title: Dietary folate and reproductive success among women undergoing assisted reproduction.
abstract: OBJECTIVE
  To prospectively evaluate the associations of folate with assisted reproductive technology outcomes within a population in the United States.
  
  
  METHODS
  This analysis included women (n=232) in a prospective cohort study at the Massachusetts General Hospital Fertility Center. Diet was assessed before assisted reproductive technology treatment using a validated food frequency questionnaire. Intermediate and clinical endpoints of assisted reproductive technology were abstracted from medical records. Generalized linear mixed models with random intercepts to account for multiple cycles per woman were used to evaluate the association of folate intake with assisted reproductive technology outcomes adjusting for calorie intake, age, body mass index, race, smoking status, infertility diagnosis, and protocol type.
  
  
  RESULTS
  Among the 232 women (median age 35.2 years, median folate intake 1,778 micrograms/day), higher folate intake was associated with higher rates of implantation, clinical pregnancy, and live birth. The adjusted percentage (95% confidence interval [CI]) of initiated assisted reproductive technology cycles resulting in a live birth for women in increasing quartiles of folate intake were 30% (95% CI 21-42%), 47% (95% CI 35-59%), 42% (95% CI 30-35%) and 56% (95% CI 43-67%) (P for trend=0.01). Live birth rates were 20% (95% CI 8-31%) higher among women in the highest quartile of supplemental folate intake (more than 800 micrograms/day) than among women in the lowest quartile (less than 400 micrograms/day). Higher supplemental folate intake was associated with higher fertilization rates and lower cycle failure rates before embryo transfer (P for trend=0.03 and 0.02).
  
  
  CONCLUSIONS
  Higher intake of supplemental folate was associated with higher live birth rates after assisted reproductive technology treatment.
  
  
  METHODS
  : II.
authors.affiliation: Departments of Nutrition, Epidemiology, Biostatistics, and Environmental Health, Harvard School of Public Health, Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, the Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, and the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Audrey J
authors.initials: AJ
authors.lastname: Gaskins
authors.forename: Myriam C
authors.initials: MC
authors.lastname: Afeiche
authors.forename: Diane L
authors.initials: DL
authors.lastname: Wright
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Toth
authors.forename: Paige L
authors.initials: PL
authors.lastname: Williams
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
authors.forename: Russ
authors.initials: R
authors.lastname: Hauser
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Chavarro
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016001:Confidence Intervals; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004624:Embryo Transfer / Q000009:adverse effects / Q000379:methods; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects / Q000379:methods; D005492:Folic Acid / Q000008:administration & dosage*; D006801:Humans; D016014:Linear Models; D050498:Live Birth / Q000453:epidemiology*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012016:Reference Values; D027724:Reproductive Techniques, Assisted; D016896:Treatment Outcome; D014481:United States
chemical_list: D005492:Folic Acid