by A new analysis of the evidence for many nutritional supplements and eating styles believed to improve outcomes in in vitro fertilization (IVF) has concluded that adopting a Mediterranean diet during treatment would offer a single “simple approach” with good evidence of benefits compared to the Western diet.
Adjuvant therapies for increase the chances of conceiving through IVFespecially in those cases where treatments have not been successful in the past, they are now a common feature both before and during the treatment cycle.
Evidence from studies of nine commonly used nutritional supplements was found to be inconsistent and not always of good quality. The analysis, carried out by Professor Roger Hart, from the University of Western Australia and City Fertility, Perth, Australia, is published in the peer-reviewed journal Reproductive Biomedicine Online.
The researcher assures that the extent to which nutritional supplements are used in IVF is largely unknown. «Normally they are not prescribed but bought online or without a prescription. They self-medicate and it is impossible to determine solid data on their use. “Our information is largely anecdotal, but it is quite clear from online IVF discussion forums that they are widely used and of great public interest,” says Professor Hart.
The nutritional supplements analyzed in the study were dehydroepiandrosterone (DHEA), melatonin, coenzyme Q10 (CoQ1O), carnitine, selenium, vitamin D, myo-inositol, omega-3, Chinese herbs and various diets (in addition to weight loss diets). Many were reviewed as adjuvants for poor response to prior IVF treatment, of which DHEA and COQ10 appeared to have more benefits in studies than control therapies. Similarly, there has been some evidence of benefits from melatonin, but it is still unclear which groups of patients might benefit or at what doses.
However, The evidence in favor of a Mediterranean diet is much stronger and includes several well-designed randomized clinical trials, showing benefits on both embryonic development and pregnancy outcome (even with a six-week intervention program).
Professor Hart points out that the common characteristics of these favorable diets were a high consumption of fruits and vegetables, whole grains, legumes, nuts, fish and monounsaturated or polyunsaturated oils, but with limited consumption of highly processed foods. “These diets are rich in B vitamins, antioxidants, omega-3 polyunsaturated fatty acids and fiber, and low in saturated fat, sugar and sodium,” he notes.
Omega-3 fatty acids, often consumed as combination preparations, are the most studied dietary fatty acids in the IVF literature, largely, Professor Hart continues, due to their perceived benefits on general health and reproduction. Evidence suggests that omega-3 fatty acids “may be beneficial” in improving clinical outcomes of IVF and embryo quality.
Similarly, antioxidants are usually taken as supplement combinations, but evidence from one major review (63 antioxidant studies in reproduction) described them as low quality and failed to demonstrate any benefit in terms of live birth rate.
Therefore, from this wealth of evidence, Professor Hart suggests that a simple nutritional approach to assist conception through IVF would be to adopt a Mediterranean diet. The use of COQ-10 and DHEA before starting IVF may be a useful supplement for women who previously had a poor response to ovarian stimulation, while supplementation with free fatty acids Omega 3 can improve some clinical and embryological results.
Professor Hart also suggests that all women trying to conceive should take adequate folate supplements, as well as seek advice from their GP or specialist to ensure they are in the best overall health for conception.
