L26/P-363 Randomized controlled study of an anti-inflammatory diet on in vitro fertilization outcomes in women with endometriosis (DANTE study): preliminary results

Abstract Study question Does a 12-week anti-inflammatory diet improve ovarian response in women with endometriosis undergoing in vitro fertilization? Summary answer Women with endometriosis following a 12-week anti-inflammatory diet had a significantly higher number of retrieved oocytes compared with controls. What is known already Endometriosis is associated with chronic pelvic pain, dyspareunia, dysmenorrhea, and infertility. Patients often modify their diet to alleviate symptoms, but no evidence-based nutritional guidelines exist. Existing data suggest that nutrition may modulate systemic inflammation and oxidative stress, which are elevated in endometriosis. Most available studies are observational, involve small sample sizes, and are prone to bias, highlighting the need for randomized trials assessing the impact of dietary interventions on reproductive outcomes. Study design, size, duration The DANTE study is a randomized controlled trial including 438 infertile women with surgically or ultrasonographically diagnosed endometriosis. Between March 2025 and January 2026, 58 patients were enrolled, of whom 54 were randomized to a control group receiving standard IVF or an intervention group following a 12-week anti-inflammatory diet before ovarian stimulation. Participants/materials, setting, methods Participants were randomized to standard IVF care or IVF combined with a personalized 12-week anti-inflammatory diet evaluated using the Dietary Inflammatory Index. Dietary recommendations were tailored to energy requirements, gastrointestinal symptoms, body composition, and food preferences. Baseline dietary intake was assessed using food frequency questionnaires, and adherence was monitored through food diaries and 24-hour recalls. The primary outcome was poor ovarian response, defined as retrieval of fewer than three oocytes according to Poseidon criteria. Main results and the role of chance Data from 16 women in the intervention group and 13 in the control group were analyzed. The proportion of women with poor ovarian response (≤3 retrieved oocytes) was significantly lower in the intervention group compared with controls (30% vs 85.7%, p = 0.05). Accordingly, the number of retrieved oocytes was significantly higher in the intervention group. A significant reduction in systemic inflammation was observed, with a greater decrease in the INFLA score in the intervention group compared with controls (median change −4 [−7, −0.25] vs 2 [−1.50, 9], p = 0.012). Circulating lipid profiles showed an increase in the omega-3/omega-6 ratio and monounsaturated fatty acids in the intervention group. Phase angle and body cell mass, estimated by bioimpedance, were positively correlated with circulating omega-3 fatty acids. Limitations, reasons for caution These findings are based on a preliminary analysis with a limited sample size. Results should therefore be interpreted cautiously until confirmed in the full randomized controlled trial. Wider implications of the findings If confirmed in the complete trial, these findings suggest that an anti-inflammatory dietary intervention may represent a feasible and non-pharmacological complementary approach to improve ovarian response in women with endometriosis undergoing IVF. Trial registration number Yes