Effect of polyphenol intake and assisted reproductive outcomes in the female population: a systematic review

Background: Polyphenols, which are the most abundant dietary antioxidants, are common constituents of plant-based foods. Evidence suggests that polyphenol intake may be associated with female reproductive outcomes. However, there is still a lack of a standardized definition of a polyphenol-based diet, which has led to conflicting evidence regarding its relationship with health outcomes in the female population undergoing assisted reproductive technology (ART). Methods: Searches were conducted on PubMed, Web of Science, Scopus, Embase, and the Cochrane Central Register of Controlled Trials from inception until February 2025. Studies were selected on the basis of clear inclusion and exclusion criteria. This analysis comprised observational, randomized controlled, and cohort studies that examined the effects of polyphenol intake on ART results. The certainty of evidence and quality of reviews were assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE), Newcastle-Ottawa Scale (NOS), JADAD, Oxford Center for Evidence-Based Medicine Levels of Evidence Working Group (OCEBM). Results: Ten studies were included in this review. The effect of polyphenol intake on outcomes in women undergoing ART is mainly divided into six outcomes: embryo quality, fertilization rate, biochemical pregnancy rate, clinical pregnancy, miscarriage rate, and live birth rates. The primary outcomes were reproductive outcome (biochemical pregnancy, clinical pregnancy and live-birth rate). The overall quality of the included studies was high, whereas most of the evidence had low or very low certainty. Conclusions: Our study suggests that the intake of polyphenols may be positively associated with reproductive health outcomes in women undergoing ART. Although currently available data indicate that increasing polyphenol intake (through exogenous supplementation) may improve the outcomes of women on ART, more evidence is needed to support long-term efficacy and safety. These findings provide a scientific basis for the further application of polyphenol intake for promoting reproductive outcomes in women undergoing ART.