TheEffectofDietaryPatternsonClinicalPregnancy andLiveBirthOutcomesinMenandWomen ReceivingAssistedReproductiveTechnologies: ASystematicReviewandMeta-Analysis

Abstract

Thenutritionalstatusofreproductive-agedcouplescanhaveasignificantimpactonfertilitystatus,buttheeffectofdietarypatternsonpregnancy outcomesinpeopleusingassistedreproductivetechnologies(ARTs)iscurrentlyunknown.Thisreviewaimedtosynthesizethepublishedresearch investigating the relation between preconception dietary patterns and clinical pregnancy or live birth in men and women of reproductive age undergoing ART. Six electronic databases were systematically searched for original research published between January 1978 and June 2021. Original research reporting on the effect of predefined dietary patterns on either clinical pregnancy and/or live birth rates following in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in men and women aged 18–49 y was eligible for inclusion. Studies were assessed for risk of bias according to the Cochrane guidelines. Included studies underwent qualitative and quantitative synthesis using random-effects model meta-analyses.Thirteenstudies(12cohortstudies,1randomizedcontrolledtrial)reportingon3638participants(93%female)wereincludedinthe review. All studies had a moderate–high risk of bias. In individual studies, maternal adherence to 4 dietary patterns [Mediterranean diet (RR: 1.22; 95% CI: 1.05, 1.43), novel profertility diet (OR: 1.43; 95% CI: 1.19, 1.72), Iranian traditional medicine diet (OR: 3.9; 95% CI: 1.2, 12.8), Dutch national dietary recommendations diet (OR: 1.65; 95% CI: 1.08, 2.52)] was associated with increased likelihood of achieving a clinical pregnancy, while 2 dietarypatterns[novelprofertilitydiet(OR:1.53;95%CI:1.26,1.85),Mediterraneandiet(RR:1.25;95%CI:1.07,1.45)]wereassociatedwithincreased probability of live birth. Meta-analyses showed an association between adherence to the Mediterranean dietary pattern and live birth across 2 studies (OR: 1.98; 95% CI: 1.17, 3.35; I2=29%, n=355), but no association with clinical pregnancy. As the relation between dietary patterns and ART outcomes is currently inconsistent, higher-quality nutrition research is required to further explore this emerging field of interest (PROSPERO registration