Abstract

Abstract Study question Is there evidence that the intake of omega–3 fatty acids has a positive effect on probability of clinical pregnancy in women undergoing IVF/ICSI treatment? Summary answer No significant correlation was found between omega- 3 fatty acid intake (neither supplemental or as fish intake) and clinical pregnancy. What is known already: Omega–3 fatty acids are important substrates in metabolism and the supplement of omega–3 fatty acids have been thought to have a positive effect on semen quality in infertile men. Studies have shown that the intake of omega–3 fatty acids might also have a direct effect on oocytes, the quality of the embryos, and implantation of the embryo in the uterus at conception. However, the role of omega–3 fatty acids in female fertility still remains unclear as the relationship between omega–3 fatty acids and successful IVF treatment in women has shown conflicting results. Study design, size, duration Systematic review. Systematic literature research (PRISMA) on PubMed, Embase, and Cochrane identifying clinical studies focusing on omega–3 fatty acid intake amongst women receiving IVF treatment, using good scientific practice for literature search and management. 5 articles meeting inclusion criteria were found, with a total of 1.100 women undergoing IVF/ICSI treatment. Participants/materials, setting, methods: Population: women in fertility treatment Intervention: omega–3 fatty acid and/or fish intake Comparison: No/low intake of omega–3 fatty acid and/or fish intake Outcome: Primary: clinical pregnancy rate, Secondary: number of follicles, embryo quality, live birth rate Main results and the role of chance Number of follicles was found to be inversely associated to omega–3 intake in a single study. Higher levels of total omega–3 intake were found to be positively associated to embryo morphology scores, and thus quality, independent on energy intake. None of the four studies considering clinical pregnancy found any statistical significance in the association between fish intake and clinical pregnancy. Regarding live birth as an endpoint, fish intake, but not fish oil supplements, was seen to significantly increase the probability in one study with a dose-response relationship. A similar association was not found by the only other study also examining live birth. Limitations, reasons for caution: Only five studies were found to meet inclusion criteria. None of the included studies were randomized controlled trials. No meta-analysis was carried out due to the heterogeneity of the studies. Wider implications of the findings: The need for further studies, including randomized controlled trials of high quality with larger population sizes, is critical in order to thoroughly investigate and conclude any possible association of the beneficial effect of omega–3 fatty acids on female fertility in regard to IVF treatment. Trial registration number Not applicable

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