Omega-3 helps conception as well as pregnancy – many studies

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Preconception Omega-3 injection – Germany 6X better, needs a RCT – Aug 2018

Impact of preconceptional omega-3-fatty acid supplementation on IVF-success and miscarriage rates in patients of a German fertility center
Arasch Bareksei1, Christoph Schwermann1, Gerd Hafner2, Sebastian Pfeiffer3, Kathrin Schlatterer4,5
1 Dental Concept, Praxis fur Zahn-, Mund- und Kieferheilkunde, Bahnhofstr. 65, 46562 Voerde
2 Universitatsmedizin, Universitat Duisburg-Essen, HufelandstraRe 55, D-45147 Essen
3 Labor Todorov, HuttenstraGe 31a, D-40215 Dusseldorf Arztehaus Mitte, In den Ministergarten 1, D-10117 Berlin
4 Ernst-Moritz-Arndt-Universitat Greifswald, Institut fur Klinische Chemie und Laboratoriumsmedizin, Ferdinand-Sauerbruch-Str., D-17475 Greifswald
5 Sankt Gertrauden-Krankenhaus, Institut fur Laboratoriumsmedizin, Paretzer Str. 12, D-10713 Berlin
Corresponding author: Dr. Arasch Bareksei, Praxis fur Zahn-, Mund- und Kieferheilkunde. Bahnhofstr. 65. D-46562 Voerde, Germany, Phone: +49-2855-7223
Fax: +49-2855-82880, dr.bareksei at zahnarzt-voerde.de

 Download the PDF from VitaminDWiki
Based on publications on potential benefits of omega-3-fatty acids an approach of IVF- success modulation by dietary measures was performed in the examined and clearly defined group of patients of a German fertility center.
A group of 52 IVF-patients with a history of at least two miscarriages or unsuccessful fertilization in vitro received periconceptional omega-3-fatty acid supplementation for at time period of at least 3 weeks. The ..historical" control group consisting of 1109 patients without omega-3-fatty acid supplementation was generated out of the fertility center's patient database. The same inclusion criteria (history of at least two miscarriages or unsuccessful fertilization in vitro) were underlied for both groups. Omega-3-fatty acid supplementation lead to significatly enhanced in vitro fertilization success rates as well as to a significant reduction of miscarriage rates compared to patients in the control group.
The results encourage to conceptualize further age-matched, double-blinded prospective studies in order to verify a positive influence of dietary intervention and life style modification on fertility rates.
Introduction
Omega-3-fatty acids belong to the group of polyunsaturated fatty acids and naturally occur in seaweed, diverse plants and fish. As they are essential for humans they have to be alimented. Omega-3-fatty acids not only represent important constituents of the cellular membrane, they also serve as basic synthesis compounds for intra- and extracellular signal messengers such as eicosanoids, which are involved in central physiological and pathophysiological processes like f.e. inflammation and tumorigenesis.
Multiple and heterogenous beneficial effects are attributed to omega-3-fatty acid intake such as prevention of cardial ischemia, stroke, depression and dementia. Also attention deficits shall be diminished as well as intelligence increased in babies of mothers supplemented with these substances. This represents just a small excerpt of the potential benefit spectrum assigned to these supplements in general health magazines. Therefore the readiness for supplementation is broad and en vogue in population, leading to an increased demand in the healthcare market. The question if these benefits are real is a trigger for a diversity of investigative approaches..
As a matter of fact various studies seem to confirm some of these beneficial effects assigned. Omega-3-fatty acids especially lower cardiovascular risks (1,2), they contribute to maintenance of mental health (3), the substances are attributed antiinflammatory advantages (4) and they even are put into context with preventive effects for certain tumor types like f.e. prostate cancer (5).
Beside that, positive associations for a linkage of omega-3-fatty acids with fertility and pregnancy have been published (6,7). Omega-3-fatty acid supplementation enhances uterine blood flow and therefore a successful onset of pregnangy is facilitated, the risk of miscarriages is reduced as well as the durance of pregnancy and the birth weight of the baby is positively influenced (6,8,9).
Beside these effects, an increased consumption of omega-3-fatty acids during pregnancy seems to reduce the risk of a postpartal depression (10). Also positive effects on intelligence quotients of those children are described (11). Recent studies indicate a positive effect of omega-3- and omega-6-fatty acids on the implantation probability with respect to in-vitro fertilization (12,13).
Kernack reports that approximately one in six couple suffers from subfertility. Despite of improvements in artificial reproductive technologies ongoing pregnancy rates per cycle are reported to still remain at ~25% (14). With growing evidence that the periconceptional nutritional status is a key determinant of fertility and long-term health of the offspring, a lucrative market has developed to meet the demand based on these benefits. Routine dietary supplementation of omega-6-fatty acids before and during IVF-treatment has not been subject to well-powered prospective randomised trials. One of the first prospective intervention trials examining the association of omega-3-fatty acid intake and the likelyhood of a pregnancy entry was initiated by Kermack et al. (14). Results of this PREPARE trial are still outstanding.
These approaches encouraged us to use the accessibility of a well defined patient group in a German fertility center for examining the effects of a periconceptional omega-3-fatty acid supplementation on fertility outcome, i.e. likelyhood of pregnancy entry and potential prevention of miscarriages in a first preparatory study, being aware that this approach does not meet classical prospective study criteria. For this purpose patients received a minimum of 3 weeks of periconceptional omega-3-fatty acid supplementation. Data for the control group without supplementation were recruted retrospectively from the database of the fertility center.

Material and Methods

Patients
Patients with a history of at least two miscarriages or unsuccessful fertilization in vitro (IVF)- treatments were recruted for the trial in a German Fertility Center (Interdisciplinary IVF- Center, Dusseldorf, Germany), leading to a selected patient group with poor prerequisites for successful fertility treatment. Patients with prednisolone intake and patients unwilling to have their data passed on were excluded from the trial group.
The same criteria were applied for the generation of a retrospective, ..historical" control group out of the fertility center database.
Overall a group of 52 patients with omega-3-fatty acid substitution was compared with a .historical" control group of 1109 patients, having received no dietary supplementation.
Omega-3-fatty acid substitution
Patients received omega-3-fatty acid substitution during the IVF-treatment concept. The dietary supplement was „OMEGAVEN Fresenius Emulsion", administered intravenously (1 ml per kg body weight per day) over at least 3 weeks. The product information reveals a content of 1.25-2.82 g eicosapentaenoic acid, 1.44-3.09 g docosahexaenoic acid, 0.0150.0296 g a-tocopherol and 2.5 g glycerol per 100 ml emulsion. First controls with respect to IVF-success were performed average 4-6 weeks after supplementation, the minimum interval was 3 weeks.
Statistics
Statistical analysis was performed by IBM SPSS Statistics (version 22). For descriptive analysis mean values and standard deviations were calculated. Stochastical independence of IVF-success rates and dietary omega-3-fatty acid supplementation were checked by means of the chi-square test of independence.

Results

Influence of omega-3-fatty acid supplementation on IVF-success rates
The likelyhood of pregnancy entry in 52 patients receiving a minimum of 3 weeks of periconceptional omega-3-fatty acid supplementation was compared with that of a ..historical" control group of 1109 patients (tab.1).
36 patients (69.2%) of the supplemented trial branch (total 52) became pregnant after IVF- treatment at the end the observation period of 4-6 weeks (minimum 3 weeks). One of these 36 patients had an miscarriage later during pregnancy.
The .historical" control group of 1109 patients, receving no omega-3-fatty acid supplementation, reveiled a pregnancy success rate of 33.3% (369 patients). The difference was statistically significant (p<0.001).
Impact of omega-3-fatty acid supplementation on miscarriage rates
After successful IVF-treatment 1 of 36 patients (2.8%) in the omega-3-fatty acid substituted group and 74 out of 369 patients in the ..historical" control goup (20.1%) suffered from a miscarriage earlier than week 12 of pregnancy (tab. 2). The difference was statistically significant (p=0.010).

Discussion

Goal of this study was to determine if there are first hints for a positive effect of omega-3-fatty acid supplementation on success of IVF-treatment and on a consecutive reduction of miscarriage rates. This lead to a study design with a prospective study group and a .historical" retrospective control group using the availibility of the well defined patient collective of a German fertility center.
For this preliminary approach the study group included 52 patients, whereas the control group with 1109 patients was nearly 20-fold larger. The substantial differences in numbers between study an control group are due to this specific study concept and of course limit conclusions.
In the interventional branch of the study successful pregnancy rates in IVF-patients periconceptionally treated with omega-3-fatty acids nearly doubled compared to the rate in the control group, which received IVF-treatment alone.
This promising result is in accordance with several recent studies. Jungheim an coworkers described a positive influence on success rates of fertilization in vitro by modification of omega-6- to omega-3-fatty acid-ratios (13). In animal experiments the quality of male sperms could be reduced by reduction of omega-3-fatty acid content in feed of freshwater guppies (15). These findings give space to the hypothesis, that with reduced dietary amounts of naturally occurring omega-3-fatty acids in industrialized countries also males in couples with fertilization problems may profit from supplementation. Further findings from the veterinary sector substantiate the hypothesis of positive effects of omega-3-fatty acids on fertility. Beside guppies, supplementation of omega-3 and omega-6 fatty acids in a special species of carp fish leads to improved maturation of gonads, breeding performance and spawn (16). Prepubescent sheep react on an increased supply with omega-3-fatty acids with increased release of reproductive hormones and increased fertility (17). Adding eicosapentaenoic acid to dairy cow feed improved folliculogenesis and the success rate of artificial fertilization (18).
Concludingly it can be postulated from human and animal data that supplementation of omega-3-fatty acids in male as well as in female may positively influence the overall reproductive success.
The influence of omega-3-fatty acid supplementation on miscarriage rates in patients after successful IVF-therapy revealed also first encouraging data. Out of the 36 patients comprhending omega-3-fatty acid-supplemented group which became successfully pregnant, just 1 patient suffered from a miscarriage later during pregnancy (2.8%), whereas in 20.1% of the non-supplemented control group miscarriage occurred. Although this ratio is significantly higher it is of limited validity and explanatory power due to the small size of both study branches well as their relation in size.
Nevertheless preventive effects of omega-3-fatty acid on miscarriage rates have been described before. Lazzarin published data for supplemented women formerly having miscarriages due to bad uterine blood circulation. These showed a significant significant improvement of arterial uterine blood supply (19).
Even patients with antiphospholipid syndrome responded to omega-3-fatty acid supplementation with a reduced incidence of miscarriages (20).
Supplementing vitamins, omega-3- fatty acids and minerals was descibed to reduce the risk of pre-eclampsia, premature births, gestation diabetes and miscarriages (21).
Veterinary data indicate halving of miscarriage rates in milk cows by adding of omega-3- fatty acids enriched linseed (22).
Our results in combination with results of human and veterinarian origin as described above reveal encouraging aspects with respect to a preventive effect of omega-3-fatty acid supplementation on as well IVF-success rates as a reduction of miscarriage rates.
A unique strength of our study is the fact that the study group, even with the relatively small number of 52 patients, is extremely well defined as well as clinically monitored during a long period and therefore strongly delineated to general female population. It also is composed by a patient collective preselected by poor prerequisites with respect to successful pregnancy (either unsuccessful fertilization in vitro (IVF)-treatment or at least two miscarriages in the past). Positive impact of dietary measures in such a negatively preselected group heavily outweighs against normal female population and gives rise to further studies. Our results are weakened by the fact, that the study could not be concipated as classical intervention study. All patients received omega-3-fatty acid supplemention and the effect with respect to influence on IVF-success rates and miscarriage rates was compared to a ..historical control group out of the same German fertility center. Study group and control group differ significantly in size, potentially influencing p-values already by stochastical fluctuations. Additionally age distribution in both groups could not be considered in this approach.
Promising first results of our study taking into account potential improvements described above and data already published before encourage in planning a new age-matched, placebo-controlled double-blinded study design. The meaningfulness of such an approach is suggested by the currently performed PREPARE trial study (14). This randomized, placebo- controlled dietary intervention study is based on a six-week duration olive oil containing alimentation combined with vitamin D and omega-3- fatty acid intake in the interventional branch and a six-week duration sunflower oil containing diet without vitamin D and omega-3- fatty acid supplementation in the control group. Goal is the evaluation of dietary intervention on early stages of embryonal development.

Conclusions

First positive effects of at least 3-week-preconceptional omega-3-fatty acid supplementation on reduction of miscarriage rates and on success of IVF-treatment could be shown in patients of a German fertility center, which encourage to conceive larger prospective studies in such well defined patient groups.
This approach of life style modification may be a low-cost mosaique block which is simple to realize improving the outcome of fertility treatment.

References and tables

1. Burr ML, Fehily AM, Gilbert JF et al. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 1989; 2:757-761
2. Marchioli R, Barzi F, Bomba E et al. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione. Circulation 2002; 105:1897-1903
3. Freeman MP, Hibbeln JR, Wisner KL et al. Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry. J Clin Psychiatry 2006; 67:1954-1967
4. Yan Y, Jiang W, Spinetti T et al. Omega-3 fatty acids prevent inflammation and metabolic disorder through inhibition of NLRP3 inflammasome activation. Immunity 2013; 38:1154-1163
5. Chavarro JE, Stampfer MJ, Li H et al. A prospective study of polyunsaturated fatty acid levels in blood and prostate cancer risk. Cancer Epidemiol Biomarkers Prev 2007; 16:1364-1370
6. Honest H, Forbes CA, Duree KH et al. Screening to prevent spontaneous preterm birth: systematic reviews of accuracy and effectiveness literature with economic modelling. Health Technol Assess 2009; 13:1-627
7. Nakao J, Ohba T, Takaishi K et al. Omega-3 fatty acids for the treatment of hypertriglyceridemia during the second trimester. Nutrition 2015; 31:409-412
8. Di Cintio E, Parazzini F, Chatenoud L et al. Dietary factors and risk of spontaneous abortion. Eur J Obstet Gynecol Reprod Biol 2001; 95:132-136
9. Saldeen P, Saldeen T Women and omega-3 Fatty acids. Obstet Gynecol Surv 2004; 59:722-730
10. Jensen CL Effects of n-3 fatty acids during pregnancy and lactation. Am J Clin Nutr 2006; 83:1452S-1457S
11. Helland IB, Smith L, Saarem K, et al. Maternal supplementation with very-long-chain n-3 fatty acids during pregnancy and lactation augments children's IQ at 4 years of age. Pediatrics 2003; 111:e39-e44
12. Mmbaga N, Luk J (2012): The impact of preconceptual diet on the outcome of reproductive treatments. Curr Opin Obstet Gynecol 2012; 24:127-131
13. Jungheim ES, Frolova AI, Jiang H, et al. Relationship between serum polyunsaturated fatty acids and pregnancy in women undergoing in vitro fertilization. J Clin Endocrinol Metab 2013; 98:E1364-E1368
14. Kermack AJ, Calder PC, Houghton FD, et al. A randomised controlled trial of a preconceptional dietary intervention in women undergoing IVF treatment (PREPARE trial). BMC Womens Health 2014; 14:130
15. Rahman MM, Gasparini C, Turchini GM, et al. Experimental reduction in dietary omega-3 polyunsaturated fatty acids depresses sperm competitiveness. Biol Lett 2014: 10:20140623
16. Nandi S, Chattopadhyay DN, Verma JP et al. Effect of dietary supplementation of fatty acids and vitamins on the breeding performance of the carp Catla catla. Reprod Nutr Dev 2001; 41:365-375
17. Ghaffarilaleh V, Fouladi-Nashta A, Paramio MT Effect of alpha-linolenic acid on oocyte maturation and embryo development of prepubertal sheep oocytes. Theriogenology 2014; 82:686-696
18. Moallem U, Shafran A, Zachut M et al. Dietary alpha-linolenic acid from flaxseed oil improved folliculogenesis and IVF performance in dairy cows, similar to eicosapentaenoic and docosahexaenoic acids from fish oil. Reproduction 2013; 146:603-614
19. Lazzarin N, Vaquero E, Exacoustos C et al. Low-dose aspirin and omega-3 fatty acids improve uterine artery blood flow velocity in women with recurrent miscarriage due to impaired uterine perfusion. Fertil Steril 2009; 92:296-300
20. Rossi E, Costa M Fish oil derivatives as a prophylaxis of recurrent miscarriage associated with antiphospholipid antibodies (APL): a pilot study. Lupus 1993; 2:319323
21. Glenville M Nutritional supplements in pregnancy: commercial push or evidence based? Curr Opin Obstet Gynecol 2006; 18:642-647
22. Ambrose DJ, Kastelic JP, Corbett R et al. Lower pregnancy losses in lactating dairy cows fed a diet enriched in alpha-linolenic acid. J Dairy Sci 2006; 89:3066-3074

Table1: Comparison of IVF-success rates between 52 omega-3-fatty acid supplemented and 1109 non-supplemented patients in a German fertility center

Table 2: Comparison of miscarriage rates between 36 omega-3-fatty acid supplemented and 369 non-supplemented patients after successful IVF-treatment in a German fertility center

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See also VitaminDWiki

Items in both categories Omega-3 and Pregnancy

Items in both categories Omega-3 and Fertility

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Pregnancy category

918 items in Pregnancy category

 - see also

• Overview Pregnancy and vitamin D
• Number of articles in both categories of Pregnancy and:Dark Skin 29;   Depression 21;   Diabetes 44;   Obesity 17;  Hypertension 44;   Breathing 35;  Omega-3 44;  Vitamin D Receptor 24 Click here for details
• All items in category Infant/Child 851 items
• Pregnancy needs at least 40 ng of vitamin D, achieved by at least 4,000 IU – Hollis Aug 2017
• 38+ papers with Breastfed etc, in the title
• Call to action – more Vitamin D for pregnancies, loading doses are OK – Holick Aug 2019
• 53+ preeclampsia studies
• 94+ studies with PRETERM in the title
• Fertility problem (PCOS) reduced by vitamin D, etc: many studies 15+
• 94+ Gestational Diabetes
• Caesarean birth much more likely if low Vitamin D - many studies 15+ studies
• Post-partum depression and low Vitamin D - many studies 15+ studies
• Stillbirth reduced by Vitamin D, Zinc, Omega-3 - several studies 5+ studies
• Search VitaminDWiki for "Assisted reproduction" 33 items as of Aug 2022
• Fertility and Sperm category listing has 141 items along with related searches
• (Stunting OR “low birth weight” OR LBW) 1180 items as of June 2020
• Less labor pain if higher level of vitamin D – August 2021
• Healthy pregnancies need lots of vitamin D
• Ensure a healthy pregnancy and baby - take Vitamin D before conception
  

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Healthy pregnancies need lots of vitamin D has the following summary

Most were taking 2,000 to 7,000 IU daily for >50% of pregnancy
   Click on hyperlinks for details

Problem	Vit. D Reduces	Evidence
0. Chance of not conceiving	3.4 times	Observe
1. Miscarriage	2.5 times	Observe
2. Pre-eclampsia	3.6 times	RCT
3. Gestational Diabetes	3 times	RCT
4. Good 2nd trimester sleep quality	3.5 times	Observe
5. Premature birth	2 times	RCT
6. C-section - unplanned	1.6 times	Observe
Stillbirth - OMEGA-3	4 times	RCT - Omega-3
7. Depression AFTER pregnancy	1.4 times	RCT
8. Small for Gestational Age	1.6 times	meta-analysis
9. Infant height, weight, head size      within normal limits		RCT
10. Childhood Wheezing	1.3 times	RCT
11. Additional child is Autistic	4 times	Intervention
12.Young adult Multiple Sclerosis	1.9 times	Observe
13. Preeclampsia in young adult	3.5 times	RCT
14. Good motor skills @ age 3	1.4 times	Observe
15. Childhood Mite allergy	5 times	RCT
16. Childhood Respiratory Tract visits	2.5 times	RCT

RCT = Randomized Controlled Trial

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Consumption of Omega-3 improves conception by 14% - Jan 2018

Dietary Fat Intake and Fecundability in 2 Preconception Cohort Studies.
Am J Epidemiol. 2018 Jan 1;187(1):60-74. doi: 10.1093/aje/kwx204.
Wise LA1, Wesselink AK1, Tucker KL2, Saklani S2, Mikkelsen EM3, Cueto H3, Riis AH3, Trolle E4, McKinnon CJ1, Hahn KA1, Rothman KJ1,5, Sørensen HT3, Hatch EE1.
1 Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts.
2 Department of Clinical Laboratory and Nutritional Sciences, College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts.
3 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
4 Division of Risk Assessment and Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark.
5 RTI Health Solutions, Research Triangle Park, North Carolina.

The association between dietary fat and fertility is not well studied. We evaluated intakes of total fat, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, trans fatty acids (TFA), ω-3 fatty acids, and ω-6 fatty acids in relation to fecundability in Danish and North American preconception cohort studies. Women who were attempting to become pregnant completed a validated food frequency questionnaire at baseline. Pregnancy status was updated bimonthly for 12 months or until pregnancy.
Fecundability ratios (FR) and 95% confidence intervals were estimated using multivariable proportional probabilities regression. Intakes of total fat and saturated, monounsaturated, polyunsaturated, and ω-6 fatty acids were not appreciably associated with fecundability.
TFA intake was associated with reduced fecundability in North American women (for the fourth quartile vs. the first, FR = 0.86, 95% confidence interval (CI): 0.71, 1.04) but not Danish women (for the fourth quartile vs. the first, FR = 1.04, 95% CI: 0.86, 1.25), though intake among Danish women was low. In North America, ω-3 fatty acid intake was associated with higher fecundability, but there was no dose-response relationship (among persons who did not use fish oil supplements: for the fourth quartile vs. the first, FR = 1.40, 95% CI: 1.13, 1.73); no association was found in Danish women, among whom low intake was rare. In the present study, high TFA intake and low ω-3 fatty acid intake were associated with reduced fecundity.

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11% of women take Omega-3 before conception - Oct 2017

Dietary Supplement Use during Preconception: The Australian Longitudinal Study on Women's Health
 Download the PDF from VitaminDWiki

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Omega-3 preconception IVF RCT - not published as of 2018

A randomised controlled trial of a preconceptional dietary intervention in women undergoing IVF treatment (PREPARE trial).
BMC Womens Health. 2014 Nov 18;14:130. doi: 10.1186/1472-6874-14-130.
Kermack AJ1 Alexandra.Kermack at uhs.nhs.uk, Calder PC, Houghton FD, Godfrey KM, Macklon NS.

BACKGROUND:
In vitro fertilisation (IVF) treatment provides an opportunity to study early developmental responses to periconceptional dietary interventions. Retrospective studies have suggested links between preconception diet and fertility, and more recently, a "Mediterranean" diet has been reported to increase pregnancy rates by up to 40%. In addition, a prospective study examining increased intake of omega-3 polyunsaturated fats demonstrated a quickened rate of embryo development after IVF. However, up to now, few prospective randomised controlled trials have investigated the impact of periconceptional dietary interventions on fertility outcomes.

METHODS AND DESIGN:
The study is a randomised controlled trial of a dietary intervention consisting of olive oil for cooking, an olive oil based spread, and a daily supplement drink enriched with Vitamin D (10 microgram daily) and marine omega-3 fatty acids (2 g daily) for 6 weeks preconception versus a control diet of sunflower seed oil for cooking, a sunflower oil based spread, and a daily supplement drink without added Vitamin D or marine omega-3 fatty acids. Couples undergoing IVF will be randomised to either the intervention or control group (55 in each arm). The primary endpoint is embryo developmental competency in vitro, measured by validated morphokinetic markers. Secondary outcomes will include the effect of the dietary intervention on the nutritional content of the intrauterine environment.

DISCUSSION: This approach will enable rigorous examination of the impact of the dietary intervention on early embryo development, together with the influence of the peri-implantation intra-uterine nutritional environment.

TRIAL REGISTRATION: ISRCTN50956936.
 Download the PDF from VitaminDWiki

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Preconception Omega-6 Obese IVF - Jan 2016

Altered Preconception Fatty Acid Intake Is Associated with Improved Pregnancy Rates in Overweight and Obese Women Undertaking in Vitro Fertilisation.
Nutrients. 2016 Jan 4;8(1). pii: E10. doi: 10.3390/nu8010010.
Moran LJ1, Tsagareli V2, Noakes M3, Norman R4,5.

Maternal preconception diet is proposed to affect fertility. Prior research assessing the effect of altering the fatty acid profile on female fertility is conflicting. The aim of this study was to assess the effect of preconception maternal diet, specifically fatty acid profile, on pregnancies and live births following in vitro fertilisation (IVF). Forty-six overweight and obese women undergoing IVF were randomised to a diet and physical activity intervention (intervention) or standard care (control). Outcome measures included pregnancy, live birth and pre-study dietary intake from food frequency questionnaire.
Twenty pregnancies (n = 12/18 vs. n = 8/20, p = 0.12) and 12 live births (n = 7/18 vs. n = 5/20, p = 0.48) occurred following the intervention with no differences between the treatment groups.
On analysis adjusted for BMI and smoking status, women who became pregnant had higher levels of polyunsaturated fatty acid (PUFA) intake (p = 0.03), specifically omega-6 PUFA and linoleic acid (LA) (p = 0.045) with a trend for an elevated intake of omega-3 PUFA (p = 0.06).
There were no dietary differences for women who did or did not have a live birth. Maternal preconception PUFA, and specifically omega-6 and LA intake, are associated with improved pregnancy rates in overweight and obese women undergoing IVF. This has implications for optimising fertility through preconception nutrition.
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Dr. Michael A Crawford - wants Omega-3 supplementation before conception

• Imperial College London
  "Having reported evidence that the brain required arachidonic and docosahexaenoic acid specifically, for its growth, structure and function in 1972, our work has focused first on testing the evidence, the specificity and the requirement. Attention is now directed on establishing
  (i) the biological reason for the uniqueness of docosahexaenoic acid in neural signaling systems which stretched unchanged over the 500- 600 million years of evolution and
  (ii) the application of this knowledge to the prevention and treatment of neurodevelopmental disorders.
• Peri-conception maternal lipid profiles predict pregnancy outcomes Nov 2016, https://doi.org/10.1016/j.plefa.2016.08.012
• Mother and Child Foundation - UK many videos
• "We work to prevent and relieve the sickness and disability of pregnant women and their children, and to preserve and protect their health"
• Research includes: "The relationship between iodine deficiency and whether it co-exists with omega-3 DHA deficiency"
• 2018 research includes
  Our work at Chelsea and Westminster Hospital has so far enabled us to predict the chances of preterm birth based on levels of oleic acid* and other mono-unsaturated fats in a mother’s blood. The lower the levels, the greater the risk of a baby being preterm, with all the associated mental health risks.
  We now need to follow up our investigations by looking at the impact of omega-3 (a fatty acid derived largely from sea foods) during pregnancy on later developmental outcomes of the children.
• Sustainability of Omega-3 production
  In 2012, South Korea adopted the highest dietary recommendation in the world for combined DHA/EPA, 2000mg/pp/pd.
  "87% of all infant formula sold in the world is now enriched with DHA/EPA"
• michael.crawford@imperial.ac.uk

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Omega-3 Optimises Pregnancy Outcomes - 2019

Omega-3 Optimises Pregnancy Outcomes
Preterm birth < 37 weeks
Early preterm birth < 34 weeks
Low birth weight babies (LBW)
Perinatal death*
Neonatal care admissions*
Low birthweight babies (LBW)
Pre-eclampsia and hypertension
Peri-natal depression
References

• Buck G, Tee P, Fitzgerald F, Vena J, Weiner J, Swanson M, Msall M. (2003). Maternal fish consumption and infant birth size and gestation: New York State angler cohort study. Environmental Health. 2:7–16.
• Borja-Hart L, Marino J. (2010) Role of omega-3 fatty acids for prevention or treatment of perinatal depression. Pharmacotherapy. 30:210–216.
• Cochrane Database of Systematic Reviews. (2018). Omega-3 fatty acid addition during pregnancy.
• Coletta J, Bell S, Roman A. (2010). Omega-3 Fatty Acids and Pregnancy. Rev Obstet Gynecol, 3(4), 163-171.
• Makrides M, Duley L, Olsen SF. (2006). Marine oil, and other prostaglandin precursor, supplementation for pregnancy uncomplicated by pre-eclampsia or intrauterine growth restriction. Cochrane Database of Systematic Reviews. Issue 3, Art. No.: CD003402.
• Nutrition in pregnancy: Scientific Advisory Committee Opinion Paper 18. London, Royal College of Obstetricians and Gynaecologists. 2010.
• Ramakrishnan U, Stein AD, Parra-Cabrera S, Wang M, Imhoff-Kunsch B, Juárez-Márquez S, et al. (2010) Effects of docosahexaenoic acid supplementation during pregnancy on gestational age and size at birth: randomized, double-blind, placebo-controlled trial in Mexico. Food and Nutrition Bulletin. 31:S108–S116.
• Swanson D, Block R, Mousa S. (2012). Omega-3 Fatty Acids EPA and DHA: Health benefits throughout life. Advances in Nutrition, Volume 3, Issue 1, 1-7.
• World Health Organisation (WHO). (2011). Marine oil supplementation to improve pregnancy outcomes. Biological, behavioral, and contextual rationale.

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