Abstract
BackgroundInfertility affects up to 15% of couples. In vitro fertilization (IVF) treatment has modest success rates and some factors associated with infertility and poor treatment outcomes are not modifiable. Several studies have assessed the association between female dietary patterns, a modifiable factor, and IVF outcomes with conflicting results. We performed a systematic literature review to identify female dietary patterns associated with IVF outcomes, evaluate the body of evidence for potential sources of heterogeneity and methodological challenges, and offer suggestions to minimize heterogeneity and bias in future studies.MethodsWe performed systematic literature searches in EMBASE, PubMed, CINAHL, and Cochrane Central Register of Controlled Trials for studies with a publication date up to March 2020. We excluded studies limited to women who were overweight or diagnosed with PCOS. We included studies that evaluated the outcome of pregnancy or live birth. We conducted an initial bias assessment using the SIGN 50 Methodology Checklist 3.ResultsWe reviewed 3280 titles and/or titles and abstracts. Seven prospective cohort studies investigating nine dietary patterns fit the inclusion criteria. Higher adherence to the Mediterranean diet, a ‘profertility’ diet, or a Dutch ‘preconception’ diet was associated with pregnancy or live birth after IVF treatment in at least one study. However, causation cannot be assumed. Studies were potentially hindered by methodological challenges (misclassification of the exposure, left truncation, and lack of comprehensive control for confounding) with an associated risk of bias. Studies of the Mediterranean diet were highly heterogenous in findings, study population, and methods. Remaining dietary patterns have only been examined in single and relatively small studies.ConclusionsFuture studies with rigorous and more uniform methodologies are needed to assess the association between female dietary patterns and IVF outcomes. At the clinical level, findings from this review do not support recommending any single dietary pattern for the purpose of improving pregnancy or live birth rates in women undergoing IVF treatment.
Highlights
Infertility affects up to 15% of couples
Approximately 15% of couples in the United States and one in four couples in developing countries are affected by infertility, defined as the inability to become pregnant after 12 months of regular unprotected intercourse [1, 2]
Nine articles, representing nine independent research studies reporting on female dietary patterns and In vitro fertilization (IVF) outcomes, remained
Summary
In vitro fertilization (IVF) treatment has modest success rates and some factors associated with infertility and poor treatment outcomes are not modifiable. Several studies have assessed the association between female dietary patterns, a modifiable factor, and IVF outcomes with conflicting results. Though in vitro fertilization (IVF) is one of the most effective treatments for infertility [4], much of the success of IVF relies on women undergoing multiple embryo transfers and oocyte retrievals. Human studies link dietary factors to longer time to pregnancy and the risk of developing reproductive disorders which may impact fertility such as anovulatory infertility, endometriosis, and uterine leiomyomata [16,17,18,19,20,21,22,23,24,25,26,27,28,29]. Despite uncovering possible links with fertility and fecundity, studies of associations between individual female dietary factors and infertility in both animals and humans are largely equivocal
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