Serum omega-3 fatty acids and treatment outcomes among women undergoing assisted reproduction.

Are serum polyunsaturated fatty acids (PUFA) concentrations, including omega-3 (omega 3-PUFA) and omega-6 (omega 6-PUFA), related to ART outcomes? Serum levels of long-chain omega 3-PUFA were positively associated with probability of live birth among women undergoing ART. Intake of omega 3-PUFA improves oocyte and embryo quality in animal and human studies. However, a recent cohort study found no relation between circulating omega 3-PUFA levels and pregnancy rates after ART. This analysis included a random sample of 100 women from a prospective cohort study (EARTH) at the Massachusetts General Hospital Fertility Center who underwent 136 ART cycles within one year of blood collection. Serum fatty acids (expressed as percentage of total fatty acids) were measured by gas chromatography in samples taken between Days 3 and 9 of a stimulated cycle. Primary outcomes included the probability of implantation, clinical pregnancy and live birth per initiated cycle. Cluster-weighted generalized estimating equation (GEE) models were used to analyze the association of total and specific PUFAs with ART outcomes adjusting for age, body mass index, smoking status, physical activity, use of multivitamins and history of live birth. The median [25th, 75th percentile] serum level of omega 3-PUFA was 4.7% [3.8%, 5.8%] of total fatty acids. Higher levels of serum long-chain omega 3-PUFA were associated with higher probability of clinical pregnancy and live birth. Specifically, after multivariable adjustment, the probability of clinical pregnancy and live birth increased by 8% (4%, 11%) and 8% (95% CI: 1%, 16%), respectively, for every 1% increase in serum long-chain omega 3-PUFA levels. Intake of long-chain omega 3-PUFA was also associated with a higher probability of life birth in these women, with RR of 2.37 (95% CI: 1.02, 5.51) when replacing 1% energy of long-chain omega 3-PUFA for 1% energy of saturated fatty acids. Serum omega 6-PUFA, ratios of omega 6 and omega 3-PUFA, and total PUFA were not associated with ART outcomes. The generalizability of the findings to populations not undergoing infertility treatment may be limited. The use of a single measurement of serum fatty acids to characterize exposure may lead to potential misclassification during follow up. Serum omega 3-PUFA are considered biomarkers of dietary intake. The association of higher serum long chain omega 3-PUFA levels with improved ART outcomes suggests that increased intake of these fats be may be beneficial for women undergoing infertility treatment with ART. NIH grants R01-ES009718 from the National Institute of Environmental Health Sciences, P30-DK046200 and T32-DK007703-16 from the National Institute of Diabetes and Digestive and Kidney Diseases, and L50-HD085359 from the National Institute of Child Health and Human Development, and the Early Life Nutrition Fund from Danone Nutricia US. Dr Rueda is involved in a patent 9,295,662, methods for enhancing, improving, or increasing fertility or reproductive function (). This patent, however, does not lead to financial gain for Dr Rueda, or for Massachusetts General Hospital. Dr Rueda does not own any part of the company nor does he have any equity in any fertility related company. As Dr Rueda is not a physician, he does not evaluate patients or prescribe medications. All other coauthors have no conflicts of interest to declare.