Background: In the last years, several scientific societies and expert groups focused on the
role played by nutritional factors, lifestyle and excess of body fat in interfering with female reproduction
and fertility. In many studies a confounding factor is represented by polycystic ovary syndrome (PCOS)
which is one of the major causes of infertility where genetic and family history are certainly playing a
role, together with lifestyle and nutritional factors.
Methods: In an attempt to define "the optimal fertility diet", we consider the role played by Mediterranean
lifestyle and some macronutrients (animal and vegetable proteins) on ovulatory disorders and female
fertility also considering some new visions derived from randomized trials of lifestyle programs in
obese infertile women asking for in vitro fertilization or alternative assisted reproduction technologies.
Results: Several reports are in favor of an increased consumption of either proteins or low-glycemic index
carbohydrates to improve ovulatory disorders and female fertility. In studies concerning infertile
women undergoing assisted reproduction, either structured exercise sessions and dietary intervention
programs seem to be effective in improving menstrual cycles and fertility as demonstrated by the increased
rate of natural conceptions.
Conclusion: The findings of this review confirm the important impact of Mediterranean diet and lifestyle
in preserving and improving fertility. However, epigenetic factors are very important in determining
fertility rate, but genetic background and ethnicity are also playing crucial roles.