Following the removal of eighty-four duplicates, the selection was made through titles, abstracts and full-text reading. The beneficial efficacy of soy is often attributed to the presence of isoflavones, capable of mitigating the excesses of endogenous estrogens, through the competition with estrogen receptors or by the activation of receptors, in the presence of low levels of endogenous estrogens. However, the number of combined participants of the two studies was very limited (n: 40). (2006), Rapid endocrine disruption: Environmental estrogen actions triggered outside the nucleus, Rowlands DJ, Chapple S, Siow RCM, et al. (2016), Soy intake modifies the relation between urinary bisphenol A concentrations and pregnancy outcomes among women undergoing assisted reproduction, The effects of soy isoflavones on metabolic status of patients with polycystic ovary syndrome, Wesselink AK, Hatch EE, Mikkelsen EM, et al. (2019), Cumulative meta-analysis of the soy effect over time, Nachvak SM, Moradi S, Anjom-Shoae J, et al. This suggests a protective effect of soy against fertility disturbance by BPA. Isoflavone genistein inhibited the enzyme tyrosine kinase in human A431 cell membranes at 07g/ml, a very high, non-physiological concentration(77) and act as a ligand for peroxisome proliferator-activated receptors (PPARs) in cultured astrocytes at 500nM(78). The https:// ensures that you are connecting to the However, urinary phytoestrogen levels were only detected at baseline and this increased the correlation uncertainty. (2001), Exposure to soy-based formula in infancy and endocrinological and reproductive outcomes in young adulthood, Unfer V, Casini ML, Costabile L, et al. Furthermore, the use of spot urine samples for BPA quantification may have underestimated its exposure. In another prospective study, 471 healthy American women were followed for 12 months or until delivery without showing significant correlations between urinary isoflavones, quantified by HPLC-MS analysis, and fertility, defined with adjusted Cox Model using time-to-pregnancy assessment(39), while lignan concentrations in urine were significantly associated with shorter time to pregnancy. Journal of Clinical Endocrinology and Metabolism randomized 70 women with PCOS into two groups to take either 50 mg/d soy isoflavones or a placebo for 12 weeks. Previously, Petrakis and colleagues proposed an interventional study with a soy isolate (374g of soy protein containing 374mg of genistein) on twenty-four women (pre- and post-menopause) followed for 6 months plus 3 months pre-intervention and 3 months post-washout(25). (2020). (1987), Genistein, a specific inhibitor of tyrosine-specific protein kinases, Valles SL, Dolz-Gaiton P, Gambini J, et al. In this context, the evaluation of urine samples cannot be underestimated as a valuable tool for detection of the real bioavailability of isoflavones whose metabolisation requires the intervention of intestinal microbiota. On consumption, they increase estrogen production in a woman's body. 1. (2020), Urinary phytoestrogens and relationship to menstrual cycle length and variability among healthy, eumenorrheic women, Haudum C, Lindheim L, Ascani A, et al. (2018), Bacterial metabolite S-equol modulates glucagon-like peptide-1 secretion from enteroendocrine L cell line GLUTag cells via actin polymerization. While soy appears to have a negligible effect on hormonal network, menstrual cycle length and fertility outcomes of healthy women, some clues emerged from literature on its possible beneficial effect in the case of endocrine diseases such as PCOS. Major equol production was associated with a reduction in androgens levels (total testosterone, free testosterone and androstenedione), in the whole cohort. Regarding observational studies, in 2015 Andrews and colleagues conducted a prospective cohort study on 246 American women with normal menstrual cycle, aged 1844 and with 13% of participants of Asian ethnicity, for a follow-up of 12 whole menstrual cycles(41). (2009), The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration, Moher D, Liberati A, Tetzlaff J, et al. Soy isoflavones have repeatedly shown a mild estrogenic effect but at high concentrations they may have enough power to act on hypothalamus and pituitary gland, reducing the ovarian synthesis of estrogens. Furthermore, no characterisation was made on the possible presence of equol-producers among the participants. Furthermore, there was no characterisation of dietary regimen, although it was a standard hospital diet. pain au chocolat recipe paul hollywood; The influence on SHBG levels can have a beneficial effect from an endocrine point of view, without negative effects on ovulation. Table 2 summarises main limitations about the studies discussed. (2009), Effects of soy protein and isoflavones on circulating hormone concentrations in pre- and post-menopausal women: a systematic review and meta-analysis, Hormonal effects of soy in premenopausal women and men, Sdergrd R, Bckstrm T, Shanbhag V, et al. A total number of twenty-two experimental articles plus a meta-analysis was used for the final synthesis. Although this was a randomised, placebo-controlled and double-blinded trial with a sample size appropriate to the power of detection, there was no evaluation of serum and urinary levels of isoflavones and/or metabolites. Fertility is defined by the number of offspring produced by an individual. From the analysis of urinary excretion of isoflavones normalised for creatinine during the intervention with soy, Asian women had significantly greater excretion of isoflavones than non-Asian women. Instead, in the cohort study by Filiberto and colleagues, 259 American women were followed for at least 2 menstrual cycles. Additionally, isoflavones can act as antioxidants in vitro (15), but the extent to which they contribute to the antioxidant status of humans is not yet clear. After adjustments, an inverse correlation between estradiol and soy intake was highlighted on the 22nd day of menstrual cycle (r: 032, P=004) but not on the 11th. Eating a few servings of soy each week could improve fertility and metabolic aspects of PCOS. (2020), Dietary phytoestrogen intakes of adult women are not strongly related to fecundability in 2 preconception cohort studies, Levine LD, Kim K, Purdue-Smithe A, et al. Although this clinical trial showed the long-term effect of soy ingestion on serum hormone levels, it was a pilot study with a limited number of participants (fourteen premenopausal women). After 6 months, estradiol levels of patients in the intervention group were higher compared with basal (P<005), whereas luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were unchanged. Furthermore, the search for sources has been extended to the single manuscripts reference lists. However, the work had several strengths: the real evaluation of luteal and follicular phase through the dosage of urinary LH:creatinine ratio, the characterisation of sampling according to the cycle; the evaluation of isoflavone content in foods used for the intervention and quantification of urinary isoflavones to check compliance; the use of soy foods and not supplements or extracts to approach a real-life pattern; the characterisation of diet at various steps of clinical trial to avoid confounding mechanisms; the stratification by ethnicity which indirectly showed the effect on equol-producer individuals. M. A. S. contributed to drafting and revising the manuscript. I started taking soy in December on CD4-8 and I got digital bfp on at 9dpo. Soy consumption was not related to estradiol levels or endometrial thickness. Overall, soy and soy components consumption do not seem to perturb healthy women's fertility and can have a favourable effect among subjects seeking pregnancy. (2013), Usual dietary isoflavone intake and reproductive function across the menstrual cycle, Jacobsen BK, Jaceldo-Siegl K, Knutsen SF, et al. The authors highlighted a marginal reduction of luteal phase in the adjusted multivariable model for an increase of 10mg/d of dietary isoflavones (aOR: 138, 95% CI 099, 192, P=006), identified by monitoring LH levels in urine by a fertility monitor and 4-d per cycle 24-h dietary recalls. Most tablets (sold by department stores) have a dosage of 40mg. Phytoestrogens and breast cancer promoters or protectors? Even if the clinical trial did not include a placebo group or randomisation, the presence of a control group and the evaluation of equol-producer individuals mitigated these issues. In a logical perspective, the effect of soy cannot be attributed to the effect of its isoflavones alone. Soy can contain numerous other phytochemicals such as saponins, phytosterols, phytic acid, non-isoflavone flavonoids, peptides, protease inhibitors and other bioactive substances. However, ethnicity was not used for outcomes stratification. Jamilian and colleagues in 2016 conducted another parallel clinical trial on seventy Iranian women with PCOS, using 50mg/d of soy isoflavones for a 1-month follow-up(43). The phytoestrogen actions of soy isoflavones may increase estrogen levels in the body and induce ovulation in women, thus, may speed up the process of pregnancy. Genistein treatment reduced LDL cholesterol and triglycerides levels. In addition, no significant changes in progesterone, LH or SHBG were found in the whole study sample. Compliance with the intervention was suggested by urinary excretion of isoflavones. Infertility is a condition that prevents pregnancy despite having regular sexual intercourse with your partner for at least a year. Consequently, the absence of fertility, called infertility, is a disease characterised by the failure to establish a clinical pregnancy and it can depend on various factors including predisposition and behavioural/environmental aspects. Furthermore, the use of spot urine samples could generate an underestimation of urinary isoflavones quantification. The authors declare that they have no conflicts of interest. In addition, full-text bibliographic lists from selected papers were screened to retrieve further relevant articles. The small number of participants significantly limited the quality of results. Available from: Messina M, Mejia SB, Cassidy A, et al. Even if serum AMH concentrations appear as a useful tool for predicting female fertility, only one study from our selection used them(46). Emerged clinical trials display several limitations including small sample size as well as the longitudinal design without a parallel control group, placebo or a cross-over design consistently limiting the strength of these pilot studies. Manuscripts exploring multiple aspects were discussed in different paragraphs, where deemed necessary. For these reasons, results should be interpreted with caution. Among the limitations of this review of literature, we must include the possible avoidance of studies that considered fertility as a secondary outcome and which therefore may have escaped from the manuscript selection. (As part of this process, a group of eggs matures so that one will be ready for release during ovulation .) In 2000, Wu et al. The obtained meta-analysis was included in the final summary because it assessed aspects relating to the topic of this review. Pending further confirmation, soy and its components do not appear to have a clinically relevant influence on menstrual cycle in healthy women. The standard guidelines for Clomid are to take it either on cycle days 3-7 or 5-9. It is an endocrine dysfunction that includes hormonal alterations (increased levels of adrenal and ovarian androgens and SHBG secretion from the liver) and anovulatory disorders(64). 44% of women of Asian descent were in the highest quartile of isoflavone intake. For example, it should be identified whether the interest is related to pharmacological effect, thus implying the use of high concentrations of soy components, or if the aim is to investigate soy functional effects that can be obtained mimicking eating habits, thus providing soy foods with realistic intake levels. No significant differences were found in the spontaneous abortion rate, the number and quality of embryos transferred or oocytes fertilised. (2019), Soy, soy isoflavones, and protein intake in relation to mortality from all causes, cancers, and cardiovascular diseases: a systematic review and dose-response meta-analysis of prospective cohort studies, Schmidt M, Arjomand-Wlkart K, Birkhuser MH, et al. Thus, consumption of soy containing 32-200 mg/d of isoflavones seems to increase menstrual cycle length and the ratios of 2- to 16- (OH) and 2- to 4- (OH) estrogens and to decrease plasma concentrations of estradiol, progesterone, midcycle gonadotropins and SHBG as well as urinary estrogens. No changes were highlighted for DHEA, DHEAS, dihydrotestosterone (DHT) concentration or LH:FSH ratio. These substances could play a role in the ovaries circulatory functions(50). Eleven interventional studies, eleven observational studies and one meta-analysis have been selected from the results of queries. Participants were classified by ethnicity; however, the population sample size did not allow to perform stratification of outcomes based on this aspect. I've heard soy increases chances of having twins. The procedure was carried out following the most recent PRISMA guidelines(23). Furthermore, women with PCOS display a higher prevalence of hyperinsulinemia, dyslipidemia, insulin resistance and obesity compared to healthy population. (2021), Neither soy nor isoflavone intake affects male reproductive hormones: an expanded and updated meta-analysis of clinical studies, Liberati A, Altman DG, Tetzlaff J, et al. In the first study, the authors administered soy milk to six American women aged 2229 for 1 month, comparing outcomes with baseline(26). However, this omission does not necessarily imply that the assessment has not been carried out. Moreover, urinary concentrations seem to reflect the isoflavone intakes in a short time window. Isoflavones also bind to ER receptor, albeit with lower affinity. One of the first research papers to look directly at soy and fertility outcomes was from the Adventist Health Study-2. and transmitted securely. However, after removing data from studies with elevated bias risk, two studies were included in the sensitivity analysis with a consequent loss of statistical significance for LH levels. Podeli na Fejsbuku. It has been said to be nature's clomid. There was no relationship between isoflavone intake and reported problems becoming pregnant. Women will take 2-4 tablets each day for a few days prior to ovulation: days 1-5, 3-7, or 5-9 of their cycle. FSH levels were not significantly changed after genistein intervention. Soy food and soy isoflavone intake were unrelated to sperm motility, sperm morphology or ejaculate volume. Received 2022 Jan 30; Accepted 2022 Feb 7. Patients showed plasma androgens levels above or at the upper limit the normal range, at baseline. (2016), The influence of religious affiliation on participant responsiveness to the complete health improvement program (CHIP) lifestyle intervention, McBride DC, Bailey KGD, Landless PN, et al. was a pilot study without a characterisation of diet among participants and without data on soy composition (isoflavone or antioxidant contents). Furthermore, it should be considered that, as already discussed, many studies display several limitations including inadequate sampling of hormone concentrations during all phases of cycle, low number of participants and the lack of a placebo group. Four clinical trials were found among search engines results: two longitudinal pilot studies(34,46) and two interventional studies with a parallel design, both conducted in Iranian populations(35,43). Longer, not clinically relevant duration of menstrual bleeding (adjusted MD: 037d, 95% CI 006, 068), without differences in severity of menstrual flow was observed. Discuss all supplements you are taking with your care team. (2010), Clinical studies show no effects of soy protein or isoflavones on reproductive hormones in men: results of a meta-analysis, Reed KE, Camargo J, Hamilton-Reeves J, et al. The significant inverse association between dietary isoflavone intake and live births (3% reduction, 95% CI 0, 7, P=005) was highlighted. (2011), Equol-stimulated mitochondrial reactive oxygen species activate endothelial nitric oxide synthase and redox signaling in endothelial cells: roles for F-actin and GPR30, Akiyama T, Ishida J, Nakagawa S, et al. The duration of menstrual cycle, especially in luteal phase, can also have a direct influence on the mammary gland proliferation, through a reduction in exposure of the epithelium to proliferative hormones. In particular, soy contains numerous non-isoflavone constituents such as phytic acid, triterpenes and sterols, BowmanBirk protease inhibitors, unsaturated fatty acids, saponins, inositol phosphates, proteins, peptides such as lunasin;(10) nevertheless, soy isoflavones have attracted much attention in the last years for its estrogenic as well as non-hormonal properties(11). Finally, twelve entries were identified and ten additional articles were obtained after the consultation of full-text bibliographic lists. Ricardo Hector Asch (born 26 October 1947) is an obstetrician, gynecologist, and endocrinologist.He worked with reproductive technology and pioneered gamete intrafallopian transfer (GIFT), as well as working on research linking fertility and marijuana usage, and investigated the use of GnRH analogues with Andrew Schally. A. F. contributed to drafting and revising the manuscript. Among selected prospective cohort studies, in 2012 Jarrell and colleagues conducted an observational study of 323 Canadian women with late pregnancy (aged at least 35) followed from the second month of pregnancy until delivery(36). There are clues about the association between soy intake and the increase in SHBG levels. The reduction of estradiol and progesterone could postpone ovulation by lengthening the menstrual cycle. Similar significant association was observed for peak luteal progesterone 10ng/ml (aOR: 140, 95% CI 100, 196, P=005). However, the evaluation of ability to absorb and metabolise isoflavones was lacking in the present study. This aspect was different from the results of the clinical trials with high intakes listed above, perhaps due to very different intakes (mean isoflavone consumption of 34mg/d in this cohort). However, soy intake did not correlate with cycle length (r: 012, P=045). The clinical studies selection included one retrospective study, two cross-sectional studies, eight longitudinal cohort studies, five parallel-designed interventional studies and six longitudinal interventional studies. These aspects considerably reduce the reliability of results, favouring data misinterpretation. Moreover, difficulties related to data collection about nutritional intakes were available, and individual reporting errors must be taken into account. From the general linear model of the analysis of covariance, the intervention with soy reduced free androgen index (0020005 v. +0010005, P<0001), total testosterone (01005 v. +01005ng/ml, P=0008) and increased SHBG levels (+4008 v. 1408nmol/l, P<0001) compared with placebo (adjusted for baseline values). From a sub-analysis on ethnic characteristics, it was further highlighted that only Asian women showed a significant reduction in follicular estradiol from baseline (174%). The detailed selection process is highlighted in Fig. Currently, data are insufficient to assess the effect of early-stage soy exposure on fertility-related outcomes. Furthermore, diet and energy intake were not investigated and sampling was not well-timed to menstrual cycle. San Diego Fertility Center is one of the most respected fertility centers in the USA with fertility clinics in Southern California and New York City.With exceptional patient care, a track record of IVF success and a sunny fertility tourism destination, San Diego Fertility Center is an international location for egg donation, IVF, IUI, PGD/PGS, gender selection, egg freezing, surrogacy and . In particular, information about the adequate choice of updated nutritional tables as well as specific nutritional choices, such as increased soy consumption due to pre-existing socio-cultural and physiological aspects should be collected. 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