Title: Can a Plant Based Diet improve female fertility?
While reviewing the literature on dietary interventions for PCOS, I came across an article about protein intake and female infertility. Researchers followed over 18,000 women from the Nurses' Health Study II who were seeking pregnancy, focusing on the women who experienced infertility (1). Infertility was defined as actively trying to become pregnant for 1 year without being successful (1).
They found that replacing just 5% of calories from animal protein with plant protein lowered the risk of infertility by 50% in women older than age 32 (1). "Adding one serving of meat (red meats, chicken, turkey, processed meats and fish) per day, while holding calories, constant was associated with a 32% greater risk of ovulatory infertility (p = 0.01)" (1). Okay, but that was a prospective study, not an interventional study.
Another study of Spanish University students found a correlation between dietary pattern and fertility rates (4). The students with the most Mediterranean style dietary patterns experienced less infertility when compared to students following a "Western Type" dietary pattern similar to the Standard American Diet (SAD)(4).
The same was found in women attending an In-Vitro Fertilization (IVF) clinic in Greece, but only for women less than 35 years old (5).
The only interventional study that I could find involved swapping meat (red, white and processed meats) for fish in women undergoing fertility treatment. The researchers found that "increasing fish intake by 2 servings per week", in place of meat, lead to a higher probability of having a live birth (2).
A more recent article from 2021 summarized the available literature, drawing the conclusion that a Mediterranean style dietary pattern does appear to be associated with improvements in fertility (3). But again, the studies that we have on this are not robust.
As always, what do I think? Infertility is stressful enough. I'm not here to tell anyone what they should or shouldn't be doing. We don't have enough interventional trials to truly draw a conclusion on cause and effect. While studies suggest that women following a more plant predominant eating pattern and swapping meat for fish could improve fertility, we don't know for sure. That said, a minimally processed whole foods plant based dietary pattern can optimize our health and weight pre-conception, and it can improve the metabolic complications associated with PCOS (a common cause of infertility). If you are looking to transition to a whole foods plant based diet for 12 weeks to see if this makes a difference, then reach out to me and let me know. I can't promise that this will make a difference, but I am here to support you if this is something that you would like to try.
References
Protein intake and ovulatory infertility. Chavarro, et al. American Journal of Obstetrics and Gynecology. (2008) https://doi.org/10.1016%2Fj.ajog.2007.06.057
Intake of protein-rich foods in relation to outcomes of infertility treatment with assisted reproductive technologies. Feiby, et al. The American Journal of Clinical Nutrition. (2018) https://doi.org/10.1093/ajcn/nqy185
Can Nutrition Help in the Treatment of Infertility? Aoun, et al. Preventative Nutrition and Food Science. (2021) https://doi.org/10.3746%2Fpnf.2021.26.2.109
Dietary patterns and difficulty conceiving: a nested case–control study. Toledo, et al. Fertility and Sterility. (2011) https://doi.org/10.1016/j.fertnstert.2011.08.034
Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility. Karayiannis, et al. Human Reproduction. (2018) https://academic.oup.com/humrep/article-pdf/33/3/494/24148745/dey003.pdf
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