Table 1.

Overview of the literature on the relation between diet and female fertility

	What is the bottom line?	What are the gaps in the evidence?	I want to read more but do not have much time.
Antioxidant supplements	Antioxidant supplements most likely do not make a difference	Too few studies have tested the exact same intervention so it is difficult to draw strong conclusions	Ref. 10
Folic acid, vitamin B12	Folic acid may increase fertility and live birth rates in ART. Doses higher than recommended for NTD prevention may offer the greatest benefit as might the additional intake of vitamin B12	No randomized trials have tested the doses related with greatest benefit in observational studies	Ref. 16 and 20 or 21
Vitamin D	Vitamin D does not have a major impact on fertility within the observed range of supplementation/adequate serum levels	Most published work has focused on women with vitamin D intakes or serum concentrations within or very close to normal range; an adverse effect of severe deficiency on fertility cannot be ruled out	Ref. 53 and 61 or 63
Dietary fats	Trans fatty acids (even at current intake levels in the US) are related to lower fertility while long chain omega-3 fatty acids have the opposite relation	The role of trans fatty acids will become an untestable hypothesis as they are phased out of the US food supply, but they may still be relevant elsewhere Trials of omega-3 fatty acid supplementation are needed	Ref 77, 78, 81, 82
Dairy	Dairy foods probably do not have an important influence on fertility	Very few studies have addressed this question	Ref 89, 90
Meats	Intake of red meats and fish with high levels of environmental contamination may be of concern	Very few studies have addressed this question	Ref 95, 96, 101
Soy, isoflavones	Soy intake does not help or hurt couples trying to conceive on their own; however, isoflavone intake may increase live birth rates in ART	Only one study to date among pregnancy planners Vast range of doses in ART studies yet all show similar effects	Ref. 106, 110
Diet patterns	“Healthy” diets have been consistently related to better fertility and higher live birth rates in ART across multiple studies. “Unhealthy” diets have consistently had the opposite relation.	Definition of healthy and unhealthy diets changes slightly from study to study. No randomized trials to date.	Ref. 111, 113
Alcohol, caffeine	Most large, well designed studies have not detected associations between higher alcohol or caffeine intake and lower fertility	Since randomized trials of alcohol/caffeine will likely be judged as unethical, there is a need for more large, high quality prospective cohort studies to clarify this issue.	Ref 144, 145, 153