregnancy test.
When you do become pregnant, it is best to continue only with your prenatal and vitamin D, with the addition of a fish oil or DHA supplement to support infant brain development. (As discussed in my upcoming pregnancy book, it may also be a good idea to to add a choline supplement once you become pregnant. Unless you eat eggs on a daily basis, it is difficult to reach the recommended daily intake and most prenatals do not contain enough).
Excerpt from the 2nd edition of It Starts with the Egg:
When to Stop Taking Coenzyme Q10/ Ubiquinol
Different IVF clinics provide different advice on when to stop taking CoQ10. Many recommend stopping CoQ10 and other egg-quality supplements the day before egg retrieval, since the supplements are no longer needed. Others advise stopping when you get a positive pregnancy test, so that you can continue to benefit from the supplement if you end up needing to do another cycle. There is also a possibility that CoQ10 may help with preparing the uterine lining for embryo transfer. If you are trying to conceive naturally or through IUI, it is typical to stop taking CoQ10 when you get a positive pregnancy test.
Doctors advise patients to stop taking CoQ10 during pregnancy simply because 0f a lack of data. There have not been any large studies demonstrating safety during pregnancy and doctors are understandably extremely conservative about supplements during this time. Yet there is little reason to expect that taking CoQ10 while pregnant is harmful. To the contrary, research so far indicates that CoQ10 may actually be able to reduce the risk of preeclampsia. (This is a serious complication of pregnancy that involves dangerously high blood pressure.)
One specific circumstance in which there may be a justification for taking a small amount of CoQ10 during pregnancy (despite a lack of safety data) is recurrent miscarriage. When researchers measured the CoQ10 levels in almost 500 pregnant women, they found that levels normally rise with each trimester. Yet another trend was evident too: those women with low levels were more likely to miscarry.
The reason for this is unclear, but new research suggests at least one interesting link between CoQ10 and miscarriage that goes beyond egg quality. Specifically, CoQ10 appears to reduce the immune and clotting mediators involved in antiphoshpolipid syndrome, a common cause of miscarriage. In a randomized, placebo-controlled study published in 2017, thirty six patients with antiphospholipid syndrome were randomized to receive 200 mg/day of ubiquinol, or a placebo.[i] After one month there was a significant reduction in the immune and clotting mediators involved in antiphospholipid syndrome. We do not know how this would translate to miscarriage, but it is a promising avenue of research.
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References
[i] Pérez-Sánchez, C., Aguirre, M. Á., Ruiz-Limón, P., Ábalos-Aguilera, M. C., Jiménez-Gómez, Y., Arias-de la Rosa, I., … & Collantes-Estévez, E. (2017). Ubiquinol effects on antiphospholipid syndrome prothrombotic profile: a randomized, placebo-controlled trial. Arteriosclerosis, thrombosis, and vascular biology, ATVBAHA-117