Female primary infertility is a major global challenge known to be influenced by dietary factors, including caffeine intake. Moderate caffeine intake has been proposed to have beneficial health effects while excessive caffeine intake may represent health risks, with the reproductive system being one of them. However, studies regarding the association between high caffeine intake and reduced female infertility are still inconclusive. This evidence-based case report was investigated to know whether daily high caffeine consumption is associated with female primary infertility indicated by time to pregnancy (TTP) and spontaneous abortion (SAB).
A structured literature search for cohort, case-control and meta-analysis was performed using Pubmed and Scopus database. Selected articles were appraised using appraisal tools from CEBM for meta-analysis, and NOS assessment tool for cohort and casecontrol studies.
Four articles (one meta-analysis, two cohort studies, and one case-control study) were selected based on predefined selection criteria. High caffeine intake was not associated with 12 months TTP based on all studies, except for one case-control study. Whereas, based on the meta-analysis of 27 studies that provided sufficient data on SAB, it was shown that increased caffeine consumption significantly increased the risk of SAB. However, studies that assessed SAB had significant heterogeneity.
In conclusion, based on studies with the highest evidence level and appropriate NOS and CEBM scores, we found an insignificant association, if any, between high caffeine intake and primary infertility based on two indicators, which were TTP and SAB. Therefore, we recommend that women trying to achieve pregnancy do not necessarily need to restrict their caffeine intake.