Preconception Dietary Patterns and Associations With IVF Outcomes: An Ongoing Prospective Cohort Study

Abstract

There is a lack of research on preconception diet and reproductive outcomes conducted in the Chinese population using individual assessment. Between April 2017 and April 2020, 2,796 couples undergoing in vitro fertilization treatment were recruited in this ongoing prospective cohort, and 1,500 eligible couples were included in the final analysis. A validated semi-quantitative food frequency questionnaire was used to evaluate the maternal preconception diet. Other lifestyle factors, including smoking status, psycho-mental status, sleep quality, and physical activity, were also assessed. Five dietary patterns were identified using principal component analysis, namely “Fruits-Vegetables-Dairy-Eggs,” “Fish/Seafood-Animal blood,” “Tubers-Beans-Cereals,” “Puffed food-Candy-Bakery,” and “Dried Fruits-Organs-Rice.” After adjusting for multiple confounders, we detected that the women who are more inclined to the “Fruits-Vegetables-Dairy-Eggs” pattern and less adherent to the “Tubers-Beans-Cereals” were more likely to achieve normally fertilized eggs and transferable embryos. Regarding pregnancy outcomes, we observed that a lower “Puffed food-Candy-Bakery” score and a higher “Dried fruits-Organs-Rice” score were related to a higher likelihood to achieve biochemical pregnancy. In terms of pregnancy complications, an inverse association between “Fish/Seafood-Animal blood” and hypertensive disorders was observed. We further clustered the dietary patterns based on the proportion of food groups consumed and found that dairy intake was beneficial to embryo quality, while frequent rice consumption was associated with a higher risk of macrosomia. Notably, in the stratified analysis, we observed that the positive relationship between the “Fruit-Dairy-Vegetables-Eggs” score and normal fertilization and the inverse association of the “Fish/Seafood-Animal blood” score with hypertensive disorders during pregnancy were exhibited only among women with body mass index ≥25 kg/m2. In conclusion, pre-treatment diets might be an important target for intervention to achieve a better reproductive outcome.

Declined Live Birth Rate from In Vitro Fertilization Fresh Cycles Performed during Chinese New Year Holiday Season

“…Fatty meals can have acute adverse effects on oocyte mitochondria 15 , and high-fat diets are detrimental to male fertility 16 . A prospective study concluded that ve Chinese food patterns, and the western food style "Puffed food-Candy-Bakery" were related to a lower likelihood of achieving biochemical pregnancy 17 . A primate study involving a short-term high-fat western-style diet before IVF treatment demonstrated that high-fat diet reduces blastocyst numbers, dysregulates RNA binding and mitochondrial function 18 .…”

Declined Live Birth Rate from in vitro Fertilization Fresh Cycles Performed During Chinese New Year Holiday Season

“…For example, a prospective study found that certain Chinese food patterns and a Western food style involving “Puffed food-Candy-Bakery” were associated with a lower likelihood of achieving biochemical pregnancy. 17 Additionally, a primate study showed that a short-term high-fat Western-style diet before IVF treatment led to a reduction in blastocyst numbers and dysregulation of RNA binding and mitochondrial function. 18 Consumption of beverages with high sugar content has also been linked to a lower number of total, mature, and fertilized oocytes, as well as a lower number of top-quality embryos after ovarian stimulation.…”

Effect of Paternal Body Mass Index on In Vitro Fertilization and Neonatal Outcomes among Oligozoospermia and Asthenospermia Patients

“…As described in previous studies [ 12 ], the IVF procedure generally includes four stages: controlled ovarian stimulation (COS), oocyte pick-up (OPU), ET, and pregnancy test ( Fig. 1 ).…”

“…After 24 hours, the number of oocytes with two pronuclei was determined by embryologists. The cleavage embryo quality was assessed using the Peter system: (1) embryos with more than three cells and anucleate fragmentation <50% were identified as having transferable quality; (2) embryos with 6–10 cells and anucleate fragmentation <20% were considered as high-quality embryos [ 12 ]. Blastocyst formation rate was defined as the number of blastocysts formed divided by the total number of embryos continuously cultured to the blastocyst stage.…”

“…Modified Poisson regression models were used to assess the associations of male BMI with fertilization, in vitro embryonic development (day 3 transferable embryos, day 3 highquality embryos, blastocyst formation, high-quality blastocyst), pregnancy outcomes (embryo implantation, biochemical and clinical pregnancy, and live birth) [ 13 ]. Moreover, logistic regression models were performed to investigate the associations of paternal BMI with pregnancy loss and neonatal outcomes, including preterm, low birth weight, macrosomia, very SGA, SGA, LGA, and very LGA [ 12 ]. All the covariates with a univariate association of p<0.2 were adjusted in the final models ( Supplement Table 1 , 2 , 3 ).…”