Preconception Dietary Patterns and Associations With IVF Outcomes: An Ongoing Prospective Cohort Study

There is a lack of research on preconception diet and reproductive outcomes conducted in the Chinese population using individual assessment. Between April 2017 and April 2020, 2,796 couples undergoing in vitro fertilization treatment were recruited in this ongoing prospective cohort, and 1,500 eligible couples were included in the final analysis. A validated semi-quantitative food frequency questionnaire was used to evaluate the maternal preconception diet. Other lifestyle factors, including smoking status, psycho-mental status, sleep quality, and physical activity, were also assessed. Five dietary patterns were identified using principal component analysis, namely Fruits-Vegetables-Dairy-Eggs, Fish/Seafood-Animal blood, Tubers-Beans-Cereals, Puffed food-Candy-Bakery, and Dried Fruits-Organs-Rice. After adjusting for multiple confounders, we detected that the women who are more inclined to the Fruits-Vegetables-Dairy-Eggs pattern and less adherent to the Tubers-Beans-Cereals were more likely to achieve normally fertilized eggs and transferable embryos. Regarding pregnancy outcomes, we observed that a lower Puffed food-Candy-Bakery score and a higher Dried fruits-Organs-Rice score were related to a higher likelihood to achieve biochemical pregnancy. In terms of pregnancy complications, an inverse association between Fish/Seafood-Animal blood and hypertensive disorders was observed. We further clustered the dietary patterns based on the proportion of food groups consumed and found that dairy intake was beneficial to embryo quality, while frequent rice consumption was associated with a higher risk of macrosomia. Notably, in the stratified analysis, we observed that the positive relationship between the Fruit-Dairy-Vegetables-Eggs score and normal fertilization and the inverse association of the Fish/Seafood-Animal blood score with hypertensive disorders during pregnancy were exhibited only among women with body mass index >= 25 kg/m(2). In conclusion, pre-treatment diets might be an important target for intervention to achieve a better reproductive outcome.

Automated summary

This study investigated the relationship between preconception diet and reproductive outcomes in the Chinese population and found that various dietary patterns were associated with fertilization, pregnancy, and pregnancy complications. The results suggest that preconception diet may have an impact on reproductive outcomes.