Dietary patterns and ovulatory infertility: a case-control study

Objective: To investigate the relationship between female ovulatory infertility and major dietary patterns among women attending fertility clinics. Methods: This case-control study was conducted on 167 infertile women with polycystic ovary syndrome (PCOS) and 251 controls. PCOS was determined by using the Rotterdam 2003 criteria. Usual dietary intake was assessed using a validated 168-item semiquantitative food frequency questionnaire. Major dietary patterns were identified using factor analysis. Results: Two main dietary patterns, namely, healthy dietary pattern and western dietary pattern, were identified. Cases were statistically more overweight and abdominally fat than controls (p < 0.01). No statistically significant difference was seen in total energy intake, nutrient intakes and dietary fiber between the two groups. Lower adherence to the Western dietary pattern was associated with decreased chance of infertility (OR  =  0.61; 95% CI, 0.41-0.91; p  =  0.01). The association remained significant even after taking other confounders into account (OR = 0.62; 95% CI, 0.41-0.96; p = 0.03). However, after adjusting for energy and macronutrient intakes, the association altered to a marginally significant relation (p = 0.07). Associations between following a healthy dietary pattern and PCOS-associated infertility was not statistically significant (p = 0.45). Conclusion: Lower adherence to the Western dietary pattern may protect women of reproductive age against infertility. Further studies are needed to confirm the role of different dietary patterns on fertility outcomes.