Preconceptional Maternal Vegetable Intake and Paternal Smoking Are Associated with Pre-implantation Embryo Quality
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ORIGINAL ARTICLE
Preconceptional Maternal Vegetable Intake and Paternal Smoking Are Associated with Pre-implantation Embryo Quality Jeffrey Hoek 1 & Sam Schoenmakers 1 & Esther B. Baart 1 & Maria P. H. Koster 1 & Sten P. Willemsen 1,2 & Eva S. van Marion 3 & Eric A. P. Steegers 1 & Joop S. E. Laven 3 & Régine P. M. Steegers-Theunissen 1 Received: 27 March 2020 / Accepted: 18 May 2020 # The Author(s) 2020
Abstract Inadequate nutrition and lifestyle behaviors, particularly during the periconception period, are associated with a negative impact on embryonic and subsequent fetal development. We investigated the associations between parental nutritional and lifestyle factors and pre-implantation embryo development. A total of 113 women and 41 partners, with a corresponding 490 embryos, who underwent intracytoplasmic sperm injection (ICSI) treatment subscribed to the mHealth coaching platform “Smarter Pregnancy.” At baseline, nutrition and lifestyle behaviors (intake of fruits, vegetables, folic acid, and smoking and alcohol use) were identified and risk scores were calculated. A lower risk score represents healthier behavior. As outcome measure, a time-lapse morphokinetic selection algorithm (KIDScore) was used to rank pre-implantation embryo quality on a scale from 1 (poor) to 5 (good) after being cultured in the Embryoscope™ time-lapse incubator until embryonic day 3. To study the association between the nutritional and lifestyle risk scores and the KIDScore in men and women, we used a proportional odds model. In women, the dietary risk score (DRS), a combination of the risk score of fruits, vegetables, and folic acid, was negatively associated with the KIDScore (OR 0.86 (95% CI 0.76 to 0.98), p = 0.02). This could mainly be attributed to an inadequate vegetable intake (OR 0.76 (95% CI 0.59 to 0.96), p = 0.02). In men, smoking was negatively associated with the KIDscore (OR 0.53 (95% CI 0.33 to 0.85), p < 0.01). We conclude that inadequate periconceptional maternal vegetable intake and paternal smoking significantly reduce the implantation potential of embryos after ICSI treatment. Identifying modifiable lifestyle risk factors can contribute to directed, personalized, and individual recommendations that can potentially increase the chance of a healthy pregnancy. Keywords Lifestyle . Vegetables . Assisted reproductive technology . Embryo development . Nutrition . Smoking
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s43032-020-00220-8) contains supplementary material, which is available to authorized users. * Régine P. M. Steegers-Theunissen [email protected] 1
Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
2
Department of Biostatistics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
3
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, the Nether
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