In another clinical trial already discussed, although no changes in cycle length were found following soy foods intervention in twenty women with a follow-up of at least seven menstrual cycles, a significant reduction in follicular phase by 93% (P<005) in estradiol concentrations was observed, but not in luteal phase(Reference Wu, Stanczyk and Hendrich28). Among the studies discussed to evaluate menstrual cycle length, three interventional studies also evaluated the levels of circulating hormones following soy intake in healthy women(Reference Lu, Anderson and Grady26,Reference Wu, Stanczyk and Hendrich28,Reference Lu, Anderson and Grady29) . The consumption of soy over time, the possible use of certain foods considered healthy in seeking pregnancy or the willingness to avoid pregnancy could generate spurious associations. This phenomenon highlights how in literature there is greater attention to phytoestrogens and their effect, frequently underestimating the role of other components that have a marginal interest. No restrictions were applied using filters and results were collected from search engines by the inception through 4 April 2021. No correlation with specific isoflavones such as equol, daidzein and O-DMA was found. This effect persisted for at least one menstrual cycle after the suspension of soy intake, with a maximum of persistence for three menstrual cycles. Isoflavones show several biological properties, acting as selective tissue estrogenic activity regulators (STEARs), thanks to the differential distribution pattern of estrogen receptors in body tissues(Reference Matthews and Gustafsson13) and the differentiated affinity between the two isoforms of estrogen receptors, called alpha and beta. However, only 106 individuals provided information on soy intake. RANCHO CUCAMONGA. 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(Reference Jarrell, Foster and Kinniburgh36). Additional considerations regarding hormonal influences will be discussed in the next paragraph. The length of menstrual cycle may represent an indirect marker of ovarian function and reproductive health(Reference Mumford, Steiner and Pollack54,Reference Vassena, Vidal and Coll55) . Isoflavones concentrations did not show significant differences between participants at baseline. From the data obtained, diet isoflavones do not seem to have a direct effect on fertility, whether positive or negative. However, for articles selection, we used search engines both for scientific literature and specific for clinical trials, without filters application that could have limited the results. If we eat soy, do we keep the beneficial effects of the Mediterranean diet? In addition, other studies investigated the urinary concentrations of isoflavones and metabolites, including equol(Reference Mumford, Sundaram and Schisterman39,Reference Levine, Kim and Purdue-Smithe45) . 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. Unfortunately, the work of Kohama et al. Isoflavones also bind to ER receptor, albeit with lower affinity. However, results are questionable due to the lack of hormone level measurements or reproductive functions. The FFQ was not specifically designed for phytoestrogen assessment and this may have underestimated intakes. Fig. The strength of these studies was the assessment of hormone levels based on the menstrual cycle phase. This could be done by empirically monitoring ovulation to get a real information of menstrual phase, such as quantifying the urinary LH peak as a marker of ovulation, as done by Wu et al. In another study, women were more likely to get pregnant if they ate soy isoflavones alongside . However, after removing data from studies with elevated bias risk, three studies were included in the sensitivity analysis with consequent loss of statistical significance. The possibility of a sexual development disorder as a neonatal programming effect is an often raised hypothesis because circulating levels of isoflavones are higher in soy-fed infants compared with cow milk formula or breastfed infants(Reference Andres, Moore and Linam69). (Reference Nagata, Kabuto and Kurisu27) and a longitudinal study published in 2013 by Filiberto et al. These changes may have resulted in the mild, non-clinically relevant prolongation of menstrual cycle, as discussed in the previous section. Furthermore, diet and energy intake were not investigated and sampling was not well-timed to menstrual cycle. 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. Metabolic, endocrine, inflammation, and oxidative stress . Pending further confirmation, soy and its components do not appear to have a clinically relevant influence on menstrual cycle in healthy women. This suggests a protective effect of soy against fertility disturbance by BPA. Manuscripts exploring multiple aspects were discussed in different paragraphs, where deemed necessary. The use of surveys only through self-administered questionnaires, although validated, is easily exposed to self-reporting errors or incompleteness and misclassifications derived from the database used for food intake quantification. Moreover, isoflavones act as selective estrogen receptor modulators (SERMs) showing both agonist and antagonist effects on ER, with subsequent estrogenic, anti-estrogenic or even neutral effects(Reference Liu, Li and Chen14). In addition, non-English papers could have provided relevant data on the topic, especially those from countries with a more consistent history of soy consumption. Soy food and soy isoflavone intake were unrelated to sperm motility, sperm morphology or ejaculate volume. 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 ethnicity assessment of participants was useful in identifying, as might be expected, a greater consumption of soy foods by Asian individuals. The present paper aims to conduct a review of available data on the effect of soy, soy foods and soy components on women's fertility and related outcomes. However, the number of participants was limited for a cross-sectional study, and dietary survey through frequency questionnaires in the absence of an assessment of blood or urine isoflavone levels could lead to uncertainty. Soy as an endocrine disruptor: cause for caution? For these reasons, results should be interpreted with caution. For this reason, in clinical studies, the nationality and ethnicity of participants may be relevant for the assessment of potential conflicting effects of soy intake. The authors found no significant differences in reproductive outcomes (missed menstrual periods, pregnancy, live births, abortions, miscarriages, full-term deliveries, preterm deliveries, etc.) Finally, they show antioxidant activity: a shared property among polyphenols(Reference Patel, Boersma and Crawford19). The generalisation of these results is complex due to the type of study, which does not allow to define a causal relationship. Shop Soy Isoflavones Menopause Relief and read reviews at Walgreens. 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. However, this omission does not necessarily imply that the assessment has not been carried out. However, the intake of isoflavones in diet has not been investigated, and therefore, it was not possible to define the presence of equol-producers among participants. Concerns that the phytoestrogens (isoflavones) in soy may feminize men continue to be raised. 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). [cited 2021 Jul 26]. Researchers did not observe any clinical improvement, alteration of menstrual cycle or hormonal alteration (estradiol, SHBG, DHEAS, androstenedione, testosterone, FSH, LH) compared with baseline levels. Isoflavones in human plasma are usually low (04157nM) in individuals consuming low-isoflavone diets but in large soy-consumers, such as Asian people, isoflavone concentration can reach up to ~4M, with equol reaching up to ~40nM in low consumers and up to ~2M in large soy-consumers(Reference Morton, Arisaka and Miyake88). On consumption, they increase estrogen production in a woman's body. There was a significant correlation between dietary soy consumption and fertilisation rate (77% v. 71%, P=0004), age-adjusted pregnancy (52% v. 41%, P=003) or age-adjusted live birth rate (44% v. 31%, P=0007) among soy consumers compared with non-consumers. Estradiol levels showed increased plasma concentrations during the intervention period among premenopausal women (n: 14) in both luteal and follicular phases (composite menstrual cycle assessment). In a logical perspective, the effect of soy cannot be attributed to the effect of its isoflavones alone. In particular, among selected studies, only the intervention study by Haudum and colleagues explored the stratification of participants for equol-competence(Reference Haudum, Lindheim and Ascani46). A list of the selected clinical studies with their characteristics is summarised in Table 1. Soy consumption was not related to estradiol levels or endometrial thickness. Overall, a trend toward improvement can be appreciated but further studies are necessary to confirm the beneficial effect. You should take them like Clomid hun so cd 1-5, 2-6, 3-7, 4-8 or 5-9. In addition, full-text bibliographic lists from selected papers were screened to retrieve further relevant articles. The detailed selection process is highlighted in Fig. Pettitt, Claire For this reason, they are classified as phytoestrogensplant-derived compounds with estrogenic activity (1). Although not strictly related to the aspect of fertility, the study is still ongoing (Clinicaltrials.gov: NCT00616395) intending to follow the participants to evaluate effects on reproductive functions, later in life. Conversely, the improvements in ovulation were seen only in two patients from the control group. However, a clear effect on reproductive system has never been highlighted, especially due to the absence of observational studies designed for this purpose. Eating Places. 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. However, even in the West, it is currently widely used, especially due to its versatility in plant-based products for health purposes and vegetarian diets(Reference Rizzo and Baroni1). The study must be considered exploratory, because of the limited number of luteal phase deficiency cycles and a small number of fertility-related outcomes. The authors declare that they have no conflicts of interest. After the soy intervention, the length of menstrual cycle marginally increased (from 28319 to 31851d, P=006). Follicular development, the number of preovulatory follicles and the pulsatility index values were not different between groups after intervention. Higher soy products intake did not correlate with the rate of infertility. There was no evaluation of dietary habits and the determination of hormone levels was performed using non-validated ELISA kits, due to limited budget. In 2005, Kohama and colleagues published a short communication about a 6 months clinical trial on thirty-six Japanese women with secondary amenorrhea (or anovulation)(Reference Kohama, Kobayashi and Inoue33). Based on our literature search, we also identified two observational studies: a cross-sectional study published in 1997 by Nagata et al. Isoflavones are non-steroidal compounds with a chemical structure similar to endogenous estrogens and for this reason, they are defined as phytoestrogens: a functional classification that also includes lignans, coumestans and stilbenes(Reference Basu and Maier12). The influence of high-dose of isoflavones on fertility emerging from the studies is difficult to be transferred to other groups of individuals with other ethnicity or different treatments. Sampling involved synchronisation on the third day of menstrual cycle follicular phase, spontaneous or pharmacologically induced. 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