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. 2025 Jun 30:13:1597910.
doi: 10.3389/fpubh.2025.1597910. eCollection 2025.

Consumption of ultra-processed foods and female infertility: a cross-sectional study

Adam T Evans  1 , Snigdha Alur-Gupta  1 , Euridice Martinez Steele  2   3 , Ying Meng  4 , Alex J Knutson  1 , Wendy S Vitek  1
Affiliations

Consumption of ultra-processed foods and female infertility: a cross-sectional study

Adam T Evans et al. Front Public Health. .

Abstract

Background: A high dietary consumption of ultra-processed foods (UPF) has been associated with abnormal semen analysis parameters in males; however, it is unclear whether there is an impact on female reproduction. The objective of this study is to assess whether high consumption of UPF is associated with female infertility.

Methods: A cross-sectional analysis of females aged 18-45 years who participated in the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018 was performed. Females were eligible for inclusion if they provided a 24-h dietary recall and responded to a question regarding infertility. Foods reported during a 24-h dietary recall were classified according to the Nova system. The relative percentage of total energy consumed from UPF and unprocessed/minimally processed foods within a 24-h period was calculated.

Results: The prevalence of infertility was 11%. The overall mean percentage of daily UPF and unprocessed/minimally processed food intake among respondents was 57 and 29%, respectively. There was no difference in the odds of female infertility when comparing females in the lowest tertile of UPF consumption to peers in the middle [aOR = 1.37, 95% CI (0.96, 1.95)] or highest tertile of consumption [aOR = 1.26, 95% CI (0.91, 1.74)]. Similarly, there was no difference in the odds of infertility between participants in the middle [aOR = 1.39, 95% CI (0.83, 2.33)] or highest tertile [aOR = 0.73, 95% CI (0.34, 1.54)] of unprocessed/minimally processed food consumption relative to those in the lowest tertile. In an intermediate model removing body mass index (BMI) as a covariate, an increased odds of infertility was noted among females with the highest tertile of UPF consumption relative to those in the lowest tertile [aOR = 1.46, 95% CI (1.01, 2.09)].

Conclusion: Among women of reproductive age, high consumption of UPF is associated with female infertility. BMI is a mediator of the association between UPF and female infertility.

Keywords: NHANES; Nova system; dietary intake; infertility; nutrition; ultra-processed foods.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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