Reproductive Endocrinology and Infertility, University of North Carolina Chapel Hill, NC, USA.
Reproductive Partners-San Diego, La Jolla, CA, USA.
Hum Reprod. 2022 May 3;37(5):1037-1046. doi: 10.1093/humrep/deac027.
Is self-reported use of omega-3 fatty acid supplements associated with fecundability, the probability of natural conception, in a given menstrual cycle?
Prospectively recorded omega-3 supplement use was associated with an increased probability of conceiving.
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.
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.
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.
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自我报告的ω-3 脂肪酸补充剂的使用与特定月经周期内的生育能力（自然受孕的概率）相关吗？
前瞻性记录的 ω-3 补充剂使用与受孕概率增加相关。
在不孕女性中，ω-3 脂肪酸的摄入与 IVF 后妊娠概率增加有关。在自然生育力方面，研究结果存在冲突，且尚无研究评估过 ω-3 脂肪酸补充剂和生育能力。
研究设计、规模、持续时间：这是对 900 名女性的二次数据分析，这些女性在 2008 年至 2015 年 12 月的前瞻性、妊娠时间队列研究“Time to Conceive (TTC)”中贡献了 2510 个周期。
参与者/材料、设置、方法：年龄在 30-44 岁、尝试怀孕<3 个月且无不孕史的女性，使用标准化妊娠检测进行随访。在尝试怀孕期间，女性每天使用 Cerner Multum 药物数据库记录月经周期事件和补充剂及药物摄入情况。确定了含有 ω-3 的补充剂和维生素。在每个妊娠尝试周期中，确定ω-3 使用（定义为在特定月经周期中至少使用 20%的天数）。使用离散时间 Cox 比例风险模型计算生育力比值。
与不服用 ω-3 的女性相比，服用 ω-3 补充剂的女性更年轻、更瘦、初产妇、白人，并且更有可能服用维生素 D、产前和多种维生素。在调整年龄、肥胖、种族、既往妊娠、维生素 D 以及产前和多种维生素使用等因素后，与不服用 ω-3 的女性相比，服用 ω-3 补充剂的女性受孕的概率增加了 1.51 倍（95%CI 1.12，2.04）。
局限性、谨慎的原因：我们的研究不是随机对照试验。服用 ω-3 补充剂的女性可能代表了更注重健康的人群。为了解决这个问题，我们在模型中调整了多个因素。此外，TTC 参与者使用的 ω-3 脂肪酸补充剂包括多种类型和品牌，ω-3 脂肪酸的剂量不同。女性报告了她们正在服用的补充剂类型，但没有报告该补充剂中 ω-3 脂肪酸的浓度。因此，我们的研究无法比较剂量或剂量反应关系。
ω-3 补充剂可能是一种可行且经济实惠的可改变因素，可提高生育能力。需要进行随机对照试验，以进一步研究ω-3 补充剂对自然尝试怀孕的女性的益处。
研究资助/利益冲突：本研究由北卡罗来纳大学教堂山分校生殖内分泌和不孕不育科、美国国立卫生研究院国家儿童健康与人类发育研究所（R21 HD060229-01 和 R01 HD067683-01）以及国家环境卫生科学研究所内部研究计划（Z01ES103333）部分支持。作者声明没有利益冲突。
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