JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):152
doi: 10.5935/1518-0557.20263937

29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025 P-140. Impacts of the Mediterranean Diet on Reproductive Health and Fertility in Women

Clara Prado¹, Gabriel Monteiro Pinheiro¹, Janine Maíra Torres Sena Barbosa¹, Julia Roverso Correa Silveira¹

¹ Universidade Santo Amaro - São Paulo - SP - Brasil

Objective: This narrative review evaluates the role of Mediterranean dietary in productive health, which has been linked to improve hormonal and metabolic profiles. This integrative review aims to synthesize current findings in Mediterranean dietary patterns on female fertility and overall reproductive function.
Methods: A narrative literature review was conducted to synthesize evidence on the association between the Mediterranean diet and female fertility. Searches were performed in PubMed, Web of Science, and SciELO for articles published from January 2000 to February 2025. The search strategy employed terms such as "Mediterranean diet," "female fertility," "female infertility," and "assisted reproduction," combined with Boolean operators. After screening titles and abstracts, six systematic review articles were selected for full-text review. Eligible studies evaluated dietary patterns, specifically adherence to the Mediterranean diet, in relation to female fertility outcomes. Studies focusing exclusively on male fertility or unrelated to dietary patterns were excluded. These six studies formed the basis of the final analysis.
Results: The Mediterranean diet (MD) is mainly composed of a high intake of fruits, vegetables, legumes, whole grains, olive oil, and low consumption of red meat and processed foods. Its properties, such as antioxidants, vitamins C, E, B, fibers, and anti-inflammatory compounds, allow possible benefits for reproductive health. Given its characteristics, in cases of infertility, MD should be considered as part of the treatment. Infertile women who adhere to the diet during the IVF cycle show a positive trend in the quantity and quality of fertilized oocytes, and in the yield and availability of embryos. This is due to folates and vitamins in the follicular environment, antioxidants, and anti-inflammatory compounds that help reduce oxidative stress that may otherwise harm oocytes. However, the dietary pattern showed an inconsistent incidence of improvement in pregnancy and live birth rates. Moreover, studies show that this way of eating benefits other aspects of reproductive health, such as infertility-related diseases, including improvement in pain in women with endometriosis or lower prevalence of premenstrual syndrome. This is possible due to the properties of the food diet, which help maintain a more stable hormonal balance, reduce chronic inflammation, and improve the metabolic profile. A review of seven studies involving 2,321 women undergoing assisted reproduction showed that while three studies found a positive association between MD adherence and reproductive outcomes, four reported no significant effect. Among the factors that affected this conclusion are the lack of standardization in feeding questionnaires and fertilization protocols, and individual differences such as BMI, alcohol use, supplements, stress, etc. Furthermore, during pregnancy, the Mediterranean diet was shown to reduce the incidence of gestational diabetes by 34% compared to the control group during the study. In addition, it presents a modest but significant reduction in weight gain. The Mediterranean diet shows positive impacts on women's reproductive health, mainly by improving oocyte quality and supporting embryo development. Its antioxidant and anti-inflammatory components help maintain hormonal balance and decrease oxidative stress. Favorable results are also seen in cases of endometriosis and premenstrual syndrome, along with a lower risk of gestational diabetes. Still, the absence of consistent standards among studies makes it hard to reach definitive conclusions.
Conclusion: The Mediterranean diet demonstrates promising signs that it can benefit Reproductive health, in improving oocyte quality, embryo development and and metabolic outcomes. While its impact on pregnancy and live birth rates remains inconsistent, evidence supports its role as a complementary strategy in infertility management and assisted reproduction. Adoption of this dietary pattern, rich in antioxidants, folates, and anti-inflammatory compounds, may help mitigate oxidative stress and support overall reproductive well-being. Future studies with standardized protocols are essential to strengthen and prove current evidence.