Does diet affect fertility?

Updated: Sep 26, 2020

The concept that nutrition in early life and prenatal nutritional environments impact both short and long-term health consequences of the offspring, is underpinned by the "Developmental Origins of Health and Disease" hypothesis, coined back in the 1990s. This was famously observed from the Dutch Hunger Winter Study where periods of starvation in the mid-1940s occurred at the end of World War II. The legacy of the Dutch famine provides significant contributions to the impact of starvation on human health, with particular relevance before and during pregnancy. Famine before pregnancy was associated with offspring's overweight, hypertension, and coronary heart disease later in life.

Those who were exposed to famine during early gestation experienced elevated rates of obesity, altered lipid profiles and cardiovascular disease as adults. Furthermore, exposure to famine at any time during pregnancy was associated with glucose intolerance in the offspring later in life. Recent reviews echo these findings, highlighting that adverse health effects, for example, poor nutritional exposures, that originate in utero, impact the health of offspring, but importantly, the timing just before pregnancy is particularly important.

The results of a prospective cohort study of 351 women who underwent 598 assisted reproductive technology (ART) cycles for infertility treatment, showed that increased fish intake, was associated with a 34-48% higher probability of live birth. In the same study, total meat intake, which included red meat, chicken, and fish, intake of eggs, and vegetable sources of protein beans, nuts, and soy, were not associated with ART outcomes.

Interestingly, when replacing meats or processed meats with two servings of fish, the likelihood of a live birth increased by a respective 54%. Comparatively, total intake of antioxidants, that is, vitamins A, C, and E, mainly found in fruits, vegetables, and nuts, was not linked with the probability of live birth.


In 244 non-obese women attempting pregnancy, women in the lowest vs. highest tertile of the #Mediterranean dietary pattern, that is, lower intakes of fruits, vegetables, legumes, fish, and olive oil, was associated with lower rates of clinical pregnancy and live birth. Similarly, in women undergoing ART, those in the second through the fourth quartiles of Mediterranean diet adherence had a higher probability of live birth compared with women in the first quartile.

Moreover, higher adherence to the pro fertility diet, characterized by a higher intake of supplemental folic acid, vitamin B12, vitamin D, low-pesticide fruits and vegetables, whole grains, seafood, dairy, and soy foods, and a lower intake of high-pesticide fruits and vegetables had higher odds of live birth by up to 50%. Further studies on dietary patterns and quantifying intakes will be helpful to potentially support recommendations on preconception diets and fertility.

Source: Preconception diet, fertility, and later health in pregnancy
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