Suggested Foods Based on the Temperament (Mizaj) of Infertile Women: A Qualitative Content Analysis Based on Persian Medicine Texts
-
Fazeleh Fazlollahpour-Rokni
,
Seyede-Sedigheh Yousefi
,
Marzieh Zamaniyan
,
Masoumeh Bagheri-Nesami
,
Abolfazl Hosseinnataj
Abstract
Infertility, affecting approximately 17.5% of the global adult population, is a multifaceted issue influenced by lifestyle and dietary factors. Persian Medicine (PM), as a complementary approach, emphasizes the role of individualized dietary and lifestyle modifications based on temperament (mizaj) in addressing infertility. This study aimed to identify and categorize dietary recommendations for infertile women according to their temperaments, as outlined in authoritative PM texts. A qualitative summative content analysis was conducted using eight key PM texts—including Qanun Fi Teb and Exir-e-Azam from the 9th to 18th centuries—alongside electronic databases such as Scopus, PubMed, Web of Science, and Google Scholar were searched. Foods were categorized based on four compound temperaments—cold and dry, cold and wet, warm and dry, and warm and wet—and subcategories such as fruits, vegetables, nuts, meats, and medicinal plants. The analysis highlighted the central role of warming, nutrient-dense foods in improving reproductive health, particularly for cold temperaments. Foods such as lamb, eggs, chickpeas, milk with cinnamon or ginger, and onions were frequently recommended. Conversely, cooling foods like cucumber and lettuce were advised for warm temperaments to achieve balance. The findings underscore PMʼs tailored dietary strategies for enhancing fertility by aligning food recommendations with individual temperaments. This approach offers a complementary pathway to modern infertility treatments by addressing underlying imbalances through personalized nutrition.
Cox C, Thoma M, Tchangalova N, Mburu G, Bornstein M, et al. Infertility prevalence and the methods of estimation from 1990 to 2021: a systematic review and meta-analysis. Hum Reprod Open 2022;2022:hoac051.
Lindsay TJ, Vitrikas K. Evaluation and treatment of infertility. Am Fam Physician 2015;91:308-314.
Fauser BC, Adamson GD, Boivin J, Chambers GM, de Geyter C, et al. Declining global fertility rates and the implications for family planning and family building: an IFFS consensus document based on a narrative review of the literature. Hum Reprod Update 2024;30:153-173.
World Health Organization. Infertility prevalence estimates, 1990–2021. World Health Organization 2023.
Shi S, Hong T, Jiang F, Zhuang Y, Chen L, et al. Letrozole and human menopausal gonadotropin for ovulation induction in clomiphene resistance polycystic ovary syndrome patients: A randomized controlled study. Medicine 2020;99:e18383.
Rodgers RJ, Reid GD, Koch J, Deans R, Ledger WL, et al. The safety and efficacy of controlled ovarian hyperstimulation for fertility preservation in women with early breast cancer: a systematic review. Hum Reprod 2017;32:1033-1045.
Huang JYJ, Rosenwaks Z. Assisted reproductive techniques. Methods Mol Biol 2014;1154:171-231.
Wade JJ, MacLachlan V, Kovacs G. The success rate of IVF has significantly improved over the last decade. Aust N Z J Obstet Gynaecol 2015;55:473-476.
Arji G, Safdari R, Rezaeizadeh H, Abbassian A, Mokhtaran M, et al. A systematic literature review and classification of knowledge discovery in traditional medicine. Comput Methods Programs Biomed 2019;168:39-57.
Ibn-e-Sina A. Al-qanun fit-tib [The canon of medicine]. Alaalami Beirut lib Press. Beirut 2005.
Chashty M. Exir-e-Azam [Great Elixir]. Research Institute for Islamic and Complementary Medicine. Tehran 2008.
Dehghan M, Mokhtarabadi S, Heidari FG. Complementary and alternative medicine usage and its determinant factors among Iranian infertile couples. J Complement Integr Med 2018;15:20170138.
Sepehrikia S, Kolangi F, Zarvandi M, Qaraaty M. Types of digestion from the perspective of Persian medicine. J Curr Oncol Med Sci 2022;2:144-152.
Noroozi S, Zarei A, Tabarrai M. A review of the gastrointestinal causes of infertility from the perspective of persian medicine. Trad Integr Med 2019;4:47-55.
Emokpae MA, Brown SI. Effects of lifestyle factors on fertility: practical recommendations for modification. Reprod Fertil 2021;2:R13-R26.
Alibeigi Z, Jafari-Dehkordi E, Kheiri S, Nemati M, Mohammadi-Farsani G, et al. The impact of traditional medicine-based lifestyle and diet on infertility treatment in women undergoing assisted reproduction: a randomized controlled trial. Complement Med Res 2020;27:230-241.
Akhtari M, Moeini R, Mojahedi M, Gorji N. Assessment of the studies on the concept of Mizaj (temperament) in Persian Medicine. J Complement Integr Med 2020;17:20180122.
Shirbeigi L, Zarei A, Naghizadeh A, Vaghasloo MA. The concept of temperaments in traditional Persian medicine. Trad Integr Med 2017;2:143-56.
Anzman-Frasca S, Stifter CA, Birch LL. Temperament and childhood obesity risk: a review of the literature. J Dev Behav Pediatr 2012;33:732-745.
Tafazoli V, Tavakoli A, Mosaffa-Jahromi M, Cooley K, Pasalar M. Approach of Persian medicine to health and disease. Adv Integr Med 2022;9:3-8.
Shakeri A, Hashempur MH, Beigomi A, Khiveh A, Nejatbakhsh F, et al. Strategies in traditional Persian medicine to maintain a healthy life in the elderly. J Complement Integr Med 2021;18:29-36.
Alibeigi Z, Tansaz M, Aliasl J, Jafari-Dehkordi E. Fertility diet for women in Persian medicine. Iran J Publ Health 2021;50:429-430.
Nejatbakhsh F, Nazem E, Goushegir A, Isfahani MM, Nasrabadi AN, et al. Recommended foods for male infertility in Iranian traditional medicine. Iran J Reprod Med 2012;10:511.
Kazemeini SK, Emtiazy M, Owlia F, Khani P. Causes of infertility in view of Iranian traditional medicine: A review. Int J Reprod Biomed 2017;15:187.
Selvi AF. Qualitative content analysis. The Routledge handbook of research methods in applied linguistics: Routledge 2019; pp 440-452.
Jorjani E. Zakhireh Khwarazmshahi (Treasure of Kharazm Shah). Iranian Medical Academy. Tehran 2001.
Ahvazi A. Kamel al-Sana’a al-Tebbiya. Jalaluddin Publications. Qom 2008.
Arzani M. Teb-e-Akbari [Akbari’s medicine]. Research Institute for Islamic and Complimentary Medicine. Tehran 2008; pp 250-254.
Ibn Nafis Qarshi A. Al-Mukhtar Men Al-aghzieh. Nahda Misr. Cairo 2008.
Azam Khan M. Romuze Azam. The Institute for Medical History-Islamic and Complementary Medicine IUoMS. Tehran 2004.
Aghili Khorasani M. Summary of Wisdom (Kholasat Alhekma). Ismaeilian Publications. Tehran 2006.
Akhtari E, Bioos S, Sohrabvand F. Infertility in Iranian traditional medicine from Hakim Mohammad Azam Khan point of view. Iran J Obstet Gynecol Infertil 2015;18:18-23.
Tansaz M, Sohrabvand F, Adhami S, Keshavarz M, Bioos S, et al. Evaluation of uterine temperament in Iranian infertile women using a quantitative instrument for uterine temperament detection. Int J Prev Med 2020;11:39.
Jamebozorg N, Ghaffari F, Alijaniha F, Karimi Y, Mohammad Beigi R, et al. The effect of metabolic persian diet on ovulation induction in infertile women. Evid Based Complement Alternat Med 2023;2023:6656779.
Nazmi S, Behmanesh F, Nikpour M, Esmaeilzadeh S. Uterine and body temperament in women with and without polycystic ovary syndrome: a case-control study. Sci Rep 2025;15:6842.
Iranzadasl M, Karimi Y, Moadeli F, Pasalar M. Persian medicine recommendations for the prevention of pandemics related to the respiratory system: a narrative literature review. Integr Med Res 2021;10:100483.
Bai H, Ding H, Wang M. Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, and Treatment. Clin Exp Obstet Gynecol 2024;51:126.
Poppe K. Management of endocrine disease: thyroid and female infertility: more questions than answers?! Eur J Endocrinol 2021;184:R123-R135.
Tanbo T, Fedorcsak P. Endometriosis‐associated infertility: aspects of pathophysiological mechanisms and treatment options. Acta Obstet Gynecol Scand 2017;96:659-667.
Azam SS, Vasudevan S, Bukhari WS, Thadhani J, Tasneem H, et al. Reproductive endocrine disorders: a comprehensive guide to the diagnosis and management of infertility, polycystic ovary syndrome, and endometriosis. Cureus 2025;17.
Kohil A, Chouliaras S, Alabduljabbar S, Lakshmanan AP, Ahmed SH, et al. Female infertility and diet, is there a role for a personalized nutritional approach in assisted reproductive technologies? A Narrative Review. Front Nutr 2022;9:927972.
Chiu Y-H, Chavarro JE, Souter I. Diet and female fertility: doctor, what should I eat? Fertil Steril 2018;110:560-569.
Hosseini B, Eslamian G. Association of dietary factors with male and female infertility: review of current evidence. Thrita 2014;3:e20953.
Gaskins AJ, Chavarro JE. Diet and fertility: a review. Am J Obstet Gynecol 2018;218:379-389.
Nassan FL, Chiu Y-H, Vanegas JC, Gaskins AJ, Williams PL, et al. Intake of protein-rich foods in relation to outcomes of infertility treatment with assisted reproductive technologies. Am J Clin Nutr 2018;108:1104-1112.
Karayiannis D, Kontogianni MD, Mendorou C, Mastrominas M, Yiannakouris N. Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility. Hum Reprod 2018;33:494-502.
Vitagliano A, Petre GC, Francini-Pesenti F, De Toni L, Di Nisio A, et al. Dietary supplements for female infertility: a critical review of their composition. Nutrients 2021;13:3552.
Garolla A, Petre GC, Francini-Pesenti F, De Toni L, Vitagliano A, et al. Dietary supplements for male infertility: a critical evaluation of their composition. Nutrients 2020;12:1472.
Gu L, Yang Y, McClements DJ, Dong S, Liu Y, et al. Preparation and characterization of folate-enriched eggs and egg yolk powders. J Agr Food Res 2022;8:100309.
Olas B. A Review of the Pro-Health Activity of Asparagus officinalis L. and Its Components. Foods 2024;13:288.
Zhang H, Jha AB, Warkentin TD, Vandenberg A, Purves RW. Folate stability and method optimization for folate extraction from seeds of pulse crops using LC-SRM MS. J Food Compos Anal 2018;71:44-55.
Arslan J, Gilani A-u-H, Jamshed H, Khan SF, Kamal MA. Edible nuts for memory. Curr Pharm Des 2020;26:4712-4720.
Razi M. Al-havi. International Academy of Medical Sciences, Tehran 2005.
Akbaribazm M, Goodarzi N, Rahimi M. Female infertility and herbal medicine: An overview of the new findings. Food Sci Nutr 2021;9:5869-5882.
Ainehchi N, Khaki A, Ouladsahebmadarek E, Hammadeh M, Farzadi L, et al. The effect of clomiphene citrate, herbal mixture, and herbal mixture along with clomiphene citrate on clinical and para-clinical parameters in infertile women with polycystic ovary syndrome: a randomized controlled clinical trial. Arch Med Sci 2020;16:1304-1318.
Chou PY, Chen CM, Wang CC, Tai CJ, Lin YK, et al. Characteristics and effects of chinese herbal medicine in the management of female infertility: a hospital-based study. Complement Med Res 2023;30:481-491.
Yılmaz N, Seven B, Timur H, Yorgancı A, İnal HA, et al. Ginger (zingiber officinale) might improve female fertility: a rat model. J Chin Med Assoc 2018;81:905-911.
| Files | ||
| Issue | Vol 10, No 3, 2025 | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/tim.v10i3.19760 | |
| Keywords | ||
| Food Temperament Persian medicine Infertility Female | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
