Oocyte Maturation and Fertilization-Related Outcomes Following a Pro-Fertility Diet Combined with Omega-3 Supplementation in Women Undergoing Assisted Reproductive Technology: A Secondary Analysis of a Randomized Controlled Trial.
- 1Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
- 2Department of Obstetrics and Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran.
- 3Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Abstract
Oocyte developmental competence is a key determinant of IVF success, but randomized evidence on multi-component dietary interventions is limited. This paper reports prespecified secondary outcomes of a registered randomized trial (IRCT20130903014551N13) that examined whether a Pro-Fertility Diet (PFD) combined with omega-3 supplementation affects oocyte-related outcomes in women undergoing IVF/ICSI. In this randomized, parallel-group, single-blind (outcome assessors) trial at Hazrat Maryam Fertility Center (Isfahan, Iran), 180 infertile women aged 18-42 years were allocated (stratified block randomization by age and BMI) to a PFD plus omega-3 supplementation or to standard dietary advice for 8 weeks before IVF/ICSI. Embryo-related outcomes and fertilization rate from this trial have been published previously. The outcomes reported here for the first time are antral follicle count (AFC), cumulus-oocyte complexes (COCs), metaphase II (MII) oocytes and two-pronuclear (2PN) zygotes, analyzed in 167 women with available outcome data (complete-case analysis; 84 intervention, 83 control). Count outcomes were analyzed using Poisson regression with robust standard errors and fertilization rate (2PN per MII oocyte) using binomial regression, both adjusted for age and BMI. Of the 180 randomized participants, 167 women (84 in the intervention group and 83 in the control group) were included in the complete-case analysis of oocyte counts. Compared with controls, the intervention group had higher MII oocyte counts (adjusted IRR = 1.16, 95% CI: 1.01-1.33; P = 0.035) and 2PN zygote counts (IRR = 1.38, 95% CI: 1.17-1.61; P < 0.001), as well as higher odds of fertilization (OR = 1.92, 95% CI: 1.41-2.63; P < 0.001). No statistically significant differences were observed for AFC or COC counts. After adjustment for multiple comparisons using the Holm and Benjamini-Hochberg procedures, the difference in 2PN zygote counts remained statistically significant (adjusted P < 0.001 with both methods), whereas the difference in MII oocyte counts did not (Holm-adjusted P = 0.104; BH-adjusted P = 0.069). In this exploratory secondary analysis, the combined nutritional intervention was associated with a higher 2PN zygote count, which remained statistically significant after correction for multiple comparisons. Although a higher MII oocyte count was observed in the initial adjusted analysis, this finding did not remain statistically significant after multiplicity adjustment. Further adequately powered randomized controlled trials are needed to confirm these findings.
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BibTeX
@article{ghadimiyari2026oocyte,
title = {{Oocyte Maturation and Fertilization-Related Outcomes Following a Pro-Fertility Diet Combined with Omega-3 Supplementation in Women Undergoing Assisted Reproductive Technology: A Secondary Analysis of a Randomized Controlled Trial.}},
author = {Mahnaz Ghadimi-Yari and Hatav Ghasemi-Tehrani and Awat Feizi and Gholamreza Askari and Zahra Borzouie and Mohammad Hossein Rouhani},
journal = {International journal of women's health},
year = {2026},
month = nov,
doi = {10.2147/ijwh.s646774},
url = {https://europepmc.org/article/MED/42999833},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Oocyte Maturation and Fertilization-Related Outcomes Following a Pro-Fertility Diet Combined with Omega-3 Supplementation in Women Undergoing Assisted Reproductive Technology: A Secondary Analysis of a Randomized Controlled Trial.
AU - Mahnaz Ghadimi-Yari
AU - Hatav Ghasemi-Tehrani
AU - Awat Feizi
AU - Gholamreza Askari
AU - Zahra Borzouie
AU - Mohammad Hossein Rouhani
PY - 2026
DA - 2026/11/03
JO - International journal of women's health
DO - 10.2147/ijwh.s646774
UR - https://europepmc.org/article/MED/42999833
AB - Oocyte developmental competence is a key determinant of IVF success, but randomized evidence on multi-component dietary interventions is limited. This paper reports prespecified secondary outcomes of a registered randomized trial (IRCT20130903014551N13) that examined whether a Pro-Fertility Diet (PFD) combined with omega-3 supplementation affects oocyte-related outcomes in women undergoing IVF/ICSI. In this randomized, parallel-group, single-blind (outcome assessors) trial at Hazrat Maryam Fertility Center (Isfahan, Iran), 180 infertile women aged 18-42 years were allocated (stratified block randomization by age and BMI) to a PFD plus omega-3 supplementation or to standard dietary advice for 8 weeks before IVF/ICSI. Embryo-related outcomes and fertilization rate from this trial have been published previously. The outcomes reported here for the first time are antral follicle count (AFC), cumulus-oocyte complexes (COCs), metaphase II (MII) oocytes and two-pronuclear (2PN) zygotes, analyzed in 167 women with available outcome data (complete-case analysis; 84 intervention, 83 control). Count outcomes were analyzed using Poisson regression with robust standard errors and fertilization rate (2PN per MII oocyte) using binomial regression, both adjusted for age and BMI. Of the 180 randomized participants, 167 women (84 in the intervention group and 83 in the control group) were included in the complete-case analysis of oocyte counts. Compared with controls, the intervention group had higher MII oocyte counts (adjusted IRR = 1.16, 95% CI: 1.01-1.33; P = 0.035) and 2PN zygote counts (IRR = 1.38, 95% CI: 1.17-1.61; P < 0.001), as well as higher odds of fertilization (OR = 1.92, 95% CI: 1.41-2.63; P < 0.001). No statistically significant differences were observed for AFC or COC counts. After adjustment for multiple comparisons using the Holm and Benjamini-Hochberg procedures, the difference in 2PN zygote counts remained statistically significant (adjusted P < 0.001 with both methods), whereas the difference in MII oocyte counts did not (Holm-adjusted P = 0.104; BH-adjusted P = 0.069). In this exploratory secondary analysis, the combined nutritional intervention was associated with a higher 2PN zygote count, which remained statistically significant after correction for multiple comparisons. Although a higher MII oocyte count was observed in the initial adjusted analysis, this finding did not remain statistically significant after multiplicity adjustment. Further adequately powered randomized controlled trials are needed to confirm these findings.
SN - 1179-1411
ER -