Background
There is growing acceptance that nutrition may be related to fertility and specifically
to assisted reproductive technologies success in women; however, there is still no
specific dietary guidance.
Objective
The objective of the study was to evaluate the relationship between pretreatment adherence
to various dietary patterns and outcomes of assisted reproductive technologies.
Study Design
We followed up 357 women enrolled in the prospective Environment and Reproductive
Health (EARTH) study, who underwent 608 assisted reproductive technologies cycles
(2007–2017). Using a validated food frequency questionnaire completed prior to treatment,
we assessed adherence to the Mediterranean diet, the alternate Healthy Eating Index
2010, the Fertility Diet (developed based on risk factors for anovulatory infertility),
and a profertility diet we developed based on factors previously related to assisted
reproductive technologies outcomes (higher intake of supplemental folic acid, vitamin
B12, vitamin D, low- rather than high-pesticide residue produce, whole grains, dairy,
soy foods, and seafood rather than other meats).
Results
Higher adherence to the alternate Healthy Eating Index 2010 and Fertility Diet was
not related to live birth following assisted reproductive technologies. Women in the
second through the fourth quartiles of Mediterranean diet adherence had significantly
higher probability of live birth (0.44, 95% confidence interval, 0.39–0.49) compared
with women in the first quartile (0.31, 95% confidence interval, 0.25–0.39); however,
there was no additional benefit of adherence to the Mediterranean diet above the second
quartile. Increased adherence to the profertility diet was linearly associated with
assisted reproductive technologies outcomes. The adjusted odds (95% confidence interval)
of implantation, clinical pregnancy, and live birth were higher by 47% (21%, 77%),
43% (19%, 72%), and 53% (26%, 85%), respectively, per SD increase. The adjusted difference
in the proportion of cycles resulting in live birth for women in the fourth vs first
quartile of adherence to the profertility diet was 0.28 (95% confidence interval,
0.16–0.38). While the profertility diet was not related to estradiol levels, oocyte
counts, or endometrial thickness, it was inversely associated with clinical pregnancy
loss (odds ratio, 0.69, 95% confidence interval, 0.53–0.90 per SD increase).
Conclusion
Higher pretreatment adherence to the profertility diet was associated with an increased
probability of live birth among women undergoing assisted reproductive technologies.
Commonly recommended dietary advice such as adhering to the Mediterranean diet may
not provide the most appropriate guidance for women undergoing infertility treatment
in the United States.
Key words
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Article info
Publication history
Published online: February 08, 2019
Accepted:
February 3,
2019
Received in revised form:
January 8,
2019
Received:
September 26,
2018
Footnotes
This work was supported by National Institutes of Health grants R01-ES009718, P30-DK046200 and K99-ES026648. The funding sources had no involvement in the study design, collection, analysis, or interpretation of the data; in the writing of the report; and in the decision to submit the article for publication.
The authors report no conflict of interest.
Cite this article as: Gaskins AJ, Nassan FL, Chiu Y-H, et al. Dietary patterns and outcomes of assisted reproduction. Am J Obstet Gynecol 2019;220:567.e1-18.
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