Decreased ovarian reserve and ovarian morphological alterations in female rat offspring exposed to a ketogenic maternal diet

OBJECTIVE: This study evaluates the effects of a ketogenic diet on morphology and follicle reserve. METHOD: Sixteen Sprague-Dawley rats were randomized into two groups: standard diet group (n=8) and ketogenic diet group (n=8). Rats were time mated. Dams were permitted to deliver spontaneously. The animals were monitored for the onset of puberty. All the rats were weighed and anesthetized, serum anti-Mullerian hormone level was measured, and the oviducts were removed. The morphological characteristics of follicles were determined and total ovarian volumes were calculated. RESULTS: The mean ovarian volume was statistically significantly lower in the ketogenic diet group compared to the standard diet group (14.41 +/- 0.99 mm(3) versus 18.89 +/- 1.28 mm(3)) (p=0.000). The mean number of antral follicles was 13.63 +/- 1.80 in the standard diet group and 4.462 +/- 0.760 in the ketogenic diet group. The mean ovarian weight of the ketogenic diet group was significantly lower than that of the standard diet group (0.42 +/- 0.06 g versus 0.815 +/- 107 g). The mean anti-Mullerian hormone levels were significantly higher in the standard diet group compared to the ketogenic diet group (1.023 +/- 4.75 ng/mL versus 0.69 +/- 0.07 ng/mL) (p=0.000). The mean percentage of staining of Ki-67 was 35.28 +/- 4.75 in the standard diet group and 16.98 +/- 3.33 in the ketogenic diet group (p=0.000). CONCLUSION: Maternal ketogenic diet reduces ovarian follicular reserve in female offspring and has important implications for maintaining reproductive potential at a population level.