IVF: Mediterranean diet, some supplements may increase success rate

In vitro fertilization (IVF) involves fertilizing an egg outside the body and then implanting the fertilized egg into the uterus. IVF may be an option for couples struggling to conceive. The end goal is a healthy pregnancy and live birth.

Whether or not IVF results in these endpoints depends on a number of factors. For example, women with endometriosis may have a lower chance of IVF being successful. Women under age 35 also have a higher probability of IVF success compared to older women.

Dr. Albrar Al-Shaer, Ph.D., with Nourish Women Nutrition, LLC, who was not involved in the study, noted the following to Medical News Today:

“IVF success depends on many factors, whether it’s ovarian reserve (number of eggs in your ovaries and their quality), ovarian stimulation, fertilization, embryo development, or implantation. Many intricate steps need to be optimized to result in a healthy pregnancy that carries to term. In addition, patients seeking IVF typically already have pre-existing struggles with their fertility, making it even more difficult at times to ensure that IVF succeeds.”

“Moreover, given the high cost burden of IVF, optimizing each step in the process as much as possible and preventing failures in any part of the process is well worthwhile. For this reason, supplements can be a helpful strategy to enhance fertility and conception outcomes in IVF,” she explained.

The current review focused on nutritional interventions that women often can often undergo without a clinician’s prescription.

Diet itself may contribute to fertility problems. For example, diets containing high amounts of trans fats, refined carbohydrates, and added sugars may decrease female fertility. Thus, it makes sense that looking at how diet influences IVF results would also be a key area of interest when studying fertility.

This review examined 27 studies published between January 2015 and May 2023. The research was a systematic review looking at several nutritional supplements and their impact on IVF outcomes. The review further examined the benefits of dietary restriction and the Mediterranean diet.

The review excluded studies based on specific criteria. It focused on females rather than males in most of the research analysis.

The findings of the study suggested that certain supplements benefit IVF outcomes, while the usefulness of other supplements remains unclear.

For example, dehydroepiandrosterone (DHEA) and COQ-10 supplements may help women undergoing ovarian stimulation. Ovarian stimulation involves increasing egg production by the ovaries so the eggs can be retrieved and fertilized outside the body.

Study author Professor Roger Hart, professor of reproductive medicine at the University of Western Australia and the medical director of fertility specialists of WA and National Medical Director of City Fertility, explained to MNT:

“If a woman was considering taking a nutritional supplement to try to improve her previous poor ovarian response to drug stimulation during her IVF cycle, it appears that taking DHEA and COQ-10 prior to starting the cycle leads to better IVF outcomes than control therapies.”

“Furthermore, the medication CoQ10 alone may have some merit, although it is unclear whether its place is for older women, those with a poor response to ovarian stimulation, or for women whose cycles have been characterized by poor embryonic development,” he continued.

The review further found that taking omega-3 free fatty acids may benefit a few IVF outcomes. The review also suggests that the supplement melatonin may benefit IVF outcomes.

Still, more research is needed to determine which patients would most benefit from melatonin and what dose would be appropriate.

Women with polycystic ovary syndrome, a condition that can cause infertility, may also benefit from taking the supplement myoinositol, but more research is needed to understand proper dosing in this area.

Finally, the review also suggests that incorporating a Mediterranean diet may assist with successful IVF.

Dr. Al-Shaer explained a few key components of the Mediterranean diet to Medical News Today:

“A Mediterranean diet follows these five simple principles:

• Lots of vegetables, legumes, and fruits.
• Whole grains like whole wheat bread and pasta instead of white bread and white pasta.
• Eating more fish and more often choosing poultry over red meat.
• Healthy plant-based fats from olive oil, avocados, nuts, and seeds.
• Limiting highly processed foods.”

“As a general dietary approach for women undertaking IVF, it appears that adopting a Mediterranean diet (rich in nuts, fruit, vegetables, legumes, etc.) is better than a traditional high fat and high carbohydrate Western diet and will lead to a slightly greater chance of IVF success.”
— Prof. Roger Hart, study author

This review does have certain limitations. First, it only included studies from specific databases and only studies that met inclusion criteria, like being written in English. Future research could seek to include even more studies in the analysis.

The review also did not have a strict definition for “poor ovarian response,” which can make it harder to apply the results to clinical practice.

Since the review is of previously conducted studies, it’s also important to consider that each of the studies had its limitations that reduce the reliability and application of the findings. For example, one study supporting the incorporation of the Mediterranean diet included both men and women, making it harder to determine where the benefit comes from.

The review was also mainly conducted by one person, which can introduce the risk of potential errors in data analysis.

It may take time for any of the findings of this review to make their way into clinical practice as well. Those seeking to undergo IVF can be in close communication with specialists about nutrition and the use of supplements. Ideally, this can lead to choosing the most beneficial intake for the unique situation.

Prof. Hart explained what future research in this area could look like:

“Further research is required to confirm the findings, to determine the actual treatment effect, and in several instances to bed down the appropriate dose of the supplement to take and the particular sub-group of patients who would benefit from the treatment.”