Fork-First Fertility curates peer-reviewed research on fertility and food and builds personalised fertility food plans backed by the evidence.
Endometriosis affects roughly one in ten women of reproductive age, and its relationship with fertility is complex. The research on diet and endometriosis is younger and less definitive than some other areas — but it is growing, and the signals are consistent enough to be worth understanding. Anti-inflammatory dietary patterns — higher in omega-3 fatty acids, vegetables, and whole foods, lower in processed foods and trans fats — are associated with reduced endometriosis symptoms and, in some studies, with better fertility outcomes. The mechanism is plausible: endometriosis involves chronic inflammation, and dietary patterns influence inflammatory markers in measurable ways. The studies below are honest about what the evidence can and cannot show. Endometriosis varies significantly in severity and presentation, and dietary changes are not a treatment. What the research does suggest is that the fertility foods associated with lower inflammation may support fertility outcomes for women with endometriosis — and that the specifics of your situation determine which of those foods are most relevant.
This research shapes Fork-First's fertility food recommendations. Try one of our assesments to discover yours.
"Young women reporting a new diagnosis of PCOS were no more likely to increase their vegetable intake or physical activity than women not reporting a PCOS diagnosis."
Copp T, Cvejic E, McCaffery K et al.
"Preconception lifestyle can improve perinatal mortality and morbidity among these women."
Kyozuka H, Nishigori H, Murata T et al.
"In the cross-sectional study, a connection was observed between a higher intake of dietary fiber and a decreased risk of endometriosis."
Zheng YF, Guo YM, Song CJ et al.
"Overall, an anti-inflammatory diet in endometriosis patients, especially when identified barriers and facilitators are addressed in an intervention, is feasible."
Huijs E, van Stigt BJ, de Roos N et al.
"The consumption of dietary products such as soya products, red meat, and alcohol had an influence on the occurrence of endometriosis."
Nowakowska A, Kwas K, Fornalczyk A et al.
"Most of the studies reported a positive effect on endometriosis; they were however characterized by moderate or high-risk bias possibly due to the challenges of conducting dietary intervention trials."
Nirgianakis K, Egger K, Kalaitzopoulos DR et al.
"No clear associations were observed between high- or low-PRBS fruit and vegetable intake and endometriosis risk among premenopausal women."
Garzia NA, Cushing-Haugen K, Chiu YH et al.
"Alternative diets, such as the Mediterranean, anti-inflammatory, vegetarian, low-nickel and low-FODMAP diets, have also been presented in the context of their potential beneficial effects on the course of endometriosis."
Piecuch M, Garbicz J, Waliczek M et al.
"The study findings provide insight into the molecular background of female infertility and lead to identification of potential molecular biomarkers and possibilities for modulating the endometrial microenvironment and, thereby, endometrial functions involved in embryo implantation and infertility."
Molina NM, Jurado-Fasoli L, Sola-Leyva A et al.
"This population-based study found that a higher triglyceride-glucose index, representing an increased level of insulin resistance, was associated with a higher risk of endometriosis among the US population."
Liu P, Wang Y, Ji X et al.
"All studies found that diet had a positive impact on pain perception among women with endometriosis."
Sverrisdóttir UÁ, Hansen S, Rudnicki M.
Deepak Kumar K, Appleby-Gunnill B, Maslin K.
De Araugo SC, Varney JE, McGuinness AJ et al.
"There is a major need for evidence-based, non-invasive adjunct management of this debilitating disease, and diet and nutritional interventions may be suitable."
Abulughod N, Valakas S, El-Assaad F.
"This appears promising to treat endometriosis-related symptoms and could be considered a new effective strategy for chronic pain management in the long term."
Cirillo M, Argento FR, Becatti M et al.
"Exercise may be another tool to improve endometriosis symptoms, but once again data are limited and best type and frequency is not well studied."
Lalla AT, Onyebuchi C, Jorgensen E et al.
"Western-style high-fat diets (HFD) have been linked to greater systemic inflammation to cause metabolic and chronic inflammatory diseases, and are also considered an environmental risk factor for gynecologic diseases."
Herup-Wheeler T, Shi M, Harvey ME et al.
"Our results suggest that consuming a dietary pattern that adheres to the Alternative Healthy Eating Index-2010 recommendations lowers the risk of endometriosis diagnosis, potentially through a beneficial impact on pelvic pain."
Dougan MM, Fest S, Cushing-Haugen K et al.
"In this large-scale cross-sectional study, multiple logistic regression analysis showed that the intake of vitamins A, B1, B2, B6, C and folate was negatively associated with the occurrence of endometriosis."
Xu T, Zhuang Y, Cao H.
"In the WHT (with hormone therapy) group, consumption of sugar, honey, sweet cereals, and sweetened beverages was associated with work absences and concentration difficulties."
Pelc A, Polak-Szczybyło E.
"A significant decrease in endometriosis-related pain was found in three out of five studies on vitamins, four out of six studies on fatty acids, one study on probiotics, two studies on medicinal plants, and five out of six studies on bioactive compounds."
Julio T, Fenerich BA, Halpern G et al.
"Based on the available evidence, Omega-3 Fatty Acids may reduce the inflammatory response in patients with endometriosis, specifically by decreasing levels of pro-inflammatory cytokines, indicating potential anti-inflammatory properties that warrant further investigation."
Liu E, Wang Q, Bai Y et al.
"The first step should be an anti-inflammatory diet, such as the Mediterranean diet or the MIND diet (Mediterranean-DASH diet intervention for neurological delay), followed by more in-depth allergy screening."
Szczuko M, Ziętek M, Janda-Milczarek K et al.
"Emerging evidence suggests a link between dietary antioxidants and endometriosis risk."
Luo H, Li X, Lao T et al.
"A significant decrease in pelvic pain following supplementation with anti-inflammatory dietary supplements was detected."
Naeini F, Tanha FD, Ansar H et al.
"Higher DII scores are associated with increased odds of endometriosis. Dietary interventions targeting inflammation may offer a novel approach to managing endometriosis."
Chen Y, Yu M, Hu S et al.
"The low FODMAP diet ameliorates gastrointestinal symptoms related to endometriosis and improves quality of life."
Varney JE, So D, Gibson PR et al.
"The findings indicate a positive association between the TyG index and the risk of endometriosis, exhibiting an approximate non-linear relationship."
Gao S, Cui X.
"In a population with a modest intake of soy products, consistent with levels seen in other Western populations, soy intake is associated with a lower risk of laparoscopically confirmed endometriosis."
Mitsunami M, Soria-Contreras DC, Ortiz-Panozo E et al.
"These findings suggest that asparagus preference significantly reduces the risk of developing EM, whereas preferences for orange juice and different types of coffee may increase the risk, offering new insights into EM management through dietary modifications."
Cheng X, Ma D, Wang X et al.
"Further research is needed to establish a causal relationship and determine the potential benefits of maintaining sufficient vitamin D levels for endometriosis prevention."
Xie B, Liao M, Huang Y et al.
Qin R, Yang Y, Xie B et al.
Li K, Zhang W.
"Nutritional interventions can target key pathophysiological mechanisms of endometriosis, such as systemic inflammation, oxidative stress, and hormonal imbalance, offering potential symptom relief and improved clinical outcomes."
Barrea L, Verde L, Annunziata G et al.
"There was suggestive evidence of favorable associations between Mediterranean diet adherence with fertility and gestational weight management."
Yang J, Song Y, Gaskins AJ et al.
"Greater adherence to these dietary patterns may be recommended as part of preventive and therapeutic strategies for endometriosis."
Noormohammadi M, Hashemi Javaheri FS, Ghasemisedaghat S et al.
"Despite the pivotal role of diet as a modifiable risk factor for various chronic conditions, its potential influence on endometriosis has remained inadequately explored."
Ghoreishy SM, Hashemi Javaheri FS, Ghasemisedaghat S et al.
Ma N, Hu Y, Xu Y.
"This study suggests a potential causal relationship between dietary theobromine intake and a modestly reduced risk of endometriosis, providing preliminary insights into the potential protective effects of theobromine against the development of this condition."
Huang Y, Liang F, Xie B et al.
"Targeted dietary interventions, particularly focusing on healthy fats, may improve pain symptoms and overall well-being."
Spagnolo E, Díaz Fuentes B, López A et al.
"After adjusting for relevant covariates, multivariable logistic regression analysis revealed a positive correlation between dietary fiber intake and the risk of endometriosis."
Huang Y, Liang F, Wei Y et al.
"The findings highlight the potential of dietary modifications as a preventative measure against the onset of these conditions."
Fu M, Deng F, Chen J et al.
Boroncsok D, Filó A, Török M et al.
"Adhering to the MIND diet, rich in healthy components such as nuts, fish and vegetables and lower consumption of inflammatory foods, may potentially reduce the odds of endometriosis."
Noormohammadi M, Ghoreishy SM, Ghasemisedaghat S et al.
"Our findings suggest a positive correlation between dietary zinc intake and the prevalence of endometriosis."
Huang Y, Wei Y, Liang F et al.
"The mean body mass index (BMI) was significantly lower in females with positive IVF outcome compared to those with negative outcome."
Kumar S, Mishra V, Thaker R et al.
"This study highlights the potential role of carotenoid-rich diets in mitigating endometriosis risk; however, further prospective studies are warranted to confirm these associations and explore underlying biological mechanisms."
Chen Z, Zhang T, Jin T.
"Traditionally, symptom management involves medical and surgical intervention; however, dietary modification has grown in popularity."
Dwyer S, Mitchell LJ, Moran L et al.
"MCT-modified ketogenic diet as an adjunct to standard treatment regimen could alleviate clinical symptoms including pelvic pain, dyspareunia, and dyschezia in women with endometriosis."
Naeini F, Tanha FD, Mahmoudi M et al.
"Low FODMAP (fermentable oligo-, di-, monosaccharides and polyols), plant-based diet and antioxidant vitamin supplementation is helpful including those with concurrent irritable bowel syndrome."
Desai J, Strong S, Ball E.
van Haaps AP, Wijbers JV, Schreurs AMF et al.
"A higher intake of total dairy [all low-fat and high-fat dairy foods] was associated with decreased risk of endometriosis (RR 0.90; 95% CI, 0.85 to 0.95; P < 0.001; I(2) = 37.0%), but these associations were not observed with intakes of low or high-fat dairy, cheese or milk. Increased risk of endometriosis was associated with higher consumption of red meat (RR 1.17; 95% CI, 1.08 to 1.26; P < 0.001; I(2) = 82.4%), trans fatty acids (TFA) (RR 1.12; 95% CI, 1.02 to 1.23; P = 0.019; I(2) = 73.0%), and saturated fatty acids (SFA) (RR 1.06; 95% CI, 1.04 to 1.09; P < 0.001; I(2) = 57.3%)."
Arab A, Karimi E, Vingrys K et al.
"Our findings suggest a negative correlation between dietary selenium intake and endometriosis risk."
Guo JJ, Li RX, Shang WL et al.
"The findings suggest that iron deficiency should be concomitantly addressed during initial diagnosis and successive management of endometriosis."
Gete DG, Doust J, Mortlock S et al.
"Reducing or eliminating gluten, reducing or eliminating dairy, and the low-fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet were the most commonly reported dietary strategies utilized."
Armour M, Middleton A, Lim S et al.
"Our findings suggests that serum ferritin level and transferrin saturation were positively associated with endometriosis."
Xu G, Chen L, Li Q.
"The endometriosis diet was associated with a better quality of life in Dutch women with endometriosis."
van Haaps A, Wijbers J, Schreurs A et al.
Huijs E, Nap A.
"Many specific dietary adjustments (71.3%), however, were reported to reduce endometriosis pain-related symptoms."
Krabbenborg I, de Roos N, van der Grinten P et al.
"Because some disease-related processes, such as inflammation, hormonal activity, menstrual cycle, or prostaglandin metabolism, can be modified by diet, nutrition may have a significant impact on development and treatment of endometriosis."
Oszajca K, Adamus A.
"These results strengthen evidence for the effectiveness of heat, rest, and dietary changes for endometriosis-related pain and underscore an individual's desire for support and understanding from health care professionals, family, and friends."
Norman M, Razmpour O, Olsen JM.
"Preclinical investigations and clinical trials indicate that dietary antioxidants and gut microbiota modulation present potential new approaches in managing endometriosis."
Türkoğlu İ, Sacinti KG, Panattoni A et al.
"The results of this systematic review indicate that EPA is suggested to have anti-inflammatory properties and may serve as a potential marker for illness severity."
Sienko A, Cichosz A, Urban A et al.
Mechsner S.
"The effects of nutrient compounds seem to have the potential to reduce pain in women with endometriosis, mainly to reduce dysmenorrhea."
Meneghetti JK, Pedrotti MT, Coimbra IM et al.
"The consumption of fruits, vegetables (not cruciferous), dairy products, fish, potatoes, legumes, vitamins (A, C, D and B12), monounsaturated and polyunsaturated fatty acids and minerals (calcium, potassium and magnesium) seems to reduce the risk of endometriosis."
Zaragoza-Martí A, Cabrera-González K, Martín-Manchado L et al.
Every study here shaped how Fork-First thinks about fertility foods. But research applied to everyone is just more advice.
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