Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility

Karayiannis, Dimitrios; Kontogianni, Meropi D.; Mendorou, Christina; Mastrominas, Minas; Yiannakouris, Nikos

doi:10.1093/humrep/dey003

Cited by 118 publications

(140 citation statements)

References 35 publications

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“…This is reflected in the questions reported by patients in our study, with a special interest on the impact of diet on infertility and its treatment (ranked third). Although recent published studies about diet and fertility (Chiu, Chavarro et al 2018;Nassan, Chavarro et al 2018) and different diet patterns and IVF outcomes indicate a keen interest in this topic (Karayiannis, Kontogianni et al 2018;Sugawa, Okubo et al 2018), in our survey the relative importance of diet appears unexpectedly high. This could be due to the relatively low difficulty in modifying this factor, for example by introducing food supplements or so called "superfoods", in comparison to other lifestyle changes more difficult to maintain, such as changing unhealthy habits or introducing regular physical activity in one's routine.…”

Section: Discussionmentioning

confidence: 60%

Identification of Research Priorities in Infertility and Assisted Reproduction: An International, Multicenter Study in Partnership with Patients

García¹,

Lidenberg²,

Hagström-Toft³

et al. 2019

Preprint

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STUDY QUESTION: Which are the main research interests among patients of assisted reproductive technologies (ART)?SUMMARY ANSWER: Patients identified as research priorities that deserve further investigation: success rates and risks of ART, side-effects of treatments, resources to cope with infertility, effectiveness of alternative therapies, lifestyle habits to protect fertility, oocyte quality and ovarian reserve, and causes of genetic or hereditary infertility.WHAT IS KNOWN ALREADY: The involvement of patients and caregivers in setting research agendas in medicine has gathered significant momentum in the last decade. Patients’ involvement in setting research priorities offers several benefits: improved patient knowledge and awareness of their condition; greater understanding of the medical professionals of the impact of the condition on patients’ quality of life; reduced costs associated with redundant research activities. This is may be also applicable to research in infertility and ART, where patients’ interests have never been explored before.STUDY DESIGN, SIZE, DURATION: This is a cross-sectional study that consists of an anonymous online survey, which was sent up to three times to 2112 patients from 11 fertility centers in 5 countries between January-December 2018. The study design was based on the James Lind Alliance priority setting partnership model, which comprises the identification of patients groups, the exploration of the research agenda, the analysis of collected data and identification of priorities.PARTICIPANTS/MATERIALS, SETTING, METHODS: Overall, 2112 patients were contacted, and 945 surveys were answered (RR: 44.7%). Patients were asked to identify research questions relevant to them in the areas of infertility causes and prevention, fertility treatments (medication and ART), and the emotional aspects of infertility. Answers were categorized in topics and ranked by frequency. A long list of the top-30 research topics was extracted from the aggregate results, from which, a short list of the top-10 research topics was created. At the end, 10 research questions related to each of the 10 research topics were constructed, based on the answers given by patients.MAIN RESULTS AND THE ROLE OF CHANCE: Female (845, 89.4%) and male (100, 10.6%) patients were included. The mean age of patients was 37.8 (SD 1.74). Most of the patients did not have children at the time of the survey (523, 59%), while 51 (5.7%) were pregnant. Sixty (6.3%) patients did not start treatment, 579 (61.3%) were performing a treatment with their own gametes and 304 (32.2%) were treated through gamete donation. Patients were mainly interested in the effectiveness of ART -especially per clinical profile-, side effects of drugs, protection of fertility and prevention of infertility –especially through diet and exercise-, and psychological aspects of the infertility journey. The top-10 research questions (and weight) obtained were: 1) What are the side-effects of ART treatments? (41.6%); 2) What are the most effective methods to cope with infertility from the psychological point of view? (37.2%); 3) What effects could diet have on fertility? (25.9%); 4) What are ART success rates per clinical profile? (25.9%); 5) Are there habits and lifestyle factors that could prevent infertility? (20.0%); 6) What are the long-term risks associated to ART? (18.5%); 7) Are alternative therapies such as acupuncture, yoga, and meditation effective to treat/prevent infertility? (18.5%); 8) What is the impact of exercise on fertility? (15.4%); 9) How does oocytes quantity and quality affect fertility? (9.5%); 10) What are the genetic patterns or hereditary conditions causing/related to infertility? (9.5%).LIMITATIONS, REASONS FOR CAUTION: Although all respondents had attended a fertility center, not all of them were diagnosed as infertile (i.e. single women) and had started treatment at the time of response, while a few were pregnant; their priorities for research might have been influenced by their infertility journey. Also, all participants attended private fertility centers: areas of interest may be different in public settings.WIDER IMPLICATIONS FOR THE FINDINGS: Researchers and clinicians should keep in mind that, in addition to improvement of treatments’ success rates and side-effects, patients greatly value research on causes, prevention and emotional aspects of infertility. As their views might differ from those of medical professionals, patients’ voices should be incorporated in setting infertility research priorities.

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Section: Discussionmentioning

confidence: 60%

Identification of Research Priorities in Infertility and Assisted Reproduction: An International, Multicenter Study in Partnership with Patients

García¹,

Lidenberg²,

Hagström-Toft³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…The effectiveness of such an intervention was discredited by Bhattacharya et al 15 who reported that a total of 33 ICSI cycles would have to be carried out to prevent one case of total fertilisation failure. Considering the financial burden of some IVF adjuncts14 and the physiological risks of others,3 it is difficult to justify implementing them in clinical practice to patient advantage, while something as simple as adherence to a healthy Mediterranean diet might have the potential to double their chances of IVF success 16. Thus, if the main aim of treatment is to truly benefit the patient, then clinicians should prioritise what is most impactful and beneficial, even if that may be dietary advice and not a sophisticated IVF tool.…”

Section: Beneficencementioning

confidence: 99%

Is it ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it?

Zemyarska

2019

J Med Ethics

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In vitro fertilisation (IVF) ‘add-ons’ are therapeutic or diagnostic tools developed in an endeavour to improve the success rate of infertility treatment. However, there is no conclusive evidence that these interventions are a beneficial or effective adjunct of assisted reproductive technologies. Additionally, IVF add-ons are often implemented in clinical practice before their safety can be thoroughly ascertained. Yet, patients continue to request and pay large sums for such additional IVF tools. Hence, this essay set out to examine if it is ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it. In order to determine what is ethical—namely, morally good and righteous, the question was considered in relation to three key values of medical ethics—autonomy, beneficence and non-maleficence. It was determined that providing IVF add-ons might be morally acceptable in specific circumstances, if true informed consent can be given, there is a potential of cost-effective physiological or psychological benefit and the risk of harm is minimal, particularly with regard to the unborn child.

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“…Confirmation of the relationship between diet and reproductive fitness also comes from studies reporting a positive effect of the Mediterranean diet (MedDiet) on the semen quality of male partners of couples attempting fertility treatment, and on in vitro fertilization (IVF) success rates among non-obese women [5,6].…”

Section: Dietary Habits and Human Reproductionmentioning

confidence: 99%

Genes and Diet in the Prevention of Chronic Diseases in Future Generations

Franzago

Santurbano²,

Vitacolonna

et al. 2020

IJMS

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Nutrition is a modifiable key factor that is able to interact with both the genome and epigenome to influence human health and fertility. In particular, specific genetic variants can influence the response to dietary components and nutrient requirements, and conversely, the diet itself is able to modulate gene expression. In this context and the era of precision medicine, nutrigenetic and nutrigenomic studies offer significant opportunities to improve the prevention of metabolic disturbances, such as Type 2 diabetes, gestational diabetes, hypertension, and cardiovascular diseases, even with transgenerational effects. The present review takes into account the interactions between diet, genes and human health, and provides an overview of the role of nutrigenetics, nutrigenomics and epigenetics in the prevention of non-communicable diseases. Moreover, we focus our attention on the mechanism of intergenerational or transgenerational transmission of the susceptibility to metabolic disturbances, and underline that the reversibility of epigenetic modifications through dietary intervention could counteract perturbations induced by lifestyle and environmental factors.

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Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility

Abstract: NCT03050944.

Cited by 118 publications

References 35 publications

Identification of Research Priorities in Infertility and Assisted Reproduction: An International, Multicenter Study in Partnership with Patients

Identification of Research Priorities in Infertility and Assisted Reproduction: An International, Multicenter Study in Partnership with Patients

Is it ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it?

Genes and Diet in the Prevention of Chronic Diseases in Future Generations

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