Summary:
Infertility, defined as the inability to achieve pregnancy after 12 months of regular unprotected intercourse, affects millions of couples worldwide and can significantly impact mental health, quality of life, and relationships. Treatments such as in-vitro fertilization (IVF) and assisted reproductive technologies (ART) are costly, carry variable success rates, and may produce side effects. While biological factors contribute to infertility, lifestyle factors including diet, physical activity, body weight, and substance use, are increasingly recognized as important contributors. Diets high in processed foods, sugars, refined carbohydrates, and unhealthy fats are linked to poorer fertility outcomes, whereas anti-inflammatory and Mediterranean-style diets rich in fruits, vegetables, healthy fats, nuts, and fish may improve reproductive outcomes. Inflammation is a key mechanism thought to link diet and fertility. This study used the Dietary Guideline Index and Mediterranean Diet score to examine the relationship between diet and fertility. Data from 5,489 women aged 31-36 years in an Australian study on Women’s Health were analysed. Higher dietary inflammatory potential was associated with increased odds of fertility problems. Conversely, higher overall diet quality was associated with lower odds of fertility problems. Further analysis showed adherence to a Mediterranean-style dietary pattern was similarly associated with reduced odds of fertility problems. This study suggests that overall healthy eating, whether measured by low dietary inflammation, adherence to Mediterranean-style patterns, or national dietary guidelines, is linked with better female fertility. These findings indicate that general guideline-based healthy diets may support reproductive outcomes and provide a flexible alternative to prescriptive dietary interventions.
Abstract:
Introduction: Diet may impact female fertility via inflammatory pathways, but the value of specific anti-inflammatory dietary indices compared with general healthy eating guidelines is unclear. We examined associations between different measures of dietary inflammation and diet quality with female infertility in a large population-based study. Methods: Data for 5,489 participants from the Australian Longitudinal Study on Women’s Health were analysed (1973–1978 cohort assessed in 2009, at 31–36 years old; n = 1,289 fertility problems, n = 4,200 no fertility problems). Dietary inflammatory potential was assessed using the energy-adjusted dietary inflammatory index (E-DII™). Diet quality was examined using the dietary guideline index (DGI) and principal component analysis (PCA) for a posteriori patterns. Cross-sectional associations between these indices and self-reported fertility problems were assessed using logistic regression, adjusted for relevant covariates. Results: A diet with greater inflammatory potential was associated with higher odds of self-reported fertility problems (adjusted odds ratio (aOR) per 1-unit increase in E-DII: 1.13, 95% confidence interval (CI): 1.06, 1.19), with significant differences between the highest and lowest E-DII quartiles (aOR: 1.53, 95%CI: 1.23, 1.90). Higher dietary quality was associated with lower odds of self-reported fertility problems (aOR per 1-unit increase in DGI: 0.99, 95% CI: 0.99, 0.99), including when comparing highest and lowest DGI quartiles (aOR: 0.76, 95% CI: 0.61, 0.95). In PCA, consumption of a Mediterranean-style dietary pattern was associated with lower odds of self-reported fertility problems (aOR: 0.92, 95% CI: 0.88, 0.97), including when comparing highest and lowest quartiles (aOR: 0.70, 95% CI: 0.57, 0.85). Discussion: Our data suggest that following a generally healthy diet is associated with improved female fertility, whether by adherence to low inflammatory potential diets, Mediterranean-style dietary patterns or national dietary guidelines. These findings suggest that general, guideline-based healthy eating can support female fertility and may offer a flexible alternative to more prescriptive dietary approaches.
Article Publication Date: 29/12/2023
DOI: 10.3389/fnut.2025.1682549
