Mediterranean diet improves blastocyst formation in women previously infected COVID-19: a prospective cohort study

Huijun Chen; Jing Wang; Hongxin Guo; Qi Zhao; Ge Lin; Berthold Hocher; Philipp Kalk; Zetao Wang; Fei Gong

doi:10.3389/fnut.2024.1371077

Mediterranean diet improves blastocyst formation in women previously infected COVID-19: a prospective cohort study

Front Nutr. 2024 Jun 20:11:1371077. doi: 10.3389/fnut.2024.1371077. eCollection 2024.

Authors

Huijun Chen^#^{1

2

3}, Jing Wang^#², Hongxin Guo^{1

4}, Qi Zhao^{1

4}, Ge Lin^{1

4

5}, Berthold Hocher^{1

5

6

7}, Philipp Kalk^{2

8}, Zetao Wang^{6

9}, Fei Gong^{1

4

5}

Affiliations

¹ Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China.
² Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
³ Department of Nephrology, Charité Universitätsmedizin Berlin, Berlin, Germany.
⁴ Institute of Reproductive and Stem Cell Engineering, NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China.
⁵ Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha, China.
⁶ Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.
⁷ Institute of Medical Diagnostics, IMD, Berlin, Germany.
⁸ Diaverum Renal Care Center, Diaverum MVZ Am Neuen Garten Standort Ludwigsfelde, Potsdam, Germany.
⁹ Department of Gastroenterology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.

^# Contributed equally.

Abstract

Objectives: Our study tries to investigate the effect of the Mediterranean diet (MeDiet) on assisted reproductive treatment outcomes in women after COVID-19 infection.

Design: A prospective observational cohort study in the Reproductive and Genetic Hospital of CITIC-Xiangya from February 2023 to August 2023.Subjects: A total of 605 participants previously infected with COVID-19 were enrolled.

Exposure: None.

Main outcome measurement: The primary outcomes are oocyte and embryo quality. The secondary outcomes are pregnancy outcomes.

Results: A majority of participants (n = 517) followed low to moderate MeDiet, and only a small group of them (n = 88) followed high MeDiet. The blastocyst formation rate is significantly higher in MeDiet scored 8-14 points women (46.08%), compared to the other two groups (which is 41.75% in the low adherence population and 40.07% in the moderate adherence population respectively) (p = 0.044). However, the follicle number on hCG day, yield oocytes, normal fertilized zygotes, fertilization rate, day three embryos (cleavage embryos), and embryo quality are comparable among the three groups. For those who received embryo transfer, we noticed an obvious trend that with the higher MeDiet score, the higher clinical pregnancy rate (62.37% vs. 76.09% vs. 81.25%, p = 0.197), implantation rate (55.84% vs. 66.44% vs. 69.23%, p = 0.240) and ongoing pregnancy rate (61.22% vs. 75.00% vs. 81.25%, p = 0.152) even though the p values are not significant. An enlarging sample size study, especially in a high adherence population should be designed to further verify the effects of MeDiet's role in improving IVF performance.

Conclusion: High adherence to MeDiet is associated with improved blastocyst formation in women after COVID-19 infection. There is also a trend that high adherence to MeDiet might be beneficial to clinical pregnancy, embryo implantation as well as ongoing pregnancy in these women.

Keywords: IVF outcomes; embryo; mediterranean diet; post COVID-19; pregnancy.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This research was supported by Hunan Provincial Grant for Innovative Province Construction (2019SK4012). Internal Grant of Reproductive and Genetic Hospital of CITIC-Xiangya (YNXM-202304, YNXM-202217). China Scholarship Council supported Huijun Chen (202108430016). Xiangyang City Science and Technology Program in Health Care (2022YL19B).