Research question

Is there an association between diet and poor ovarian response to ovarian stimulation in women with normal biomarkers of ovarian reserve?

Design

Women eligible for IVF at an Academic Fertility Center were invited to participate in this prospective cross-sectional study. The main inclusion criteria were age 18–39 years, body mass index 18–25 kg/m², preserved ovarian reserve (antral follicle count 10–22 or anti-Müllerian hormone concentration 2–5 ng/ml) and a starting dose of gonadotrophins of 150–225 IU/day. Information on diet was obtained using a validated food frequency questionnaire. ‘Unexpected poor ovarian response’ was defined as the retrieval of three or fewer suitable oocytes. A logistic regression model was used to adjust for confounders.

Results

Out of the 303 women enrolled in the study, 48 (16%) showed an unexpected poor ovarian response. The frequency of poor responders increased with increasing glycaemic load, carbohydrate intake and fibre intake. When comparing the third with the first tertile (reference), the adjusted odds ratios for these were 3.91 (95% confidence interval [CI] 1.11–13.83, P = 0.04), 4.78 (95% CI 1.23–18.51, P = 0.02) and 6.03 (95% CI 1.18–30.77, P = 0.07), respectively.

Conclusions

Elevated dietary glycaemic load as well as carbohydrate intake and fibre intake is significantly associated with unexpected poor ovarian response. Future interventional studies should clarify whether dietary modification might restore normal response.

中文翻译：

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饮食在对卵巢刺激的意外不良反应中的作用：一项横断面研究。

研究问题

在卵巢储备生物标志物正常的女性中，饮食与卵巢刺激的不良反应之间是否存在关联？

设计

有资格在学术生育中心接受 IVF 的女性被邀请参加这项前瞻性横断面研究。主要纳入标准是年龄 18-39 岁、体重指数 18-25 kg/m ²、保留的卵巢储备（窦卵泡计数 10-22 或抗苗勒管激素浓度 2-5 ng/ml）和起始剂量为150-225 IU/天的促性腺激素。饮食信息是使用经过验证的食物频率问卷获得的。“意外的卵巢反应不佳”被定义为检索到三个或更少的合适卵母细胞。使用逻辑回归模型来调整混杂因素。

结果

在参与该研究的 303 名女性中，48 名 (16%) 表现出意外的卵巢反应不佳。不良反应者的频率随着血糖负荷、碳水化合物摄入量和纤维摄入量的增加而增加。当将第三个与第一个三分位数（参考）进行比较时，这些调整后的优势比为 3.91（95% 置信区间 [CI] 1.11–13.83，P =  0.04）、4.78（95% CI 1.23–18.51，P =  0.02）和 6.03（95% CI 1.18–30.77，P =  0.07）。

结论

升高的膳食血糖负荷以及碳水化合物摄入量和纤维摄入量与意外的卵巢反应不良显着相关。未来的干预研究应该阐明饮食调整是否可以恢复正常反应。