Diet and Lifestyle in the Prevention of Ovulatory Disorder Infertility

Chavarro, Jorge E. MD, ScD1,2; Rich-Edwards, Janet W. MPH, ScD2,3,4; Rosner, Bernard A. PhD2,5; Willett, Walter C. MD, DrPH1,2,4

doi: 10.1097/01.AOG.0000287293.25465.e1
Original Articles

OBJECTIVE: To evaluate the relation of a dietary pattern and other lifestyle practices to risk of ovulatory disorder infertility.

METHODS: We followed a cohort of 17,544 women without a history of infertility for 8 years as they tried to become pregnant or became pregnant. A dietary score based on factors previously related to lower ovulatory disorder infertility (higher consumption of monounsaturated rather than trans fats, vegetable rather than animal protein sources, low glycemic carbohydrates, high fat dairy, multivitamins, and iron from plants and supplements) and other lifestyle information was prospectively related to the incidence of infertility.

RESULTS: Increasing adherence to a “fertility diet” pattern was associated with a lower risk of ovulatory disorder infertility. The multivariable-adjusted relative risk of ovulatory disorder infertility comparing women in the highest with women in the lowest quintile of the “fertility diet” pattern score was 0.34 (95% confidence interval 0.23–0.48; P for trend<.001). This inverse relation was similar in subgroups defined by women’s age, parity, and body weight. A combination of five or more low-risk lifestyle factors, including diet, weight control, and physical activity was associated with a 69% lower risk of ovulatory disorder infertility and an estimated population attributable risk of 66% (95% confidence interval 29–86%).

CONCLUSION: Following a “fertility diet” pattern may favorably influence fertility in otherwise healthy women. Further, the majority of infertility cases due to ovulation disorders may be preventable through modifications of diet and lifestyle.

LEVEL OF EVIDENCE: II

Increasing adherence to a specific dietary pattern is associated with a substantially reduced risk of infertility due to ovulation disorders.

From the 1Department of Nutrition, Harvard School of Public Health; 2Channing Laboratory and 3Division of Women’s Health and Connors Center for Women’s Health and Gender Biology, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health; and 5Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts.

Supported by CA50385, the main Nurses’ Health Study II grant, the training grant T32 DK-007703, and by the Yerby Postdoctoral Fellowship Program. The Nurses Health Study II is supported for other specific projects by the following National Institutes of Health grants: CA55075, CA67262, AG/CA14742, CA67883, CA65725, DK52866, HL64108, and HL03804.

The authors thank Ellen Hertzmark for her assistance with the analyses of population attributable risks.

Corresponding author: Jorge E. Chavarro, MD, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115; e-mail: jchavarr@hsph.harvard.edu.

Financial Disclosure The authors have no potential conflicts of interest to disclose.

© 2007 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.