Conflicting messages on diet and fertility: food for thought - Fertility and Sterility

“How can I change my diet to improve my fertility?” This is one of the most frequently asked fertility-related questions to both providers and Google over the last several years, indicating that women of reproductive age have a vested interest in the subject matter. The evaluation of diet and fertility is a growing area of epidemiologic research, and in recent years much work has focused on how diet may influence the rate of ovarian aging, a critical component of female fertility. The need for identifying modifiable lifestyle factors related to ovarian aging is becoming increasingly relevant, as more women choose to delay childbearing into their later reproductive years. Current treatment options for infertility are often prohibitively expensive, so couples are particularly motivated to adopt lifestyle changes to improve their probability of conceiving naturally. In theory, diet is highly modifiable (at least compared to other risk factors, such as genetics), providing a clear rationale for conducting epidemiologic studies of diet and reproductive health. We were thus excited to see new research in this issue of Fertility and Sterility by Anderson et al. (1x1Anderson, C., Mark Park, Y.-M., Stanczyk, F.Z., Sandler, D.P., and Nichols, H.B. Dietary factors and serum antimüllerian hormone concentrations in late premenopausal women. Fertil Steril. 2018; 110: 1145–1153 Google ScholarSee all References)(1) exploring the relationships between various dietary factors and antimüllerian hormone (AMH), a biomarker of ovarian aging. Many recent studies have reported associations between dietary exposures and menopause timing, the putative marker of reproductive senescence; however, evaluations with biomarkers of ovarian reserve, including AMH, follicle-stimulating hormone, and antral follicle count have been less consistent. In this particular study, Anderson et al. (1x1Anderson, C., Mark Park, Y.-M., Stanczyk, F.Z., Sandler, D.P., and Nichols, H.B. Dietary factors and serum antimüllerian hormone concentrations in late premenopausal women. Fertil Steril. 2018; 110: 1145–1153 Google ScholarSee all References)(1) report positive cross-sectional associations of carbohydrate intake and levels of AMH among 296 late-reproductive age women in the prospective Sister Study cohort. The authors also report inverse associations of fat intake, specifically, monounsaturated fatty acids and omega-6 fatty acids, and AMH. Notably, these findings are at odds with those of a recent prospective study (2x2Sjaarda, L.A., Schisterman, E.F., Schliep, K.C., Plowden, T., Zarek, S.M., Yeung,