Maternal whole grain intake and outcomes of in vitro fertilization

Capsule:
Higher pretreatment whole grain intake was related to a higher probability of live birth among women undergoing in vitro fertilization.

Authors:
Audrey J. Gaskins, Sc.D., Yu-Han Chiu, M.D., Paige L. Williams, Ph.D., Myra G. Keller, R.N.C., B.S.N., Thomas L. Toth, M.D., Russ Hauser, M.D., Sc.D., Jorge E. Chavarro, M.D., Sc.D. for the EARTH Study Team

Volume 105, Issue 6, Pages 1503-1510

Abstract:

Objective:
To evaluate the relationship between pretreatment intake of whole grains and outcomes of IVF.

Design:
Prospective cohort study.

Setting:
Academic medical center.

Patient(s):
A total of 273 women who collectively underwent 427 IVF cycles.

Intervention(s):
Whole grain intake was assessed with a validated food frequency questionnaire at enrollment.

Main Outcome Measure(s):
Intermediate and clinical end points of IVF were abstracted from medical records.

Result(s):
Women had a median whole grain intake of 34.2 g per day (∼1.2 servings/day). Higher pretreatment whole grain intake was associated with higher probability of implantation and live birth. The adjusted percentage of cycles resulting in live birth for women in the highest quartile of whole grain intake (>52.4 g/day) was 53% (95% confidence interval [CI] 41%, 65%) compared with 35% (95% CI 25%, 46%) for women in the lowest quartile (<21.4 g/day). This association was largely driven by intake of bran as opposed to germ. When intermediate end points of IVF were examined, only endometrial thickness on the day of ET was associated with whole grain intake. A 28-g per day (∼1 serving/day) increase in whole grain intake was associated with a 0.4-mm (95% CI 0.1, 0.7 mm) increase in endometrial thickness. Conclusion(s):
Higher pretreatment whole grain intake was related to higher probability of live birth among women undergoing IVF. The higher probability of live birth may result from increased endometrial thickness on the day of ET and improved embryo receptivity manifested in a higher probability of implantation.

  • The findings of this study by Gaskins et al. on whole grain intake and IVF success are intriguing, especially the observation of an association with endometrial thickness. It is doubtful that whole grains would contain sufficient quantities of phytoestrogens to be responsible for the observed difference, especially given that they only have weakly estrogenic effects compared to estradiol, which is very elevated during ovarian stimulation.
    Whole grain intake may be a marker for other healthy behaviors, although authors did a nice job to control for confounders.
    Ultimately the next question will be whether a change in whole grain intake prior to IVF (with potentially only a short duration in the change in exposure) can improve IVF success, and whether the findings therefore should be integrated in the lifestyle counseling for IVF patients.

Translate »