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. 2023 Nov 2;29(6):811-828.
doi: 10.1093/humupd/dmad018.

Assessing the influence of preconception diet on female fertility: a systematic scoping review of observational studies

Simon Alesi  1 , Nahal Habibi  2   3 , Thais Rasia Silva  4 , Nicole Cheung  2 , Sophia Torkel  1 , Chau Thien Tay  1 , Alejandra Quinteros  2 , Hugo Winter  1 , Helena Teede  1 , Aya Mousa  1 , Jessica A Grieger  2   3 , Lisa J Moran  1   3
Affiliations

Assessing the influence of preconception diet on female fertility: a systematic scoping review of observational studies

Simon Alesi et al. Hum Reprod Update. .

Abstract

Background: Preconception diet is a proposed modifiable risk factor for infertility. However, there is no official guidance for women in the preconception period as to which dietary approaches may improve fertility.

Objective and rationale: A comprehensive synthesis of the relevant evidence is key to determine the potentially effective dietary patterns and components as well as evidence gaps, and to provide information for nutritional recommendations for couples planning a pregnancy.

Search methods: In this systematic scoping review, four electronic databases (Medline and EMBASE via Ovid processing, CAB Direct, and CINAHL via EBSCO) were searched for observational studies (prospective and retrospective cohort, cross-sectional, and case-control studies) from inception to 27 September 2021. Eligible studies included women of reproductive age during the preconception period, and evaluated exposures related to preconception diet and outcomes related to fertility. Results were synthesized using a descriptive approach.

Outcomes: A total of 36 studies were eligible for inclusion (31 prospective, 3 cross-sectional, and 2 case-control studies) and were published between 2007 and 2022. Of the assessed dietary exposures, increased adherence to the Mediterranean diet displayed the strongest and most consistent association with improved clinical pregnancy rates. Reducing trans fatty acids (TFAs), saturated fatty acids, and discretionary food intake (fast food and sugar-sweetened beverages) were associated with improvements in live birth, clinical pregnancy rates, and related ART outcomes. The dietary components of seafood, dairy, and soy demonstrated inconsistent findings across the few included studies.

Wider implications: Due to heterogeneity and the limited available literature on most exposures, there is insufficient evidence to support any specific dietary approach for improving fertility. However, following some of the dietary approaches outlined in this review (anti-inflammatory diets, reducing TFA, and discretionary food intake) are consistent with broad healthy eating guidelines, have little to no associated risk, and offer a plausible set of possible benefits. This warrants further exploration in randomized controlled trials.

Keywords: ART; Mediterranean diet; female infertility; macronutrients; preconception diet.

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Conflict of interest statement

All authors declare no conflicts of interest.

Figures

None
Systematic search for preconception nutrition in female fertility identified that the Mediterranean diet and reducing discretionary foods/drinks yielded benefits; however, there was limited evidence for some foods.
Figure 1.
Figure 1.
PRISMA diagram for literature search process.
Figure 2.
Figure 2.
The number of included studies regarding ART or spontaneous conception with the various primary or secondary exposures related to the main categories of diet-related categories. aHEI-2010, alternative healthy eating index 2010; aMedDiet, alternative Mediterranean diet; Carbs, carbohydrates; ART, assisted reproductive technologies; DII, dietary inflammatory index; FAs, fatty acids; GI/GL, glycemic index/glycemic load; MedDiet, Mediterranean diet; SSB, Sugar-sweetened beverages.
Figure 3.
Figure 3.
The number of included studies for the reported outcomes among the populations. (A) women conceiving spontaneously and (B) women conceiving with ART.
See this image and copyright information in PMC

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