{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T02:56:45Z","timestamp":1777085805539,"version":"3.51.4"},"reference-count":29,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T00:00:00Z","timestamp":1488153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>(1) Background: Medical interventions including assisted reproductive technologies have improved fertility outcomes for many sub-fertile couples. Increasing research interest has investigated the effect of low carbohydrate diets, with or without energy restriction. We aimed to systematically review the published literature to determine the extent to which low carbohydrate diets can affect fertility outcomes; (2) Methods: The review protocol was registered prospectively with Prospective Register for Systematic Reviews (registration number CRD42016042669) and followed Preferred Reporting Items For Systematic Reviews and Meta-Analyses guidelines. Infertile women were the population of interest, the intervention was low carbohydrate diets (less than 45% total energy from carbohydrates), compared to usual diet (with or without co-treatments). Four databases were searched from date of commencement until April 2016; a supplementary Google scholar search was also undertaken. Title and abstract, then full text review, were undertaken independently and in duplicate. Reference lists of included studies and relevant systematic reviews were checked to ensure that all relevant studies were identified for inclusion. Quality assessment was undertaken independently by both authors using the Quality Criteria Checklist for Primary Research. Outcome measures were improved fertility outcomes defined by an improvement in reproductive hormones, ovulation rates and\/or pregnancy rates; (3) Results: Seven studies fulfilled the inclusion criteria and were included in the evidence synthesis. Interventions were diverse and included a combination of low carbohydrate diets with energy deficit or other co-treatments. Study quality was rated as positive for six studies, suggesting a low risk of bias, with one study rated as neutral. Of the six studies which reported changes in reproductive hormones, five reported significant improvements post intervention; (4) Conclusion: The findings of these studies suggest that low carbohydrate diets warrant further research to determine their effect. These randomised controlled trials should consider the effect of carbohydrates (with or without energy deficit) on hormonal and fertility outcomes.<\/jats:p>","DOI":"10.3390\/nu9030204","type":"journal-article","created":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T11:00:20Z","timestamp":1488193220000},"page":"204","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["The Effect of Low Carbohydrate Diets on Fertility Hormones and Outcomes in Overweight and Obese Women: A Systematic Review"],"prefix":"10.3390","volume":"9","author":[{"given":"Melanie","family":"McGrice","sequence":"first","affiliation":[{"name":"Dietetics Department, Eastern Health, 5 Arnold Street, Box Hill VIC 3128, Australia"},{"name":"Nutrition Plus Enterprises, 1004\/1 Queens Road, Melbourne VIC 3004, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judi","family":"Porter","sequence":"additional","affiliation":[{"name":"Allied Health Research Office, 5 Arnold Street, Box Hill VIC 3128, Australia"},{"name":"Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill VIC 3168, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2017,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.maturitas.2012.10.003","article-title":"Should the ketogenic diet be considered for enhancing fertility?","volume":"74","author":"Kulak","year":"2013","journal-title":"Maturitas"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1097\/MED.0b013e3282f1cfc6","article-title":"Dietary effects on fertility treatment and pregnancy outcomes","volume":"14","author":"Lim","year":"2007","journal-title":"Curr. Opin. Endocrinol. Diabetes Obes."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/cob.12048","article-title":"Weight loss improves reproductive outcomes in obese women undergoing fertility treatment: A randomized controlled trial","volume":"4","author":"Sim","year":"2014","journal-title":"Clin. Obes."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1101\/gad.979102","article-title":"Y4 receptor knockout rescues fertility in ob\/ob mice","volume":"16","author":"Sainsbury","year":"2002","journal-title":"Genes Dev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/obr.12217","article-title":"Does weight loss in overweight or obese women improve fertility treatment outcomes? A systematic review","volume":"15","author":"Sim","year":"2014","journal-title":"Obes. Rev."},{"key":"ref_6","unstructured":"World Health Organization Obesity: Preventing and Managing the Global Epidemic. Available online: http:\/\/apps.who.int\/iris\/handle\/10665\/42330."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"495","DOI":"10.2147\/DMSO.S85134","article-title":"Weight loss for women with and without polycystic ovary syndrome following a very low-calorie diet in a community-based setting with trained facilitators for 12 weeks","volume":"8","author":"Nikokavoura","year":"2015","journal-title":"Diabetes Metab. Syndr. Obes. Targets Ther."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.fertnstert.2012.04.004","article-title":"The effect of body mass index on the outcomes of first assisted reproductive technology cycles","volume":"98","author":"Moragianni","year":"2012","journal-title":"Fertil. Steril."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.fertnstert.2012.04.012","article-title":"Body mass index and short-term weight change in relation to treatment outcomes in women undergoing assisted reproduction","volume":"98","author":"Chavarro","year":"2012","journal-title":"Fertil. Steril."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.soard.2011.09.021","article-title":"Effect of bariatric surgery on obesity-related infertility","volume":"8","author":"Musella","year":"2012","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S44","DOI":"10.1093\/aje\/kws264","article-title":"Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: A meta-analysis of randomized controlled clinical trials","volume":"176","author":"Hu","year":"2012","journal-title":"Am. J. Epidemiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1038\/sj.ejcn.1602557","article-title":"Low-carbohydrate-high-protein diet and long-term survival in a general population cohort","volume":"61","author":"Trichopoulou","year":"2007","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1111\/j.1467-789X.2005.00196.x","article-title":"Safety of low-carbohydrate diets","volume":"6","author":"Crowe","year":"2005","journal-title":"Obes. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"578","DOI":"10.3945\/ajcn.2009.27909","article-title":"Lack of suppression of circulating free fatty acids and hypercholesterolemia during weight loss on a high-fat, low-carbohydrate diet","volume":"91","author":"Hernandez","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"b2535","DOI":"10.1136\/bmj.b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: The prisma statement","volume":"339","author":"Moher","year":"2009","journal-title":"BMJ"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"b2700","DOI":"10.1136\/bmj.b2700","article-title":"The prisma statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration","volume":"339","author":"Liberati","year":"2009","journal-title":"BMJ"},{"key":"ref_17","unstructured":"Academy of Nutrition and Dietetics Evidence Analysis Manual: Steps in the Academy Evidence Analysis Process. Available online: https:\/\/www.andeal.org\/files\/Docs\/2012_Jan_EA_Manual.pdf."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/1743-7075-2-35","article-title":"The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: A pilot study","volume":"2","author":"Mavropoulos","year":"2005","journal-title":"Nutr. Metab."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1093\/humrep\/dem391","article-title":"Structured exercise training programme versus hypocaloric hyperproteic diet in obese polycystic ovary syndrome patients with anovulatory infertility: A 24-week pilot study","volume":"23","author":"Palomba","year":"2008","journal-title":"Hum. Reprod."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1210\/jc.2002-020815","article-title":"Dietary composition in restoring reproductive and metabolic physiology in overweight women with polycystic ovary syndrome","volume":"88","author":"Moran","year":"2003","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.fertnstert.2003.08.023","article-title":"A randomized trial of the effects of two types of short-term hypocaloric diets on weight loss in women with polycystic ovary syndrome","volume":"81","author":"Stamets","year":"2004","journal-title":"Fertil. Steril."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2783","DOI":"10.1093\/humrep\/deq254","article-title":"Six weeks of structured exercise training and hypocaloric diet increases the probability of ovulation after clomiphene citrate in overweight and obese patients with polycystic ovary syndrome: A randomized controlled trial","volume":"25","author":"Palomba","year":"2010","journal-title":"Hum. Reprod."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3373","DOI":"10.1210\/jc.2008-0751","article-title":"The effect of a hypocaloric diet with and without exercise training on body composition, cardiometabolic risk profile, and reproductive function in overweight and obese women with polycystic ovary syndrome","volume":"93","author":"Thomson","year":"2008","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.numecd.2013.11.006","article-title":"Long term weight maintenance after advice to consume low carbohydrate, higher protein diets\u2014A systematic review and meta analysis","volume":"24","author":"Clifton","year":"2014","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1111\/j.1467-789X.2008.00518.x","article-title":"Systematic review of randomized controlled trials of low-carbohydrate vs. Low-fat\/low-calorie diets in the management of obesity and its comorbidities","volume":"10","author":"Hession","year":"2009","journal-title":"Obes. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/S0889-8529(03)00044-6","article-title":"Assessment and management of anovulatory infertility in polycystic ovary syndrome","volume":"32","author":"Franks","year":"2003","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.jand.2012.11.018","article-title":"Dietary composition in the treatment of polycystic ovary syndrome: A systematic review to inform evidence-based guidelines","volume":"113","author":"Moran","year":"2013","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.fertnstert.2005.12.041","article-title":"Effect of a very-low-calorie diet on in vitro fertilization outcomes","volume":"86","author":"Tsagareli","year":"2006","journal-title":"Fertil. Steril."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1017\/S1751731114000834","article-title":"Nutritional management to optimize fertility of dairy cows in pasture-based systems","volume":"8","author":"Butler","year":"2014","journal-title":"Animal"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/3\/204\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:29:16Z","timestamp":1760207356000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/3\/204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,27]]},"references-count":29,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2017,3]]}},"alternative-id":["nu9030204"],"URL":"https:\/\/doi.org\/10.3390\/nu9030204","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,27]]}}}