{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:50:11Z","timestamp":1790423411449,"version":"4.1.0"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi230860-4\"><jats:title>Importance<\/jats:title><jats:p>Increasing evidence suggests that specific foods and nutrients may improve infertility treatment outcomes in women. However, less is known about the role of dietary patterns.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230860-5\"><jats:title>Objective<\/jats:title><jats:p>To investigate whether women\u2019s adherence to a priori\u2013defined dietary patterns promoted for the prevention of chronic conditions is associated with outcomes of infertility treatment.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230860-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This prospective cohort study was conducted at a fertility center at an academic medical center in Boston, Massachusetts. Women undergoing infertility treatment cycles, including intrauterine insemination cycles and in vitro fertilization with or without intracytoplasmic sperm injection were included. Data were collected from January 2007 to October 2019, and data were analyzed from February to December 2022.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230860-7\"><jats:title>Exposures<\/jats:title><jats:p>Women\u2019s pretreatment diet was assessed with a validated food frequency questionnaire from which 8 a priori\u2013defined scores were calculated (higher score indicates greater adherence): (1) Trichopoulou Mediterranean diet, (2) alternate Mediterranean diet, (3) Panagiotakos Mediterranean diet, (4) Healthy Eating Index, (5) Alternate Healthy Eating Index, (6) American Heart Association (AHA) index, (7) Dietary Approaches to Stop Hypertension index, and (8) plant-based diet.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230860-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The adjusted probability of clinically relevant outcomes (live birth as a primary outcome and clinical pregnancy and pregnancy loss as secondary outcomes) was evaluated across quartiles of adherence to each dietary pattern using multivariable generalized linear mixed models to account for repeated cycles.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230860-9\"><jats:title>Results<\/jats:title><jats:p>This analysis included 612 women with a median (IQR) age of 35.0 (32.0-38.0) years. There was no association between women\u2019s adherence to the 8 a priori dietary patterns and probability of clinical pregnancy or live birth following in vitro fertilization or intrauterine insemination. However, an inverse association was found between adherence to AHA dietary pattern and risks of total and clinical pregnancy loss. Among women who became pregnant during the course of infertility treatment, the adjusted probabilities of pregnancy loss in the lowest and highest quartile of the AHA dietary pattern were 0.41 (95% CI, 0.33-0.50) and 0.28 (95% CI, 0.21\u20130.36), respectively (<jats:italic>P<\/jats:italic> for trend\u2009=\u2009.02). The corresponding adjusted probabilities of clinical pregnancy loss were 0.30 (95% CI, 0.22-0.39) and 0.15 (95% CI, 0.10-0.23) (<jats:italic>P<\/jats:italic> for trend\u2009=\u2009.007). A similar pattern was observed for all other dietary patterns, with the exception of the plant-based diet pattern.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230860-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>Findings of this cohort study suggest that preconception adherence to the AHA diet may be associated with a lower likelihood of pregnancy loss during the course of infertility treatment.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.29982","type":"journal-article","created":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T11:31:16Z","timestamp":1692358276000},"page":"e2329982","source":"Crossref","is-referenced-by-count":21,"title":["Women\u2019s Adherence to Healthy Dietary Patterns and Outcomes of Infertility Treatment"],"prefix":"10.1001","volume":"6","author":[{"given":"Albert","family":"Salas-Huetos","sequence":"first","affiliation":[{"name":"Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts"},{"name":"Unit of Preventive Medicine and Public Health, Alimentaci\u00f3, Nutrici\u00f3, Desenvolupament i Salut Mental, Faculty of Medicine and Health Sciences, Institut d'Investigaci\u00f3 Sanit\u00e0ria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain"},{"name":"Consorcio Centro de Investigaci\u00f3n Biom\u00e9dica en Red, M.P. Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n, Instituto de Salud Carlos III, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makiko","family":"Mitsunami","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siwen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"M\u00ednguez-Alarc\u00f3n","sequence":"additional","affiliation":[{"name":"Channing Division of Network Medicine, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Ribas-Maynou","sequence":"additional","affiliation":[{"name":"Biotechnology of Animal and Human Reproduction (TechnoSperm), Institute of Food and Agricultural Technology, University of Girona, Girona, Spain."},{"name":"Unit of Cell Biology, Faculty of Sciences, Department of Biology, University of Girona, Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Yeste","sequence":"additional","affiliation":[{"name":"Biotechnology of Animal and Human Reproduction (TechnoSperm), Institute of Food and Agricultural Technology, University of Girona, Girona, Spain."},{"name":"Unit of Cell Biology, Faculty of Sciences, Department of Biology, University of Girona, Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Souter","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Fertility Center and Harvard Medical School, Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge E.","family":"Chavarro","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts"},{"name":"Channing Division of Network Medicine, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"EARTH Study Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russ","family":"Hauser","sequence":"additional","affiliation":[{"name":"for the EARTH Study Team"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige L","family":"Williams","sequence":"additional","affiliation":[{"name":"for the EARTH Study Team"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge E","family":"Chavarro","sequence":"additional","affiliation":[{"name":"for the EARTH Study Team"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Minguez-Alarcon","sequence":"additional","affiliation":[{"name":"for the EARTH Study Team"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Ford","sequence":"additional","affiliation":[{"name":"for the EARTH Study Team"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myra","family":"Keller","sequence":"additional","affiliation":[{"name":"for the EARTH Study Team"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramace","family":"Daad","sequence":"additional","affiliation":[{"name":"for the EARTH Study Team"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Souter","sequence":"additional","affiliation":[{"name":"for the EARTH Study Team"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Petrozza","sequence":"additional","affiliation":[{"name":"for the EARTH Study Team"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas L","family":"Toth","sequence":"additional","affiliation":[{"name":"for the EARTH Study Team"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane L.","family":"Wright","sequence":"additional","affiliation":[{"name":"for the EARTH Study Team"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Bormann","sequence":"additional","affiliation":[{"name":"for the EARTH Study Team"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,8,18]]},"reference":[{"issue":"12","key":"zoi230860r1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001356","article-title":"National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys.","volume":"9","author":"Mascarenhas","year":"2012","journal-title":"PLoS Med"},{"issue":"4","key":"zoi230860r2","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1093\/humupd\/dmv016","article-title":"Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century.","volume":"21","author":"Inhorn","year":"2015","journal-title":"Hum Reprod Update"},{"issue":"6","key":"zoi230860r3","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1093\/humupd\/dmx022","article-title":"Temporal trends in sperm count: a systematic review and meta-regression analysis.","volume":"23","author":"Levine","year":"2017","journal-title":"Hum Reprod Update"},{"issue":"10159","key":"zoi230860r4","doi-asserted-by":"publisher","first-page":"1995","DOI":"10.1016\/S0140-6736(18)32278-5","article-title":"Population and fertility by age and sex for 195 countries and territories, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017.","volume":"392","author":"GBD 2017 Population and Fertility Collaborators","year":"2018","journal-title":"Lancet"},{"issue":"8","key":"zoi230860r5","doi-asserted-by":"publisher","first-page":"1900","DOI":"10.1093\/humrep\/deaa090","article-title":"International Committee for Monitoring Assisted Reproductive Technologies world report: assisted reproductive technology 2012.","volume":"35","author":"de Mouzon","year":"2020","journal-title":"Hum Reprod"},{"issue":"7","key":"zoi230860r6","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1007\/s11934-018-0805-0","article-title":"The role of lifestyle in male infertility: diet, physical activity, and body habitus.","volume":"19","author":"Hayden","year":"2018","journal-title":"Curr Urol Rep"},{"issue":"4","key":"zoi230860r7","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1093\/humupd\/dmx006","article-title":"Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies.","volume":"23","author":"Salas-Huetos","year":"2017","journal-title":"Hum Reprod Update"},{"issue":"4","key":"zoi230860r8","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/j.ajog.2017.08.010","article-title":"Diet and fertility: a review.","volume":"218","author":"Gaskins","year":"2018","journal-title":"Am J Obstet Gynecol"},{"issue":"6","key":"zoi230860r9","doi-asserted-by":"publisher","first-page":"2096","DOI":"10.1016\/j.fertnstert.2009.12.079","article-title":"The preconception Mediterranean dietary pattern in couples undergoing in vitro fertilization\/intracytoplasmic sperm injection treatment increases the chance of pregnancy.","volume":"94","author":"Vujkovic","year":"2010","journal-title":"Fertil Steril"},{"issue":"6","key":"zoi230860r10","doi-asserted-by":"publisher","first-page":"567.e1","DOI":"10.1016\/j.ajog.2019.02.004","article-title":"Dietary patterns and outcomes of assisted reproduction.","volume":"220","author":"Gaskins","year":"2019","journal-title":"Am J Obstet Gynecol"},{"issue":"3","key":"zoi230860r11","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1093\/humrep\/dey003","article-title":"Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility.","volume":"33","author":"Karayiannis","year":"2018","journal-title":"Hum Reprod"},{"issue":"2","key":"zoi230860r12","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/j.fertnstert.2019.09.041","article-title":"Effect of a 6-week \u201cMediterranean\u201d dietary intervention on in vitro human embryo development: the Preconception Dietary Supplements in Assisted Reproduction double-blinded randomized controlled trial.","volume":"113","author":"Kermack","year":"2020","journal-title":"Fertil Steril"},{"issue":"2","key":"zoi230860r13","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoy001","article-title":"The Environment and Reproductive Health (EARTH) study: a prospective preconception cohort.","volume":"2018","author":"Messerlian","year":"2018","journal-title":"Hum Reprod Open"},{"issue":"4","key":"zoi230860r14","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1016\/j.rbmo.2016.07.002","article-title":"Maternal physical and sedentary activities in relation to reproductive outcomes following IVF.","volume":"33","author":"Gaskins","year":"2016","journal-title":"Reprod Biomed Online"},{"issue":"7","key":"zoi230860r15","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1093\/aje\/kww104","article-title":"Validity of a dietary questionnaire assessed by comparison with multiple weighed dietary records or 24-hour recalls.","volume":"185","author":"Yuan","year":"2017","journal-title":"Am J Epidemiol"},{"issue":"5","key":"zoi230860r16","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1093\/aje\/kwx328","article-title":"Relative validity of nutrient intakes assessed by questionnaire, 24-hour recalls, and diet records as compared with urinary recovery and plasma concentration biomarkers: findings for women.","volume":"187","author":"Yuan","year":"2018","journal-title":"Am J Epidemiol"},{"issue":"26","key":"zoi230860r17","doi-asserted-by":"publisher","first-page":"2599","DOI":"10.1056\/NEJMoa025039","article-title":"Adherence to a Mediterranean diet and survival in a Greek population.","volume":"348","author":"Trichopoulou","year":"2003","journal-title":"N Engl J Med"},{"issue":"8","key":"zoi230860r18","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1161\/CIRCULATIONAHA.108.816736","article-title":"Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women.","volume":"119","author":"Fung","year":"2009","journal-title":"Circulation"},{"issue":"4","key":"zoi230860r19","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.ypmed.2006.12.009","article-title":"Adherence to the Mediterranean food pattern predicts the prevalence of hypertension, hypercholesterolemia, diabetes and obesity, among healthy adults; the accuracy of the MedDietScore.","volume":"44","author":"Panagiotakos","year":"2007","journal-title":"Prev Med"},{"issue":"9","key":"zoi230860r20","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1016\/j.jand.2018.05.021","article-title":"Update of the Healthy Eating Index: HEI-2015.","volume":"118","author":"Krebs-Smith","year":"2018","journal-title":"J Acad Nutr Diet"},{"issue":"6","key":"zoi230860r21","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1093\/ajcn\/76.6.1261","article-title":"Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance.","volume":"76","author":"McCullough","year":"2002","journal-title":"Am J Clin Nutr"},{"issue":"23","key":"zoi230860r22","doi-asserted-by":"publisher","first-page":"2542","DOI":"10.1001\/jama.2016.7491","article-title":"Dietary intake among US adults, 1999-2012.","volume":"315","author":"Rehm","year":"2016","journal-title":"JAMA"},{"issue":"7","key":"zoi230860r23","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1001\/archinte.168.7.713","article-title":"Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women.","volume":"168","author":"Fung","year":"2008","journal-title":"Arch Intern Med"},{"key":"zoi230860r24","doi-asserted-by":"publisher","first-page":"320S","DOI":"10.3945\/ajcn.113.071431","article-title":"A provegetarian food pattern and reduction in total mortality in the Prevenci\u00f3n con Dieta Mediterr\u00e1nea (PREDIMED) study.","volume":"100","author":"Mart\u00ednez-Gonz\u00e1lez","year":"2014","journal-title":"Am J Clin Nutr"},{"issue":"24","key":"zoi230860r25","doi-asserted-by":"publisher","first-page":"2654","DOI":"10.1001\/jama.2015.17296","article-title":"Live-birth rate associated with repeat in vitro fertilization treatment cycles.","volume":"314","author":"Smith","year":"2015","journal-title":"JAMA"},{"issue":"10","key":"zoi230860r26","doi-asserted-by":"publisher","first-page":"2303","DOI":"10.1007\/s10815-022-02616-8","article-title":"Donor sperm recipients: fertility treatments, trends, and pregnancy outcomes.","volume":"39","author":"Diego","year":"2022","journal-title":"J Assist Reprod Genet"},{"issue":"3","key":"zoi230860r27","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-034566","article-title":"Observational retrospective study of UK national success, risks and costs for 319,105 IVF\/ICSI and 30,669 IUI treatment cycles.","volume":"10","author":"Bahadur","year":"2020","journal-title":"BMJ Open"},{"issue":"6","key":"zoi230860r28","doi-asserted-by":"publisher","first-page":"627.e1","DOI":"10.1016\/j.ajog.2019.07.011","article-title":"Mediterranean diet and outcomes of assisted reproduction: an Italian cohort study.","volume":"221","author":"Ricci","year":"2019","journal-title":"Am J Obstet Gynecol"},{"issue":"1","key":"zoi230860r29","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1186\/s12958-019-0520-9","article-title":"Mediterranean diet improves embryo yield in IVF: a prospective cohort study.","volume":"17","author":"Sun","year":"2019","journal-title":"Reprod Biol Endocrinol"},{"issue":"7","key":"zoi230860r30","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.3945\/jn.113.190173","article-title":"Processed meat intake is unfavorably and fish intake favorably associated with semen quality indicators among men attending a fertility clinic.","volume":"144","author":"Afeiche","year":"2014","journal-title":"J Nutr"},{"issue":"7","key":"zoi230860r31","doi-asserted-by":"publisher","first-page":"2680","DOI":"10.1210\/jc.2018-00385","article-title":"Seafood intake, sexual activity, and time to pregnancy.","volume":"103","author":"Gaskins","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"zoi230860r32","doi-asserted-by":"publisher","first-page":"1503","DOI":"10.1016\/j.fertnstert.2016.02.015","article-title":"Maternal whole grain intake and outcomes of in vitro fertilization.","volume":"105","author":"Gaskins","year":"2016","journal-title":"Fertil Steril"},{"issue":"2","key":"zoi230860r33","doi-asserted-by":"publisher","first-page":"246.e1","DOI":"10.1016\/j.ajog.2022.03.053","article-title":"Women\u2019s and men\u2019s intake of omega-3 fatty acids and their food sources and assisted reproductive technology outcomes.","volume":"227","author":"Salas-Huetos","year":"2022","journal-title":"Am J Obstet Gynecol"},{"issue":"4","key":"zoi230860r34","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1097\/AOG.0000000000000477","article-title":"Dietary folate and reproductive success among women undergoing assisted reproduction.","volume":"124","author":"Gaskins","year":"2014","journal-title":"Obstet Gynecol"},{"issue":"5","key":"zoi230860r35","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1093\/ajcn\/nqy181","article-title":"Effect of nut consumption on semen quality and functionality in healthy men consuming a Western-style diet: a randomized controlled trial.","volume":"108","author":"Salas-Huetos","year":"2018","journal-title":"Am J Clin Nutr"},{"issue":"25","key":"zoi230860r36","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1800389","article-title":"Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts.","volume":"378","author":"Estruch","year":"2018","journal-title":"N Engl J Med"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2808489\/salashuetos_2023_oi_230860_1691685275.53357.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T11:31:19Z","timestamp":1692358279000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2808489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,18]]},"references-count":36,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.29982","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,18]]}}}