title: Relationship between serum polyunsaturated fatty acids and pregnancy in women undergoing in vitro fertilization.
abstract: BACKGROUND
  Polyunsaturated fatty acids (PUFAs) and their metabolism may be important in normal reproductive function and fertility. Associations between physiologic PUFAs and pregnancy have not been established in women.
  
  
  OBJECTIVE
  The purpose of this study was to investigate associations between serum levels of PUFAs and embryo implantation in women undergoing in vitro fertilization (IVF).
  
  
  METHODS
  This was a prospective cohort study conducted between 2010 and 2012.
  
  
  METHODS
  The study was conducted at the Washington University Reproductive Medicine Center.
  
  
  METHODS
  Participants were 200 women undergoing IVF and participating in an ongoing specimen tissue bank.
  
  
  METHODS
  Fasting serum PUFAs were measured with liquid chromatography-mass spectroscopy. PUFAs measured included linoleic acid (LA), α-linolenic acid (ALA), eicosapentaenoic acid, arachidonic acid, and docosahexaenoic acid.
  
  
  METHODS
  Relationships between serum levels of measured PUFAs and embryo implantation in women undergoing IVF were analyzed.
  
  
  RESULTS
  In unadjusted analyses, none of the PUFAs alone were associated with a chance of pregnancy; however, women with increased LA:ALA ratios had a higher chance of pregnancy compared with women with lower LA:ALA ratios (relative risk, 1.52; 95% confidence interval, 1.09-2.13). This relationship held after multivariable logistic regression adjusting for age, antral follicle count, body mass index, history of previous pregnancy, and history of endometriosis (odds ratio, 2.7; 95% confidence interval, 1.3-5.7). Embryo implantation rates were also weakly associated with LA:ALA ratios (r = 0.21, P = .003).
  
  
  CONCLUSIONS
  Our work shows that increased ω-6 to ω-3 PUFA ratios in women undergoing IVF are associated with increased implantation and pregnancy rates. Prospective trials are needed to determine whether manipulation of PUFA ratios through diet or pharmacologic intervention may benefit women planning to conceive.
authors.affiliation: Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri 63105, USA. jungheime@wustl.edu
authors.forename: Emily S
authors.initials: ES
authors.lastname: Jungheim
authors.forename: Antonina I
authors.initials: AI
authors.lastname: Frolova
authors.forename: Hui
authors.initials: H
authors.lastname: Jiang
authors.forename: Joan K
authors.initials: JK
authors.lastname: Riley
mesh_terms: D000328:Adult; D015331:Cohort Studies; D010064:Embryo Implantation; D005231:Fatty Acids, Unsaturated / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies
chemical_list: D005231:Fatty Acids, Unsaturated