Interest in soy is particularly driven by its possible beneficial effects on human health. However, the mechanisms underlying isoflavones effects on human health are manifold. The diagnosis of PCOS occurs in the presence of at least two of the three Rotterdam Criteria: oligo or anovulation, polycystic ovary morphology and biochemical or clinical hyperandrogenism(Reference Pfieffer67). Implantation (P for interaction <002), pregnancy (P for interaction <003) and live birth rates (P for interaction <001) were higher among soy-consumers (n: 176, 74%; mean isoflavone intake of 34mg/d) without linear dependence with urinary BPA quartiles (P trend >005), compared with no consumer who had lower rates with higher BPA excretion (P trend <005). Only 6% of participants had not soy isoflavone intake. Fertility is closely associated with menstrual cycle functions and a longer time to pregnancy is associated with shorter menstrual cycles(Reference Crawford, Pritchard and Herring56Reference Wise, Mikkelsen and Rothman58). Consequently, it is plausible that research efforts have been aimed at evaluating the effects of soy, especially isoflavones, on human fertility and hormonal regulation. Soy isoflavones are generally considered safe .Numerous randomized controlled trials in menopausal women reported that side effects were not significantly different between soy isoflavone and placebo groups .Adverse events were generally mild and included gastrointestinal and musculoskeletal complaints .One systematic review of over 100 studies in patients with or at risk of breast cancer . SHBG levels were not associated with the intake of soy foods, except in the case of miso intake on the 22nd day of cycle (r: 036, P=002). Measurement of urinary isoflavones and their metabolites appears to be a more reliable approach than dietary assessment alone. Those women eating or taking soy isoflavones were more likely to get pregnant. Most women taking soy isoflavones to induce ovulation take around 150-200 mg a day on cycle day 3 -7 or 5-9. 1. Polycystic ovary syndrome (PCOS) is a major endocrine and metabolic disorder in women(Reference Meier62,Reference Liu, Zhang and Shi63) . Soybeans are the most common source of isoflavones in human food; the major isoflavones in soybean are genistein and daidzein. The fertility concept differs from the fecundity one, which refers to reproductive potential and depends on reproductive physiology, from the production of gametes phase to the ability to carry a pregnancy to term. It is widely used in eastern traditional cuisine and it has recently diffused among self-conscious and vegetarian diets. However, the difference became not significant after adjustment for isoflavone intake. Zhang, Yuehui Published online by Cambridge University Press: 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 slight increase of approximately 1d (MD: 105, 95% CI 013, 197) was seen compared with the control, with no significant effects in the length of luteal and follicular phases. Additionally, the enrolment criteria included only women who had stopped oral contraception less than 2 months earlier, so highly fertile individuals could have been excluded. Improvements were observed only in lipid profile (circulating total cholesterol, LDL and LDL/HDL ratio and triglycerides). Meanwhile, the possible influence on endocrine system, in particular by isoflavones, raised concerns among some researchers. Soy protein has gained considerable attention for its potential role in improving risk factors for cardiovascular disease (CVD). M. A. S. contributed to drafting and revising the manuscript. Furthermore, the use of spot urine samples for BPA quantification may have underestimated its exposure. Concerns that the phytoestrogens (isoflavones) in soy may feminize men continue to be raised. for this article. Only three articles declared power analysis to assess adequate sample size(Reference Strom, Schinnar and Ziegler30,Reference Jamilian and Asemi43,Reference Haudum, Lindheim and Ascani46) . In the only clinical trial available, even if it is considered a pilot study, it emerges that a significant role could be played not only by isoflavones, but also by phytochemicals present in soy, particularly in black soy. The individual conversion capacity, equol-competence, offers a useful tool for estimating the biological effect of these compounds(Reference Zubik and Meydani15). 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. However, the specific effect of soy intake on women's fertility has not yet been systematically evaluated. The present study has numerous strengths: a large sample of participants with good adherence to the study, a detailed assessment of dietary habits, and comprehensive sampling during all phases of menstrual cycle. Ma, Haoyue Get company information for Twins Club, Inc. in RANCHO CUCAMONGA, CA. The concentration of isoflavones in the amniotic fluid was related to soy intake, but there was no significant association between soy intake or phytoestrogens in the amniotic fluid and complications of pregnancy or previous infertility. Choose any of these varieties. The study included the evaluation of patients microbiota composition as the primary endpoint, but androgen levels were also evaluated with AMH as markers of fertility as a secondary endpoint. Metabolic, endocrine, inflammation, and oxidative stress . The authors declare that they have no conflicts of interest. In two studies, women having fertility treatment took part in research looking at the amount of soya they ate, and whether that affected the success of their treatment. No restrictions were applied using filters and results were collected from search engines by the inception through 4 April 2021. Isoflavones concentrations did not show significant differences between participants at baseline. In addition, full-text bibliographic lists from selected papers were screened to retrieve further relevant articles. Total loading time: 0 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. In order to assess the association between urinary isoflavones and fertility, adjustment for various confounding factors including ethnicity, supplement use, nutrients and lifestyle aspects was applied. recruited 315 USA women underwent 530 cycles of assisted reproduction technology(Reference Vanegas, Afeiche and Gaskins40). Feature Flags: { Regarding the two mentioned studies, the use of very high amounts of isoflavones is noteworthy because it is not possible to obtain such a dose through diet, therefore the effects found can be interpreted as a pharmacological and not nutritional intervention. Soy contains numerous phytochemicals that can be responsible for these positive effects through multiple mechanisms. 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. 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. 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) . DOI: 10.1017/jns.2022.15. However, there were also limitations: the duration of the study which was limited to two menstrual cycles and an evaluation of equol-producers among individuals was lacking. The lack of variation in gonadotropins can explain the absence of variation in menstrual cycle. 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. However, stratification for the control group or PCOS patients did not show a significant correlation between androgens and equol production. Adapted from Moher et al.(24). 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. The authors defined the unusual estradiol increase as erratic. Isoflavones are plant-based compounds found almost exclusively in beans, like soybeans, that mimic the action of the hormone estrogen. Adapted from Moher, Main cellular mechanism for isoflavones. A total number of twenty-two experimental articles plus a meta-analysis was used for the final synthesis. The significant inverse association between dietary isoflavone intake and live births (3% reduction, 95% CI 0, 7, P=005) was highlighted. Fig. The present study used a community-based approach with recruitment of couples seeking pregnancy. The chemical structure similarity between soy isoflavones and endogenous estrogens has always stimulated the attention for this class of compounds. From data that emerged on individuals with PCOS, there is no homogeneous improvement effect on hormonal picture, on menstrual cycle and therefore on fertility associated with soy consumption. Although some works investigate the relationship between consumption of soy formulations in infancy and age at menarche, as well as the onset of puberty or pre-puberty reproductive organ size, these outcomes are not strictly related to fertility in reproductive age(Reference Andres, Moore and Linam69Reference Sinai, Ben-Avraham and Guelmann-Mizrahi71). The obtained meta-analysis was included in the final summary because it assessed aspects relating to the topic of this review. The evaluation at two different times of menstrual cycle allowed to discriminate the effect between luteal and follicular phases but not day by day hormonal fluctuations. Nevertheless, a reduction in FSH levels was confirmed (SMD: 087IU/l, 95% CI 172, 002). Why did you take Soy Isoflavones: I had tried most other things so decided to be a guinea pig. Progesterone and sex hormone-binding globulin (SHGB) levels were not significantly changed by soy intake. 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. The authors found that consuming moderate amounts of traditionally . Regarding isoflavones, the equol metabolite derives from the precursor daidzein by the action of intestinal bacteria. The same authors admitted that they had no information on the type of soy used and about the last ingestion. The authors responsibilities were as follows: G. R. study conception and drafting the manuscript. 1 The FDA based this decision on clinical studies showing that at least 25 g of soy protein per day lowered . Studies have also shown that soybeans contribute towards lower levels of cholesterol, less risk of heart disease, breast cancer, and osteoporosis and fewer menopausal symptoms. From the sub-analysis by ethnic stratification, follicular SHBG levels were higher in non-Asians. The results of selected manuscripts were grouped according to the outcomes used, for a clear comparison. Soy consumption is supposed to have protective effects against cardiovascular disease by cholesterol-lowering and blood pressure improvement action and in the prevention of cancer or diabetes and it also supports bone health and the management of menopause symptoms(Reference Ding, Pan and Manson2Reference Mosallanezhad, Mahmoodi and Ranjbar8). Other weak aspects of the population sample characterisation are given by a lack of stratification by ethnicity and equol-producers. Results from a pilot study, Effect of soy phytoestrogen on metabolic and hormonal disturbance of women with polycystic ovary syndrome, Usual dietary isoflavone intake and reproductive function across the menstrual cycle, Soy isoflavone intake and the likelihood of ever becoming a mother: the adventist health study-2, Higher urinary lignan concentrations in women but not men are positively associated with shorter time to pregnancy, Soy food intake and treatment outcomes of women undergoing assisted reproductive technology, Dietary factors and luteal phase deficiency in healthy eumenorrheic women, 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, Dietary phytoestrogen intakes of adult women are not strongly related to fecundability in 2 preconception cohort studies, Urinary phytoestrogens and relationship to menstrual cycle length and variability among healthy, eumenorrheic women, Impact of short-term isoflavone intervention in polycystic ovary syndrome (PCOS) patients on microbiota composition and metagenomics, Fecundity and natural fertility in humans, Isolation and determination of anthocyanins in seed coats of black soybean (, Antioxidants and reactive oxygen species in follicular fluid of women undergoing IVF: relationship to outcome, The influence of religious affiliation on participant responsiveness to the complete health improvement program (CHIP) lifestyle intervention, Health beliefs, behavior, spiritual growth, and salvation in a global population of seventh-day adventists, A brief historical overview of the past two decades of soy and isoflavone research, The utility of menstrual cycle length as an indicator of cumulative hormonal exposure, Menstrual cycle length in reproductive age women is an indicator of oocyte quality and a candidate marker of ovarian reserve, Prospective evaluation of luteal phase length and natural fertility, Menstrual cycle characteristics and fecundability in a North American preconception cohort, A prospective cohort study of menstrual characteristics and time to pregnancy, 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, Calculation of free and bound fractions of testosterone and estradiol-17 beta to human plasma proteins at body temperature, Dysbiosis of gut microbiota associated with clinical parameters in polycystic ovary syndrome, The (TAAAA)n microsatellite polymorphism in the SHBG gene influences serum SHBG levels in women with polycystic ovary syndrome, Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis, Dietary patterns and outcomes of assisted reproduction, Compared with feeding infants breast milk or cow-milk formula, soy formula feeding does not affect subsequent reproductive organ size at 5 years of age, Early-life soy exposure and age at menarche, Consumption of soy-based infant formula is not associated with early onset of puberty, Cellular and biochemical mechanisms by which environmental oestrogens influence reproductive function, Steroid hormone activity of flavonoids and related compounds, Interaction of estrogenic chemicals and phytoestrogens with estrogen receptor beta, Rapid endocrine disruption: Environmental estrogen actions triggered outside the nucleus, Equol-stimulated mitochondrial reactive oxygen species activate endothelial nitric oxide synthase and redox signaling in endothelial cells: roles for F-actin and GPR30, Genistein, a specific inhibitor of tyrosine-specific protein kinases, Estradiol or genistein prevent Alzheimer's disease-associated inflammation correlating with an increase PPAR gamma expression in cultured astrocytes, Bacterial metabolite S-equol modulates glucagon-like peptide-1 secretion from enteroendocrine L cell line GLUTag cells via actin polymerization. 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