Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
Present address: Department of Obstetrics and Gynecology, Atrium Health, Charlotte, NC, 28204, USA.
Reprod Biol Endocrinol. 2022 Feb 19;20(1):33. doi: 10.1186/s12958-022-00907-4.
Growing evidence suggests that adherence to certain dietary patterns is associated with improved fecundity and reproductive outcomes in the general population and infertile couples assisted reproductive treatments. The objective of this study was to assess if dietary patterns are associated with ovarian reserve in reproductive age women without a history of infertility.
This was a cross-sectional study of 185 women in the Lifestyle and Ovarian Reserve (LORe) cohort. Women aged 18-44 without a history of infertility were recruited from the local community at an academic medical center. Subjects completed validated food frequency and physical activity questionnaires to assess patterns over the year prior to presentation. Dietary patterns including a Western (including meat, refined carbohydrates, high-calorie drinks), prudent (including fruits, vegetables, olive oil and nuts), fertility (lower intake of trans fat with higher intake of monounsaturated fatty acids, increased intake of plant based protein, high-fat dairy, lower glycemic load carbohydrates and supplemental iron) and profertility diet (PFD) (characterize by whole grains, soy and seafood, low pesticide residue produce, supplemental folic acid, B12 and vitamin D) were identified through principal component analysis. Main outcome measures were serum antimullerian hormone concentration (AMH) (ng/mL) and antral follicle count (AFC) obtained by transvaginal ultrasound.
After stratifying by BMI, adjusting for age, smoking and physical activity, dietary patterns were not associated with ovarian reserve in normal weight women. Increased adherence to a profertility diet in overweight and obese women (BMI ≥ 25 kg/m) was associated with a significantly higher AMH. Women in the third and fourth quartiles of PFD adherence had a mean AMH concentration of 1.45 ng/mL (95%CI 0.33-2.56, p = 0.01) and 1.67 ng/mL (95%CI 0.60-2.74, p = 0.003) higher than women in the lowest quartile respectively. The highest adherence to PFD was also associated with a higher AFC in women with a BMI ≥ 25 kg/m (β = 7.8, 95%CI 0.003-15.34, p < 0.05). Other common dietary patterns were not significantly associated with ovarian reserve.
Increased adherence to a profertility diet is associated with improved markers of ovarian reserve in overweight and obese women. These findings provide novel insight on potential modifiable lifestyle factors associated with ovarian reserve.
越来越多的证据表明，某些饮食模式与普通人群和接受辅助生殖治疗的不孕夫妇的生育能力和生殖结局的改善有关。本研究的目的是评估在没有不孕史的生殖年龄妇女中，饮食模式是否与卵巢储备有关。
这是一项在生活方式和卵巢储备（LORe）队列中进行的 185 名妇女的横断面研究。在学术医疗中心，从当地社区招募了年龄在 18-44 岁之间、无不孕史的妇女。受试者完成了经过验证的食物频率和体力活动问卷，以评估在就诊前一年的饮食模式。饮食模式包括西方模式（包括肉、精制碳水化合物、高热量饮料）、谨慎模式（包括水果、蔬菜、橄榄油和坚果）、生育模式（反式脂肪摄入较低，单不饱和脂肪酸摄入较高，植物性蛋白质、高脂肪乳制品、低血糖负荷碳水化合物和补充铁摄入增加）和促生育饮食（PFD）（以全谷物、大豆和海鲜为特征，农药残留低的农产品，补充叶酸、B12 和维生素 D）通过主成分分析确定。主要观察指标是血清抗苗勒管激素浓度（AMH）（ng/mL）和经阴道超声获得的窦卵泡计数（AFC）。
在按 BMI 分层后，调整年龄、吸烟和体力活动因素，正常体重妇女的饮食模式与卵巢储备无关。超重和肥胖妇女（BMI≥25kg/m）中促生育饮食的依从性增加与 AMH 显著升高有关。PFD 依从性第三和第四四分位的妇女的平均 AMH 浓度分别为 1.45ng/mL（95%CI 0.33-2.56，p=0.01）和 1.67ng/mL（95%CI 0.60-2.74，p=0.003）高于最低四分位的妇女。BMI≥25kg/m 的妇女中，PFD 最高的依从性也与 AFC 升高有关（β=7.8，95%CI 0.003-15.34，p<0.05）。其他常见的饮食模式与卵巢储备无显著相关性。
促生育饮食的依从性增加与超重和肥胖妇女卵巢储备的改善标志物有关。这些发现为与卵巢储备相关的潜在可改变的生活方式因素提供了新的见解。
