Migraine and female subfertility are commonly managed as separate clinical conditions, although both may share important biological mechanisms, particularly mitochondrial dysfunction and oxidative stress. Coenzyme Q10 (CoQ10), a lipid-soluble molecule involved in mitochondrial ATP synthesis and antioxidant defense, may represent a relevant therapeutic link between these two fields. Current evidence suggests that CoQ10 supplementation may reduce migraine frequency, duration, and severity, while reproductive studies indicate potential benefits in women with diminished ovarian reserve, ovarian aging, and poor ovarian response undergoing assisted reproductive treatment. Its favorable tolerability profile may be particularly important for women of reproductive age, in whom some standard migraine preventive therapies raise reproductive safety concerns. However, the available evidence remains limited by differences in dose, formulation, treatment duration, study populations, and the lack of clinical trials specifically evaluating women with both migraine and subfertility. This editorial highlights the need for closer collaboration between neurologists, gynecologists, and reproductive specialists, and calls for prospective studies to determine whether CoQ10 can serve as a safe and effective adjunctive strategy at the intersection of migraine prevention and fertility care.