Effect of a pro-fertility diet combined with omega-3 supplementation on embryo quality in infertile women undergoing IVF: a randomized controlled trial

Abstract

Research question: Does adherence to a pro-fertility diet (PFD) combined with omega-3 supplementation improve the fertilization rate and embryo quality in infertile women undergoing IVF? Design: A randomized, single-blind, parallel clinical trial was conducted from June 2024 to June 2025 among 180 infertile women aged 18-42 years undergoing IVF at Hazrat Maryam Fertility Center, Isfahan, Iran. Participants were randomized (1:1) to receive either a structured PFD with daily omega-3 (1000 mg), vitamin D (1000 IU), folate (1 mg) and vitamin B12 (500 mg) supplementation for 60 days, or general dietary advice based on the Healthy Eating Plate model plus 500 mg/day folic acid. Fertilization rate, embryo formation rate and embryo quality (grades A-D) were evaluated. Results: Compared with controls, the intervention group had significantly higher fertilization rates (0.81 f 0.16 versus 0.66 f 0.24; P < 0.001) and embryo formation rates (0.79 f 0.26 versus 0.62 f 0.30; P < 0.001), and an increased number of embryos formed (3.78 f 2.34 versus 2.22 f 1.46; P < 0.001). Additionally, the proportion of grade A embryos was markedly higher in the intervention group (45.2 versus 21.7; P = 0.003). Conclusion: Adherence to a PFD combined with omega-3 supplementation significantly improved the fertilization rate and embryo quality in women undergoing IVF. This combined nutritional intervention represents a safe, feasible and cost-effective adjunctive approach to optimize embryological outcomes in assisted reproductive technology.