The Periconceptional Healthy Dietary Pattern Mitigates Estradiol Response and Increases the Chance of Pregnancy after Conventional IVF/ICSI Treatment

Background: Subfertility rates are increasing worldwide. Nutrition influences natural fertility, but also after assisted reproduction. In addition, the ovarian response after ovarian stimulation treatment possibly influences assisted reproduction treatment outcome. Aim: to investigate the impact of periconceptional nutrition on endocrine response and reproductive outcome after controlled ovarian hyperstimulation and In Vitro Fertilization treatment (IVF) with and without Intracytoplasmatic Sperm Injection (ICSI). Methods: We assessed the habitual dietary intake in 203 women undergoing IVF, using a Food Frequency Questionnaire and performed Principal Components Analysis to identify dietary patterns. Blood samples taken at CD2 preceding treatment and on the day of hCG were used for determination of endocrine and one-carbon metabolism biomarkers. The relation between the identified dietary patterns and estradiol (E2) response after COH and pregnancy chance was assessed using regression analysis. Results: Independent of stimulation protocol, adherence to a Healthy dietary pattern, characterized by high intakes of fruits, whole grains and margarine, associates with lower E2 concentrations on the day of hCG. There was no difference in baseline anthropomorphic parameters between the groups of adherence. After adjustments, every one-unit increase in adherence to this dietary pattern decreased the E2 response by 16.4%. Similarly, adherence to the Healthy dietary pattern associates with a 61% increased chance of ongoing pregnancy after IVF/ICSI treatment. Conclusion: Adherence to a habitual Healthy dietary pattern mitigates the E2 response and increases the chance of ongoing pregnancy after IVF/ICSI treatment. This data contributes to the explanation of the beneficial effects of a healthy lifestyle on IVF/ICSI treatment outcomes and provides an opportunity to improve the quality as well as the further personalization of IVF/ICSI treatment.