Lifestyle and Environment · Nutrition and Metabolic Health

Anti-Inflammatory Diets in Fertility: An Evidence Review

Alesi S, Villani A, Mantzioris E, Takele WW, Cowan S, Moran LJ, Mousa A

Published September 21, 2022 Nutrients, 14(19)
DOI 10.3390/nu14193914 PMID 36235567 PMC PMC9570802

RRM Academy Synopsis

Anti-inflammatory diets tie to better sperm quality, mixed IVF results

A 2022 review of diet studies links anti-inflammatory eating to better sperm quality, with mixed results for IVF.

Key Findings

  • Among 937 Iranian men in a case-control study (400 newly diagnosed infertile, 537 healthy), above-median adherence to a healthy pattern went with lower odds of infertility (OR: 0.52 [95% CI: 0.33, 0.83]).
  • The same study linked higher Western-pattern adherence to greater odds of infertility (OR: 2.66 [95% CI: 1.70, 4.17]) and higher mixed-pattern adherence to greater odds (OR: 2.82 [95% CI: 1.74, 4.56]).
  • A 2021 meta-analysis of eight prospective cohort studies (2229 women, 2067 embryo transfer cycles) found no significant link between a Mediterranean-style pattern and clinical pregnancy or live birth in IVF.
  • A randomized trial of 150 overweight women with PMOS (polyendocrine metabolic ovarian syndrome, formerly PCOS) reported better menstrual cyclicity and spontaneous pregnancy in the diet-plus-activity group after 12 weeks.
  • Across nine human and 12 animal studies, a systematic review linked diets rich in certain vitamins, fish oils and mineral salts to fewer endometriosis symptoms. Many had moderate or high bias risk.

Interpretation

This review walks through diet studies in women and in men. Men who ate more anti-inflammatory foods tended to have better sperm quality. In women, a healthy diet pattern went with lower odds of infertility, while Western and mixed patterns went with higher odds. Women with PMOS (PCOS) who followed a diet and exercise program had better cycles and more spontaneous pregnancies. People with endometriosis who ate more vitamins, fish oils and mineral salts had fewer symptoms in both human and animal studies. The authors point to low-grade inflammation as the shared link, and note that most of the human evidence is observational. Larger trials could test these diet links.

RRM Context

Restorative reproductive medicine looks for causes that can be fixed in both partners. This review treats food as a factor in male and female fertility alike, worth checking along with other causes.

Abstract

Infertility is a global health concern affecting 48 million couples and 186 million individuals worldwide. Infertility creates a significant economic and social burden for couples who wish to conceive and has been associated with suboptimal lifestyle factors, including poor diet and physical inactivity. Modifying preconception nutrition to better adhere with Food-Based Dietary Guidelines (FBDGs) is a non-invasive and potentially effective means for improving fertility outcomes. While several dietary patterns have been associated with fertility outcomes, the mechanistic links between diet and infertility remain unclear. A key mechanism outlined in the literature relates to the adverse effects of inflammation on fertility, potentially contributing to irregular menstrual cyclicity, implantation failure, and other negative reproductive sequelae. Therefore, dietary interventions which act to reduce inflammation may improve fertility outcomes. This review consistently shows that adherence to anti-inflammatory diets such as the Mediterranean diet (specifically, increased intake of monounsaturated and n-3 polyunsaturated fatty acids, flavonoids, and reduced intake of red and processed meat) improves fertility, assisted reproductive technology (ART) success, and sperm quality in men. Therefore, integration of anti-inflammatory dietary patterns as low-risk adjunctive fertility treatments may improve fertility partially or fully and reduce the need for prolonged or intensive pharmacological or surgical interventions.

Topics

By this author

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Lifestyle and Environment › Nutrition and Metabolic Health › Dietary Patterns
Simon Alesi, Anthony Villani, Evangeline Mantzioris, Wubet Worku Takele, Stephanie Cowan, Lisa J Moran, Aya Mousa
S Alesi, Tony Villani, A Villani, E Mantzioris, W Takele, S Cowan, L Moran, A Mousa
PMID 36235567 36235567 DOI 10.3390/nu14193914 10.3390/nu14193914 Alesi et al. 2022, Alesi 2022