Abstract
In recent decades, increasing attention has been paid to the influence of diet on reproductive health. Carbohydrates in diet affect glucose metabolism and multiple evidences showed the key role of insulin sensitivity in regulating female fertility. We designed a prospective cohort study to investigate the relation between dietary carbohydrate intake, glycemic load (GL) and the outcomes of assisted reproduction. A population of 494 female partners of couples referring to an Italian Fertility Center and eligible for in vitro fertilization (IVF) were enrolled in the study. On the day of the oocyte retrieval, information on their diet was obtained using a validated food frequency questionnaire (FFQ). We calculated the relative risk and 95% confidence interval of embryo transfer, clinical pregnancy and live birth according to the following dietary exposures: GL, glycemic index (GI) as well as the daily carbohydrate and fiber intake. A multiple regression model was used to account for the confounders. After adjusting for age, college degree, body mass index (BMI), leisure physical activity and previous assisted reproduction techniques (ART) cycles, no significant association was observed between the considered dietary exposures and the IVF outcomes. The roles of GL, carbohydrate intake and GI were assessed in strata of the cause of infertility and body mass index and no relation emerged in this further analysis. We found no clear association between the dietary carbohydrate quantity and quality and IVF outcomes in a cohort of infertile Italian women.
Highlights
In recent decades, increasing attention has been paid to the influence of lifestyle on reproductive health, highlighting the impact of body weight, physical activity and dietary habits on fertility [1,2,3].In this regard, the tight connection between energy metabolism and reproduction, especially in female animals, plays a key role and multiple evidences have linked glucose metabolism and insulin sensitivity to ovulatory function and fertility [4,5]
From September 2014 to December 2016, infertile couples referring to the Infertility Unit of Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico located in Milan, and eligible for in vitro fertilization, were invited to take part in an ongoing prospective cohort study investigating the influence of lifestyle and dietary habits on assisted reproduction techniques (ART)
We are unaware of previous studies primarily investigating the association between carbohydrate intake, glycemic load and the outcomes of in vitro fertilization, several reports have to date showed that the amount and quality of carbohydrates in the diet may influence the fertility and ovulatory function, in polycystic ovary syndrome (PCOS) and obese women and in apparently healthy women [5,16,18]
Summary
In recent decades, increasing attention has been paid to the influence of lifestyle on reproductive health, highlighting the impact of body weight, physical activity and dietary habits on fertility [1,2,3].In this regard, the tight connection between energy metabolism and reproduction, especially in female animals, plays a key role and multiple evidences have linked glucose metabolism and insulin sensitivity to ovulatory function and fertility [4,5]. Several authors have investigated ovulation and, in general, the reproductive function of women with polycystic ovary syndrome (PCOS) and of obese women [9,10,11], two subgroups of patients characterized by hyperinsulinemia and insulin resistance. In these conditions, Nutrients 2020, 12, 1568; doi:10.3390/nu12061568 www.mdpi.com/journal/nutrients. Referring to in vitro fertilization (IVF), these observations may help to explain, on the one hand, the higher percentages of low-quality oocytes and consequent lower fertilization rate reported in PCOS women [13], while on the other hand, the higher frequency of poor ovarian response to follicle-stimulating hormone (FSH)-stimulation and the decreased E2 production described in obese women [8,14]
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