Personalized anti-infertility diet with a ‘full body’ x-ray to evaluate the woman’s body composition and create a nutritional program for her aimed at optimizing the chances of conception. This is the approach tested by the nutrition experts of the Genera group, led by the biologist Gemma Fabozzi, head of the B-Woman center for women’s health, in collaboration with the team of Laura di Renzo, full professor of Clinical Nutrition at the University Tor Vergata in Rome, who presented the results of their pilot test at the 40th congress of the European Society of Reproductive Medicine and Embryology (ESHRE), underway in Amsterdam.
“It is known from the data present in the literature – explains Fabozzi, first author of the work – that being underweight, overweight or obese increases the risk of repeated embryo implantation failures or spontaneous abortion, probably due to the key role that adipose tissue plays in reproduction”. But it is not a trivial question of weight. “The body mass index (BMI) is the most used indicator to define anthropometric characteristics, but – the expert underlines – it represents an inadequate indicator of body composition, with the risk of incorrectly calculating the percentage of fat mass and underestimating possible reproductive failure. This study aimed to analyze the body composition of infertile patients using dual-energy X-ray absorptiometry (DXA), the gold standard for calculating and localizing lean mass, regardless of body weight, providing a three-dimensional image of the density of body organs. A path that can be taken especially to develop personalized nutritional plans for patients with infertility problems”.
The trial involved 66 women, 50 of whom already had children and 16 with a history of repeated implantation failures of embryos produced with assisted fertilization. A characterization of body composition was performed using Dxa and it was discovered that “this composition and also bone density are different between fertile and infertile patients: compared to the former, infertile women who had unsuccessfully resorted to PMA show differences in tissue distribution especially in the lower part of the body, and in bone mineralization”.
“The analysis of the microbiota – continues Fabozzi – has also shown significant differences between the two groups: infertile patients have an increased percentage of Proteobacteria and Enterobacteriaceae, which are the bacteria that commonly cause vaginal infection problems that we know are a risk factor for embryo implantation. A percentage far greater than the 4%, on average, of normal presence of these microorganisms”.
“It is fundamental – Renzo points out – to determine body mass, divided into muscle, fat and bone. The condition of infertility is in fact characterized by a reduction in lean mass with a consequent increase and proportional expansion of fat mass, not only at the visceral level, but also peripheral. Furthermore, compared to fertile women, those with infertility problems have a lower bone mass at the trunk level. A condition that occurs regardless of the patient’s BMI”, he points out.
“The goal is to make the way we are able to evaluate the body composition of an infertile woman more objective – Fabozzi points out – Today we rely on Bia (bioimpedance analysis), BMI and weight, which are fairly imprecise analysis indices, but also easy to use. With Dxa, a sort of full body x-ray, we can study how much lean and fat mass are present, how they are distributed, together with a photograph of the bone and lipid composition that apparently varies between those who are fertile and those who are infertile. This is an important starting point. The studies must now continue to better understand these differences, identify patients at risk of infertility and develop a targeted nutritional and lifestyle therapy for each one”.
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