Lifestyle and Environment · Nutrition and Metabolic Health

Female Fertility and the Nutritional Approach: The Most Essential Aspects

Skoracka K, Ratajczak AE, Rychter AM, Dobrowolska A, Krela-Kaźmierczak I

Published December 2021 Advances in nutrition (Bethesda, Md.), 12(6), 2372-2386
DOI 10.1093/advances/nmab068 PMID 34139003 PMC PMC8634384

RRM Academy Synopsis

Mediterranean-style eating is linked to better female fertility

A review of diet and female fertility links a Mediterranean-style diet to better fertility, and trans fats and added sugars to worse fertility. The authors searched one database. Few studies tested diet changes, so they could not write diet guidelines.

Key Findings

  • In a cohort of 17,544 women planning pregnancy, a diet similar to the Mediterranean pattern was associated with a lower risk of infertility from ovulation disorders.
  • In 18,555 women, a trans fat intake higher by even 2% was linked to a significant rise in infertility risk from ovulation disorders.
  • The BioCycle Study, run after US trans fat labeling began, saw no association between trans fat intake and not ovulating.
  • In a study of 501 women with moderate or severe iodine deficiency, the chance of pregnancy in each cycle fell by 46% versus women without iodine deficiency.
  • A meta-analysis of 23 studies put celiac disease seroprevalence in women with infertility at 1.3–1.6%. The review found no recommendation to remove gluten for every woman with infertility.

Interpretation

The authors call this a narrative review, so they may have missed studies and acknowledge publication bias. The findings are associations from cohort studies and the literature. Results conflict for trans fats, omega-3 fats and soy. Many supplement questions remain open, and the authors call for more research. The review covers female fertility only. Male diet appears in a separate paper by the same group.

RRM Context

Restorative reproductive medicine looks for the cause of infertility in both partners. Diet is one factor that can change. The review counts 15% of infertility cases as unexplained. Restorative reproductive medicine calls those couples undiagnosed. The review says diet seems especially important in ovulation disorders and endometriosis.

Abstract

Infertility is an increasing problem that affects couples attempting pregnancy. A growing body of evidence points to a link between diet and female fertility. In fact, data show that a diet high in trans fats, refined carbohydrates, and added sugars can negatively affect fertility. Conversely, a diet based on the Mediterranean dietary patterns, i.e., rich in dietary fiber, omega-3 (ɷ-3) fatty acids, plant-based protein, and vitamins and minerals, has a positive impact on female fertility. An unhealthy diet can disrupt microbiota composition, and it is worth investigating whether the composition of the gut microbiota correlates with the frequency of infertility. There is a lack of evidence to exclude gluten from the diet of every woman trying to become pregnant in the absence of celiac disease. Furthermore, there are no data concerning adverse effects of alcohol on female fertility, and caffeine consumption in the recommended amounts also does not seem to affect fertility. On the other hand, phytoestrogens presumably have a positive influence on female fertility. Nevertheless, there are many unanswered questions with regard to supplementation in order to enhance fertility. It has been established that women of childbearing age should supplement folic acid. Moreover, most people experience vitamin D and iodine deficiency; thus, it is vital to control their blood concentrations and consider supplementation if necessary. Therefore, since diet and lifestyle seem to be significant factors influencing fertility, it is valid to expand knowledge in this area.

Topics

Related research

Lifestyle and Environment › Nutrition and Metabolic Health › Dietary Patterns
Kinga Skoracka, Alicja Ewa Ratajczak, Anna Maria Rychter, Agnieszka Dobrowolska, Iwona Krela-Kaźmierczak
K Skoracka, A Ratajczak, A Rychter, A Dobrowolska, I Krela-Kaźmierczak
PMID 34139003 34139003 DOI 10.1093/advances/nmab068 10.1093/advances/nmab068 Skoracka et al. 2021, Skoracka 2021