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Trop-Steinberg S, Gal M, Azar Y, Kilav-Levin R, Heifetz EM. Effect of omega-3 supplements or diets on fertility in women: A meta-analysis. Heliyon 2024; 10:e29324. [PMID: 38628754 PMCID: PMC11019195 DOI: 10.1016/j.heliyon.2024.e29324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024] Open
Abstract
Objective This study aimed to assess the effect of increased omega-3 consumption on fertilization rates and the probability of women getting pregnant. This study is needed because different perspectives exist regarding the use of omega-3 fatty acids in enhancing fertility among women with reproductive issues, and information for those planning a spontaneous pregnancy is limited. Methods PubMed, Clinical Trials, CINAHL/EBSCO, Medline Complete, Cochrane Library, and Google Scholar were searched for articles published until April 2021, and the search was limited to articles in English language. The search strategy included the following key words: "in-vitro fertilization (IVF)," "intracytoplasmic sperm injection techniques (ICSI)," "pregnancy," "omega-3 fatty acid," "alpha-linolenic acid," "eicosapentaenoic acid," "docosahexaenoic acid," "n-3 polyunsaturated fatty acid," and "fish oil and seafood." Studies reporting female fertility occurring naturally or IVF/ICSI concurrent with omega-3 intake were included. Retrospective studies, studies including postmenopausal women, and unevenly matched control and study groups were excluded. To assess bias, we used the Cochrane Handbook for Systematic Reviews of Interventions, version 5.1.0. To synthesize the findings from the studies included in this review, a meta-analysis was conducted using calculated or extracted odds ratios (OR) of clinical pregnancies and fertilization rates for each group in each study. Results We included six trials involving 1789 women who received fertility treatment, four trials involving 2607 women who conceived naturally, and three trials involving 1725 oocytes for fertility rates. Aggregated ORs for the effects of omega-3 on pregnancies were 1.74, 1.36, and 2.14 for women who received fertility treatment, those who conceived naturally, and fertilization rate, respectively. All these results were significant (p ≤ 0.01), although they had high heterogeneity I2>68 %. Conclusion This systematic review and meta-analysis suggest that omega-3 intake significantly improves women's pregnancy and fertilization rates; however, the high heterogeneity in this review somewhat limits its interpretation. Therefore, further prospective randomized studies are necessary to better understand this relationship.
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Affiliation(s)
- Shivtia Trop-Steinberg
- Jerusalem College of Technology, Faculty of Life and Health Science, P.O.B. 16031, Jerusalem, Israel
| | - Michael Gal
- Shaare Zedek Medical Center, IVF Unit, Department of Obstetrics and Gynecology, P.O.B. 3235, Jerusalem, Israel
- Israel and Hebrew University School of Medicine, Jerusalem, Israel
| | - Yehudith Azar
- Hadassah Medical Center, Bone Marrow Transplantation Unit, P.O.B. 12000, Jerusalem, Israel
| | - Rachel Kilav-Levin
- Jerusalem College of Technology, Faculty of Life and Health Science, P.O.B. 16031, Jerusalem, Israel
| | - Eliyahu M Heifetz
- Jerusalem College of Technology, Faculty of Life and Health Science, P.O.B. 16031, Jerusalem, Israel
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Chu Q, Yu YX, Zhang JZ, Zhang YT, Yu JP. Effects of flaxseed oil supplementation on metaphase II oocyte rates in IVF cycles with decreased ovarian reserve: a randomized controlled trial. Front Endocrinol (Lausanne) 2024; 15:1280760. [PMID: 38469148 PMCID: PMC10925664 DOI: 10.3389/fendo.2024.1280760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/31/2024] [Indexed: 03/13/2024] Open
Abstract
Background This study was designed to explore the effects of flaxseed oil on the metaphase II (MII) oocyte rates in women with decreased ovarian reserve (DOR). Methods The women with DOR were divided into a study group (n = 108, flaxseed oil treatment) and a control group (n = 110, no treatment). All patients were treated with assisted reproductive technology (ART). Subsequently, the ART stimulation cycle parameters, embryo transfer (ET) results, and clinical reproductive outcomes were recorded. The influencing factors affecting the MII oocyte rate were analyzed using univariate analysis and multivariate analysis. Results Flaxseed oil reduced the recombinant human follicle-stimulating hormone (r-hFSH) dosage and stimulation time and increased the peak estradiol (E2) concentration in DOR women during ART treatment. The MII oocyte rate, fertilization rate, cleavage rate, high-quality embryo rate, and blastocyst formation rate were increased after flaxseed oil intervention. The embryo implantation rate of the study group was higher than that of the control group (p = 0.05). Additionally, the female age [odds ratio (OR): 0.609, 95% confidence interval (CI): 0.52-0.72, p < 0.01] was the hindering factor of MII oocyte rate, while anti-Müllerian hormone (AMH; OR: 100, 95% CI: 20.31-495, p < 0.01), peak E2 concentration (OR: 1.00, 95% CI: 1.00-1.00, p = 0.01), and the intake of flaxseed oil (OR: 2.51, 95% CI: 1.06-5.93, p = 0.04) were the promoting factors for MII oocyte rate. Conclusion Flaxseed oil improved ovarian response and the quality of oocytes and embryos, thereby increasing the fertilization rate and high-quality embryo rate in DOR patients. The use of flaxseed oil was positively correlated with MII oocyte rate in women with DOR. Clinical trial number https://www.chictr.org.cn/, identifier ChiCTR2300073785.
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Affiliation(s)
| | | | | | | | - Jia-ping Yu
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
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Concepción-Zavaleta MJ, Coronado-Arroyo JC, Quiroz-Aldave JE, Durand-Vásquez MDC, Ildefonso-Najarro SP, Rafael-Robles LDP, Concepción-Urteaga LA, Gamarra-Osorio ER, Suárez-Rojas J, Paz-Ibarra J. Endocrine factors associated with infertility in women: an updated review. Expert Rev Endocrinol Metab 2023; 18:399-417. [PMID: 37702309 DOI: 10.1080/17446651.2023.2256405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/09/2023] [Accepted: 09/04/2023] [Indexed: 09/14/2023]
Abstract
INTRODUCTION Infertility is defined as the inability to conceive after unprotected sexual intercourse for at least 12 consecutive months. Our objective is to present an updated narrative review on the endocrine causes of infertility in women. AREAS COVERED A comprehensive review was conducted using Scielo, Scopus, and EMBASE databases, comprising 245 articles. The pathophysiology of infertility in women was described, including endocrinopathies such as hypothalamic amenorrhea, hyperprolactinemia, polycystic ovary syndrome, primary ovarian insufficiency, obesity, thyroid dysfunction, and adrenal disorders. The diagnostic approach was outlined, emphasizing the necessity of hormonal studies and ovarian response assessments. Additionally, the treatment plan was presented, commencing with non-pharmacological interventions, encompassing the adoption of a Mediterranean diet, vitamin supplementation, moderate exercise, and maintaining a healthy weight. Subsequently, pharmacological treatment was discussed, focusing on the management of associated endocrine disorders and ovulatory dysfunction. EXPERT OPINION This comprehensive review highlights the impact of endocrine disorders on fertility in women, providing diagnostic and therapeutic algorithms. Despite remaining knowledge gaps that hinder more effective treatments, ongoing research and advancements show promise for improved fertility success rates within the next five years. Enhanced comprehension of the pathophysiology behind endocrine causes and the progress in genetic research will facilitate the delivery of personalized treatments, thus enhancing fertility rates.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - José Paz-Ibarra
- Department of Medicine, School of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú
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Niu H, An X, Wang X, Yang M, Cheng F, Lei A, Luo J. Dynamic role of Scd1 gene during mouse oocyte growth and maturation. Int J Biol Macromol 2023; 247:125307. [PMID: 37315672 DOI: 10.1016/j.ijbiomac.2023.125307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/07/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023]
Abstract
Mammalian reproductive ability is regulated by many factors, among which the fatty acid metabolism network provides energy for oocyte growth and primordial follicle formation during early mouse oogenesis. But the mechanism behind that is still unknown. Stearoyl-CoA desaturase 1 (Scd1) gene expression is increased during the oogenesis process, supporting the oocyte's healthy growth. Taking advantage of gene-edited mice lacking stearoyl-Coenzyme A desaturase 1 gene (Scd1-/-), we analyzed relative gene expression in perinatal ovaries from wildtype, and Scd1-/- mice. Scd1 deficiency dysregulates expression of meiosis-related genes (e.g., Sycp1, Sycp2, Sycp3, Rad51, Ddx4) and a variety of genes (e.g., Nobox, Lhx8, Bmp15, Ybx2, Dppa3, Oct4, Sohlh1, Zp3) associated with oocyte growth and differentiation, leading to a lower oocyte maturation rate. The absence of Scd1 significantly impedes meiotic progression, causes DNA damage, and inhibits damage repair in Scd1-/- ovaries. Moreover, we find that Scd1 absense dramatically disrupts the abundance of fatty acid metabolism genes (e.g., Fasn, Srebp1, Acaca) and the lipid droplet content. Thus, our findings substantiate a major role for Scd1 as a multifunctional regulator of fatty acid networks necessary for oocyte maintenance and differentiation during early follicular genesis.
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Affiliation(s)
- Huimin Niu
- Shaanxi Key Laboratory of Molecular Biology for Agriculture, College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China
| | - Xuetong An
- Shaanxi Key Laboratory of Molecular Biology for Agriculture, College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China
| | - Xinpei Wang
- Shaanxi Key Laboratory of Molecular Biology for Agriculture, College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China
| | - Min Yang
- Shaanxi Key Laboratory of Molecular Biology for Agriculture, College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China
| | - Fei Cheng
- Shaanxi Key Laboratory of Molecular Biology for Agriculture, College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China
| | - Anmin Lei
- Institute of Shaanxi Stem Cell Engineering and Technology Center, College of Veterinary Medicine, Northwest A&F University, Yangling 712100, China
| | - Jun Luo
- Shaanxi Key Laboratory of Molecular Biology for Agriculture, College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China.
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Chen Z, Lu Q, Wang J, Cao X, Wang K, Wang Y, Wu Y, Yang Z. The function of omega-3 polyunsaturated fatty acids in response to cadmium exposure. Front Immunol 2022; 13:1023999. [PMID: 36248838 PMCID: PMC9558127 DOI: 10.3389/fimmu.2022.1023999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
Throughout history, pollution has become a part of our daily life with the improvement of life quality and the advancement of industry and heavy industry. In recent years, the adverse effects of heavy metals, such as cadmium (Cd), on human health have been widely discussed, particularly on the immune system. Here, this review summarizes the available evidence on how Cd exposure may affect health. By analyzing the general manifestations of inflammation caused by Cd exposure, we find that the role of omega-3 (n-3) polyunsaturated fatty acids (PUFAs) in vivo can counteract Cd-induced harm. Additionally, we elucidate the effects of n-3 PUFAs on the immune system, and analyze their prophylactic and therapeutic effects on Cd exposure. Overall, this review highlights the role of n-3 PUFAs in the pathological changes induced by Cd exposure. Although n-3 PUFAs remain to be verified whether they can be used as therapeutic agents, as rehabilitation therapy, supplementation with n-3 PUFAs is reliable and effective.
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Affiliation(s)
- Zhi Chen
- College of Animal Science and Technology, Yangzhou University, Yangzhou, China
- Joint International Research Laboratory of Agriculture & Agri-Product Safety, Ministry of Education, Yangzhou University, Yangzhou, China
| | - Qinyue Lu
- College of Animal Science and Technology, Yangzhou University, Yangzhou, China
| | - Jiacheng Wang
- College of Medical, Yangzhou University, Yangzhou, China
| | - Xiang Cao
- College of Animal Science and Technology, Yangzhou University, Yangzhou, China
| | - Kun Wang
- College of Animal Science and Technology, Yangzhou University, Yangzhou, China
| | - Yuhao Wang
- College of Animal Science and Technology, Yangzhou University, Yangzhou, China
| | - Yanni Wu
- College of Animal Science and Technology, Yangzhou University, Yangzhou, China
| | - Zhangping Yang
- College of Animal Science and Technology, Yangzhou University, Yangzhou, China
- Joint International Research Laboratory of Agriculture & Agri-Product Safety, Ministry of Education, Yangzhou University, Yangzhou, China
- *Correspondence: Zhangping Yang,
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Calanni-Pileri M, Weitzel JM, Dannenberger D, Langhammer M, Michaelis M. Lower Plasmatic Levels of Saturated Fatty Acids and a Characteristic Fatty Acid Composition in the Ovary Could Contribute to the High-Fertility Phenotype in Dummerstorf Superfertile Mice. Int J Mol Sci 2022; 23:ijms231810245. [PMID: 36142150 PMCID: PMC9499129 DOI: 10.3390/ijms231810245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/27/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
In recent decades, fertility traits in humans as well as in farm animals have decreased worldwide. As such, it is imperative to know more about the genetics and physiology of increased or high fertility. However, most of the current animal models with reproductive phenotypes describe lower fertility or even infertility (around 99%). The “Dummerstorf high-fertility lines” (FL1 and FL2) are two unique mouse lines selected for higher reproductive performances, more specifically for higher number of pups per litter. We recently described how those superfertile mice managed to increase their reproductive phenotype by doubling the ovulation rate and consequently the litter size compared to the unselected mice of the same founder population. FLs show an unusual estrous cycle length and atypical levels of hormones that link reproduction and metabolism, such as insulin in FL1 and leptin in FL2. Moreover, we described that their higher ovulation rate is mostly due to a higher quality of their oocytes rather than their sheer quantity, as they are characterized by a higher quantity of high-quality oocytes in antral follicles, but the quantity of follicles per ovary is not dissimilar compared to the control. In the present study, we aimed to analyze the lipid composition of the fertility lines from plasma to the gonads, as they can connect the higher reproductive performances with their metabolic atypicalities. As such, we analyzed the fat content of FLs and fatty acid composition in plasma, liver, fat, oocytes of different quality, and granulosa cells. We demonstrated that those mice show higher body weight and increased body fat content, but at the same time, they manage to decrease the lipid content in the ovarian fat compared to the abdominal fat, which could contribute to explaining their ovarian quality. In addition, we illustrate the differences in fatty acid composition in those tissues, especially a lower level of saturated fatty acids in plasma and a different lipid microenvironment of the ovary. Our ongoing and future research may be informative for farm animal biology as well as human reproductive medicine, mostly with cases that present characteristics of lower fertility that could be reversed following the way-of-managing of Dummerstorf high-fertility lines.
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Affiliation(s)
- Michela Calanni-Pileri
- Institute of Reproductive Biology, Research Institute for Farm Animal Biology (FBN), FBN Dummerstorf, Wilhelm-Stahl-Allee 2, 18196 Dummerstorf, Germany
| | - Joachim M. Weitzel
- Institute of Reproductive Biology, Research Institute for Farm Animal Biology (FBN), FBN Dummerstorf, Wilhelm-Stahl-Allee 2, 18196 Dummerstorf, Germany
- Correspondence: (J.M.W.); (M.M.); Tel.: +49-38208-68763 (J.M.W.); Fax: +49-38208-68752 (J.M.W.)
| | - Dirk Dannenberger
- Institute of Muscle Biology and Growth, Research Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany
| | - Martina Langhammer
- Institute of Genetics and Biometry, Service Group Lab Animal Facility, Research Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany
| | - Marten Michaelis
- Institute of Reproductive Biology, Research Institute for Farm Animal Biology (FBN), FBN Dummerstorf, Wilhelm-Stahl-Allee 2, 18196 Dummerstorf, Germany
- Correspondence: (J.M.W.); (M.M.); Tel.: +49-38208-68763 (J.M.W.); Fax: +49-38208-68752 (J.M.W.)
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Wang R, Feng Y, Chen J, Chen Y, Ma F. Association between polyunsaturated fatty acid intake and infertility among American women aged 20-44 years. Front Public Health 2022; 10:938343. [PMID: 36062133 PMCID: PMC9428268 DOI: 10.3389/fpubh.2022.938343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/28/2022] [Indexed: 01/25/2023] Open
Abstract
Background Infertility is a nationwide public health priority in the U.S. However, few studies have investigated the effects of dietary intake of polyunsaturated fatty acids (PUFAs) on female infertility. This study explored the association between PUFA intake and risk of infertility. Methods A total of 1,785 women aged 20-44 years from three National Health and Nutrition Examination Survey cycles (2013-2018) were included in this cross-sectional study. The intake of PUFAs was obtained from a 24-h dietary interview on two separate days with a 3-10-day interval, and nutrient residue models were used. Fertility status was assessed by positive response to two relative questions via a questionnaire. Logistic regression models were used and some covariates were adjusted. Results Among all the participants, 340 (19.05%) women suffered from infertility. The intake of docosahexaenoic acid (DHA) (OR = 0.998, 95% CI 0.998, 0.009) was slightly related to the risk of infertility. In contrast, women with higher α-linolenic acid (ALA) (OR = 1.416, 95% CI 1.138, 1.763) and linoleic acid (LA) intake (OR = 1.020, 95% CI 1.002, 1.038) presented with a relatively higher risk of primary infertility. Furthermore, in 20-34-year-old women, higher omega-6/omega-3 was significant associated with the risk of infertility (OR = 1.002, 95%CI 1.000, 1.005). Conclusions Our results suggest that PUFA intake is only slightly associated with infertility. The higher the DHA intake, the lower the risk of infertility regardless of age. In women with primary infertility, ALA and LA has negative effect.
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Affiliation(s)
- Ruohan Wang
- Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China,Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Ying Feng
- West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Jiahe Chen
- West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yingjiao Chen
- Office for West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China,Yingjiao Chen
| | - Fang Ma
- Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China,Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China,*Correspondence: Fang Ma
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Crohn's Disease and Female Infertility: Can Nutrition Play a Supporting Role? Nutrients 2022; 14:nu14122423. [PMID: 35745153 PMCID: PMC9230147 DOI: 10.3390/nu14122423] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 02/04/2023] Open
Abstract
Crohn's disease (CD) is a chronic inflammatory disease (IBD) that can affect the entire gastrointestinal tract in a non-continuous mode. CD is generally diagnosed most commonly between 15 and 35 years of age and may affect female fertility. The role of diet in supporting wellbeing outcome and reproductive potential in women is well-known; however, no effective efforts have been made to improve women's awareness in CD. Our review aims to describe the burden of CD on women's fertility, reporting the most relevant nutrients that support reproductive function to ensure women diagnosed with IBD an adequate health-related quality of life.
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Stanhiser J, Jukic AMZ, McConnaughey DR, Steiner AZ. Omega-3 fatty acid supplementation and fecundability. Hum Reprod 2022; 37:1037-1046. [PMID: 35147198 PMCID: PMC9308390 DOI: 10.1093/humrep/deac027] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/05/2022] [Indexed: 02/17/2024] Open
Abstract
STUDY QUESTION Is self-reported use of omega-3 fatty acid supplements associated with fecundability, the probability of natural conception, in a given menstrual cycle? SUMMARY ANSWER Prospectively recorded omega-3 supplement use was associated with an increased probability of conceiving. WHAT IS KNOWN ALREADY In infertile women, omega-3 fatty acid intake has been associated with increased probability of pregnancy following IVF. In natural fertility, studies are conflicting, and no study of natural fertility has evaluated omega-3 fatty acid supplementation and fecundity. STUDY DESIGN, SIZE, DURATION Secondary data analysis of 900 women contributing 2510 cycles in Time to Conceive (TTC), a prospective, time to pregnancy cohort study from 2008 to December 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS Women aged 30-44 years, trying to conceive <3 months, without history of infertility were followed using standardized pregnancy testing. While attempting to conceive, women daily recorded menstrual cycle events and supplement and medication intake using the Cerner Multum Drug Database. Supplements and vitamins containing omega-3 were identified. Omega-3 use, defined as use in at least 20% of days in a given menstrual cycle, in each pregnancy attempt cycle was determined. A discrete-time Cox proportional hazards model was used to calculate the fecundability ratio. MAIN RESULTS AND THE ROLE OF CHANCE Women taking omega-3 supplementation were more likely to be younger, thinner, nulligravid, white and to take vitamin D, prenatal and multivitamins compared to women not taking omega-3s. After adjusting for age, obesity, race, previous pregnancy, vitamin D and prenatal and multivitamin use, women taking omega-3 supplements had 1.51 (95% CI 1.12, 2.04) times the probability of conceiving compared to women not taking omega-3s. LIMITATIONS, REASONS FOR CAUTION Our study was not a randomized controlled trial. The women who used omega-3 supplements may represent a more health-conscious population. We sought to address this by adjusting for multiple factors in our model. Additionally, the omega-3 fatty acid supplements that TTC participants used included multiple types and brands with varying dosages of omega-3 fatty acids. Women reported the type of supplement they were taking but not the concentration of omega-3s in that supplement. It is therefore not possible to compare dosing or a dose-response relationship in our study. WIDER IMPLICATIONS OF THE FINDINGS Omega-3 supplementation may present a feasible and inexpensive modifiable factor to improve fertility. Randomized controlled trials are needed to further investigate the benefits of omega-3 supplementation for women trying to conceive naturally. STUDY FUNDING/COMPETING INTERESTS This study was supported by the Division of Reproductive Endocrinology and Infertility at the University of North Carolina at Chapel Hill, the NIH/NICHD (R21 HD060229-01 and R01 HD067683-01), and in part by the Intramural Research Program of the National Institute of Environmental Health Sciences (Z01ES103333). The authors declare that there is no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- J Stanhiser
- Reproductive Endocrinology and Infertility, University of North Carolina Chapel Hill, NC, USA
- Reproductive Partners—San Diego, La Jolla, CA, USA
- Department of Obstetrics and Gynecology, University of California San Diego, La Jolla, CA, USA
| | - A M Z Jukic
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | | | - A Z Steiner
- Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA
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Women's and men's intake of omega-3 fatty acids and their food sources and assisted reproductive technology outcomes. Am J Obstet Gynecol 2022; 227:246.e1-246.e11. [PMID: 35364062 PMCID: PMC9308672 DOI: 10.1016/j.ajog.2022.03.053] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/12/2022] [Accepted: 03/24/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Long-chain omega-3 fatty acids and their food sources have garnered interest as a potential nutrient with wide-range health benefits, including fertility. OBJECTIVE This study aimed to investigate the association of women's and men's intake of omega-3 fatty acids and omega-3 rich-foods with semen quality and outcomes of infertility treatment with assisted reproductive technologies. STUDY DESIGN Couples presenting to the Massachusetts General Hospital were invited to enroll in a prospective cohort study (2007-2020). Male and female diets were assessed using a validated 131-item food frequency questionnaire. The primary outcomes were implantation, clinical pregnancy, and live birth probabilities. The secondary outcomes included total and clinical pregnancy loss and conventional semen parameters, for males only. We estimated the relationship between intakes of omega-3 fatty acids, nuts, and fish and the probability (95% confidence interval) of study outcomes using generalized linear mixed models to account for repeated treatment cycles per participant while simultaneously adjusting for age, body mass index, smoking status, education, dietary patterns, total energy intake, and male partner diet. RESULTS A total of 229 couples and 410 assisted reproductive technology cycles were analyzed for primary and secondary outcomes. Of note, 343 men contributing 896 semen samples were included in analyses for semen quality measures. Women's docosahexaenoic acid + eicosapentaenoic acid intake was positively associated with live birth. The multivariable-adjusted probabilities of live birth for women in the bottom and top quartiles of eicosapentaenoic acid + docosahexaenoic acid intake were 0.36 (95% confidence interval, 0.26-0.48) and 0.54 (95% confidence interval, 0.42-0.66) (P trend=.02). Eicosapentaenoic acid + docosahexaenoic acid intake was inversely related to the risk of pregnancy loss, which was 0.53 among women in the lowest quartile of eicosapentaenoic acid + docosahexaenoic acid intake and 0.05 among women in the highest quartile (P trend=.01). Men's intake of total omega-3 fatty acids was positively related to sperm count, concentration, and motility, but unrelated to any assisted reproductive technology outcomes. Similar associations were observed when evaluating the intake of primary food sources of these fatty acids. CONCLUSION Women's consumption of omega-3 fatty acids and omega-3-rich foods may improve the probability of conception by decreasing the risk of pregnancy loss. In addition, men's intake of omega-3 fatty acids may influence semen quality.
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Skoracka K, Ratajczak AE, Rychter AM, Dobrowolska A, Krela-Kaźmierczak I. Female Fertility and the Nutritional Approach: The Most Essential Aspects. Adv Nutr 2021; 12:2372-2386. [PMID: 34139003 PMCID: PMC8634384 DOI: 10.1093/advances/nmab068] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/19/2021] [Accepted: 05/05/2021] [Indexed: 12/17/2022] Open
Abstract
Infertility is an increasing problem that affects couples attempting pregnancy. A growing body of evidence points to a link between diet and female fertility. In fact, data show that a diet high in trans fats, refined carbohydrates, and added sugars can negatively affect fertility. Conversely, a diet based on the Mediterranean dietary patterns, i.e., rich in dietary fiber, omega-3 (ɷ-3) fatty acids, plant-based protein, and vitamins and minerals, has a positive impact on female fertility. An unhealthy diet can disrupt microbiota composition, and it is worth investigating whether the composition of the gut microbiota correlates with the frequency of infertility. There is a lack of evidence to exclude gluten from the diet of every woman trying to become pregnant in the absence of celiac disease. Furthermore, there are no data concerning adverse effects of alcohol on female fertility, and caffeine consumption in the recommended amounts also does not seem to affect fertility. On the other hand, phytoestrogens presumably have a positive influence on female fertility. Nevertheless, there are many unanswered questions with regard to supplementation in order to enhance fertility. It has been established that women of childbearing age should supplement folic acid. Moreover, most people experience vitamin D and iodine deficiency; thus, it is vital to control their blood concentrations and consider supplementation if necessary. Therefore, since diet and lifestyle seem to be significant factors influencing fertility, it is valid to expand knowledge in this area.
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Affiliation(s)
- Kinga Skoracka
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
| | - Alicja Ewa Ratajczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
| | - Anna Maria Rychter
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
| | - Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
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