Anti-Inflammatory Diets in Fertility: An Evidence Review

Abstract

Infertility is a global health concern affecting 48 million couples and 186 million individuals worldwide. Infertility creates a significant economic and social burden for couples who wish to conceive and has been associated with suboptimal lifestyle factors, including poor diet and physical inactivity. Modifying preconception nutrition to better adhere with Food-Based Dietary Guidelines (FBDGs) is a non-invasive and potentially effective means for improving fertility outcomes. While several dietary patterns have been associated with fertility outcomes, the mechanistic links between diet and infertility remain unclear. A key mechanism outlined in the literature relates to the adverse effects of inflammation on fertility, potentially contributing to irregular menstrual cyclicity, implantation failure, and other negative reproductive sequelae. Therefore, dietary interventions which act to reduce inflammation may improve fertility outcomes. This review consistently shows that adherence to anti-inflammatory diets such as the Mediterranean diet (specifically, increased intake of monounsaturated and n-3 polyunsaturated fatty acids, flavonoids, and reduced intake of red and processed meat) improves fertility, assisted reproductive technology (ART) success, and sperm quality in men. Therefore, integration of anti-inflammatory dietary patterns as low-risk adjunctive fertility treatments may improve fertility partially or fully and reduce the need for prolonged or intensive pharmacological or surgical interventions.

Association between dietary inflammatory index and self‐reported female infertility from the National Health and Nutrition Examination Survey 2013–2020

“…Inflammation may affect the ovary, uterus, cervix and placenta, leading to irregular menstrual cycles and failure of implantation. 41,42 Increased infiltration of macrophages into the ovary and overexpressed proinflammatory cytokines is associated with abnormal ovarian function. Elevated concentrations of proinflammatory cytokines in the peritoneal fluid create a pro-inflammatory environment in endometriosis, which could interfere with granulosa cell proliferation, oocyte development, oocyte-sperm interactions, embryo development and implantation, thereby impairing fertility.…”

Differences in histomorphology and expression of key lipid regulated genes of four adipose tissues from Tibetan pigs

“…Monounsaturated fatty acids are beneficial to human health ( Shang et al, 2019 ). Increased monounsaturated intake improves sperm quality and fertility and assists reproductive technology success in men ( Alesi et al, 2022 ). Considering the beneficial fat composition of Tibetan pigs, studying the mechanism of fat synthesis in Tibetan pig adipose tissue is of great interest.…”

Diet and Fertility Status: Relevance in Health and Disease

“…Although our currently fragmentary knowledge limits the full comprehension of the underlying mechanisms, current evidence suggests that the negative impact of HFDs on fertility may be due to a direct action on reproductive somatic and germinal cells and/or to an indirect effect mediated by endocrine, metabolic, and immune signaling [ 9 ]. The burden of chronic inflammatory diseases, including Crohn’s disease, negatively impact on female reproduction, potentially contributing to irregular menstrual cyclicity, implantation failure, and other negative fertility outcomes [ 10 , 11 ].…”

“…Dietary interventions might represent the most promising and invaluable strategy to limit or prevent metabolic and inflammatory complications associated with, or consequent to, subfertility [ 10 , 11 , 20 ]. Given the adverse effects of inflammation on reproductive processes, anti-inflammatory diets rich in monounsaturated (MUFA) and ω-3 polyunsaturated (PUFA) fatty acids and flavonoids, and poor in red and processed meat, such as the Mediterranean diet, may improve fertility and ART success in women [ 10 , 11 ].…”

“…Dietary interventions might represent the most promising and invaluable strategy to limit or prevent metabolic and inflammatory complications associated with, or consequent to, subfertility [ 10 , 11 , 20 ]. Given the adverse effects of inflammation on reproductive processes, anti-inflammatory diets rich in monounsaturated (MUFA) and ω-3 polyunsaturated (PUFA) fatty acids and flavonoids, and poor in red and processed meat, such as the Mediterranean diet, may improve fertility and ART success in women [ 10 , 11 ]. In insulin-resistant PCOS (polycystic ovary syndrome) adolescents with obesity, lifestyle changes and appropriate early dietary interventions aiming to reduce insulin resistance (i.e., diets rich in carbohydrate with low glycemic index, plant protein, MUFA and PUFA, folic acid, vitamin D, antioxidants, and iron) are recommended approaches to restore ovulation and to protect fertility [ 20 ].…”