{"columns":["object_id","question_id","canonical_url","intent","demand_provenance","question","direct_answer","certainty","source_strength","review_state","evidence_refs","risk_tier","sensitivity","content_version","last_searched_on","updated_on","correction_state","withdrawal_state","rubric_state","rubric_evaluators","comprehension_state","release_status","snapshot_evidence_question_and_decision_boundary","snapshot_population_and_fertility_context","snapshot_intervention_comparator_and_dose","snapshot_outcome_and_horizon","snapshot_source_hierarchy_and_evidence_types","snapshot_studies_and_participants","snapshot_direction_and_magnitude","snapshot_consistency_and_conflicts","snapshot_certainty","snapshot_source_strength","snapshot_review_state","snapshot_applicability","snapshot_harms_and_care_boundary","snapshot_search_date_and_records"],"generated_from":"T-047 answer objects","objects":[{"snapshot_source_hierarchy_and_evidence_types":"Health-authority guidance (NIH Office of Dietary Supplements, FDA, WHO/FAO, NASEM) plus two systematic reviews.","direct_answer":"Folate is the one health authorities agree on: they recommend women who could become pregnant take it before conceiving, and it is the best-supported item on this list. Choline has published intake figures too, though from fewer authorities. Neither is established to make you conceive faster, and this page does not cover every supplement you may have read about.","snapshot_population_and_fertility_context":"Women planning a pregnancy, and women in early pregnancy. Not women in fertility treatment specifically, and not a treatment protocol.","risk_tier":"high","rubric_evaluators":2,"snapshot_evidence_question_and_decision_boundary":"Which supplements should I take before pregnancy? The decision is what, if anything, to start taking in the months before trying to conceive.","review_state":"machine_verified; clinical_review pending","snapshot_intervention_comparator_and_dose":"Folate/folic acid and choline at the intakes health authorities publish. There is no comparator: these are intake recommendations, not a trial of one supplement against another or against nothing.","question_id":"T049-Q8ED29A1288","release_status":"released (operator_deferred: comprehension_not_passed,clinical_review_pending @2026-09-03)","correction_state":"none","demand_provenance":"T-049 v1.0 registry rank 16, two source classes (search demand and support/quiz language), observed 2026-08-28","updated_on":"2026-09-01","content_version":1,"snapshot_applicability":"Describes women planning or in early pregnancy. Does not describe women in IVF cycles, women on medication affecting folate metabolism, or anyone given a different dose by a clinician. A previous pregnancy affected by a neural tube defect changes the folate figure substantially and is a clinician's call.","snapshot_review_state":"machine_verified; clinical_review pending","certainty":"moderate — high that these are the published intakes, low that taking them changes anyone's chance of conceiving, because nothing here tested that","snapshot_search_date_and_records":"Last evidence search 2026-08-25. Records: REG:crs_25793991a7@2026-08-25, REG:crs_ea94463acf@2026-08-25, REG:crs_41dd112a10@2026-08-25, REG:crs_a13c52462b@2026-08-25, REG:crs_2d7718b479@2026-08-25, REG:crs_8057a1ef1e@2026-08-25, REG:crs_2c2425242e@2026-08-25, REG:crs_0cd5296f3a@2026-08-25, REG:crs_026c4336de@2026-08-25, REG:crs_18783fa8dc@2026-08-25, REG:crs_969ef97036@2026-08-25.","object_id":"AL-PILOT-0001","source_strength":"guideline_stated on eight records, multi_authority_consensus on one, systematic_review_supported on two","snapshot_studies_and_participants":"Not reliably reported in the evidence.","snapshot_direction_and_magnitude":"Reported as the authorities state them, in DFE — dietary folate equivalents, the unit authorities use so folate from food and folic acid from supplements can be counted together. Folate: 600 mcg DFE a day in pregnancy, 500 while breastfeeding (FDA). Supplemental folic acid counts double — 1 mcg of folic acid is 2 mcg DFE, and 1 mcg from fortified food is about 1.7 mcg DFE (ODS). Choline: 425 mg a day for women trying to conceive (NASEM) and 450 mg in pregnancy (ODS). These are the authorities' figures, not our instruction.","question":"Which supplements should I take before pregnancy?","evidence_refs":["REG:crs_25793991a7@2026-08-25","REG:crs_ea94463acf@2026-08-25","REG:crs_41dd112a10@2026-08-25","REG:crs_a13c52462b@2026-08-25","REG:crs_2d7718b479@2026-08-25","REG:crs_8057a1ef1e@2026-08-25","REG:crs_2c2425242e@2026-08-25","REG:crs_0cd5296f3a@2026-08-25","REG:crs_026c4336de@2026-08-25","REG:crs_18783fa8dc@2026-08-25","REG:crs_969ef97036@2026-08-25"],"last_searched_on":"2026-08-25","comprehension_state":"missing","canonical_url":"https://gyna.com/answers/fertility-supplements","sensitivity":"high","snapshot_source_strength":"guideline_stated on eight records, multi_authority_consensus on one, systematic_review_supported on two","snapshot_harms_and_care_boundary":"Folate from food alone is very hard to overconsume (ODS). Supplements are a different matter and prenatal products vary, so totals should be added up rather than assumed. The gap this page cannot close is whether any of it affects your chance of conceiving; if that is the question, it is a conversation with a clinician, not a supplement choice.","snapshot_consistency_and_conflicts":"The folate figures are consistent across ODS, FDA and WHO/FAO, and one folate record carries two independent authorities. The two choline figures each rest on a single authority, and no second independent authority was found for either — a real difference in strength between the two halves of this page.","rubric_state":"pass","withdrawal_state":"none","snapshot_certainty":"moderate — high that these are the published intakes, low that taking them changes anyone's chance of conceiving, because nothing here tested that","snapshot_outcome_and_horizon":"Nutrient adequacy during conception and early pregnancy. Not conception, not clinical pregnancy, not live birth — none of the records here measures any of those.","intent":"If you are planning a pregnancy, folate is the item with the clearest backing behind it, and the authorities' own figures are below. What the evidence here does not support is treating any supplement as something that will help you conceive sooner — that is a different claim, and these records do not test it. Bring the figures to whoever prescribes for you rather than acting on them here."},{"snapshot_source_hierarchy_and_evidence_types":"A clinical reference text (hypothalamic amenorrhea), a narrative review (energy availability and the reproductive axis), and three observational studies — two prospective biomarker cohorts and one life-events study.","direct_answer":"At the extreme, yes: severe stress or under-eating can suppress ovulation and stop periods — that much is established. Below the extreme the evidence is mixed: women with the highest levels of one stress marker took somewhat longer to conceive in observational studies, but those studies cannot tell whether stress slowed conception or trying to conceive was itself the stress, and no study here shows that reducing stress makes pregnancy more likely.","snapshot_population_and_fertility_context":"Women trying to conceive naturally (the biomarker cohorts), women already in fertility treatment (the distress finding), men reporting major life events (the semen study), and women whose periods have changed or stopped under severe stress or energy deficit.","risk_tier":"moderate","rubric_evaluators":2,"snapshot_evidence_question_and_decision_boundary":"Does stress affect fertility, and is anything worth changing? The decision is what, if anything, to change — without treating stress as a personal failure or an established cause.","review_state":"machine_verified; clinical_review pending","snapshot_intervention_comparator_and_dose":"No intervention was tested. The comparisons are observational: highest versus lowest levels of salivary alpha-amylase (a stress marker), or two or more major life events versus fewer.","question_id":"T049-Q2F07FFA2E3","release_status":"released (operator_deferred: comprehension_not_passed,clinical_review_pending @2026-09-03)","correction_state":"none","demand_provenance":"T-049 v1.0 registry rank 19, two source classes (google_autocomplete and structured_quiz_response), 8 signals, observed 2026-08-28","updated_on":"2026-09-01","content_version":1,"snapshot_applicability":"Describes couples trying naturally, women in treatment, and men under major life stress. Does not describe the effect of ordinary day-to-day stress on a given cycle — no cited design can isolate that — and does not describe any stress-reduction programme, because none was tested. Periods changing or stopping moves this from statistics to a clinician.","snapshot_review_state":"machine_verified; clinical_review pending","certainty":"split, and the split is the answer — high that severe stress or energy deficit can suppress ovulation and stop periods; low for any effect of everyday stress on conception, because the evidence is observational, modest, and cannot tell cause from effect; insufficient for whether reducing stress improves fertility, because nothing here tested it","snapshot_search_date_and_records":"Last evidence search 2026-08-25. Records: REG:crs_6f4e686b24@2026-08-25, REG:crs_c838d8c0bf@2026-08-25, REG:crs_aea4e142b1@2026-08-25, REG:crs_71f2b284a4@2026-08-25, REG:crs_6df9264a75@2026-08-25.","object_id":"AL-PILOT-0002","source_strength":"emerging_evidence on one record; insufficient_partial on the other four — the register's own grades, shown as recorded rather than upgraded","snapshot_studies_and_participants":"Not reliably reported in the evidence.","snapshot_direction_and_magnitude":"Where an association is found it is modest. Women in the highest third of salivary alpha-amylase showed a 29% reduction in fecundability versus the lowest third (fecundability odds ratio 0.71, confidence interval 0.51 to 1.00 — an interval whose upper edge is no effect at all). In a second cohort the highest quartile had about twice the risk of meeting the 12-month infertility definition. Men reporting two or more major life events had roughly double the odds of semen parameters below WHO reference thresholds.","question":"Does stress affect fertility, and what can I do?","evidence_refs":["REG:crs_6f4e686b24@2026-08-25","REG:crs_c838d8c0bf@2026-08-25","REG:crs_aea4e142b1@2026-08-25","REG:crs_71f2b284a4@2026-08-25","REG:crs_6df9264a75@2026-08-25"],"last_searched_on":"2026-08-25","comprehension_state":"missing","canonical_url":"https://gyna.com/answers/stress-and-fertility","sensitivity":"ordinary","snapshot_source_strength":"emerging_evidence on one record; insufficient_partial on the other four — the register's own grades, shown as recorded rather than upgraded","snapshot_harms_and_care_boundary":"The harm this page guards against is blame: nothing here supports telling a woman her stress caused her infertility, or that relaxing would have changed an outcome. If periods become irregular or stop, that is a clinician's visit. If distress is heavy — especially during fertility treatment — mental-health support is worth seeking for its own sake, not as a conception strategy.","snapshot_consistency_and_conflicts":"Mixed, and reported as mixed. The biomarker cohorts point the same way, but the headline interval touches no-effect, \"stress\" is measured differently in every study, and reverse causation — difficulty conceiving causing the stress — is excluded by none of these designs. The one consistent, strong finding is the extreme: severe stress or energy deficit suppressing ovulation is an established mechanism, not a statistical association.","rubric_state":"pass","withdrawal_state":"none","snapshot_certainty":"split, and the split is the answer — high that severe stress or energy deficit can suppress ovulation and stop periods; low for any effect of everyday stress on conception, because the evidence is observational, modest, and cannot tell cause from effect; insufficient for whether reducing stress improves fertility, because nothing here tested it","snapshot_outcome_and_horizon":"Time to pregnancy over about a year of trying, infertility at the 12-month definition, semen parameters, and menstrual function at the extreme. Not pregnancy after a stress intervention, and not live birth — no record measures what changing stress does.","intent":"The evidence supports caring for stress in its own right — how heavy the trying-to-conceive months feel is reason enough — and it supports seeing a clinician if your periods become irregular or stop, because that is the one place stress measurably reaches the reproductive system. It does not support \"just relax\" as fertility advice, and it does not support blame: nothing here shows that a stressful month is why a pregnancy did or did not happen."},{"snapshot_source_hierarchy_and_evidence_types":"Public-health guidance (WHO, NHS, Mayo Clinic), one multi-authority consensus statement on smoking cessation, and mechanistic/narrative reviews of chromosomal causes of loss.","direct_answer":"No lifestyle change is established to prevent miscarriage — the evidence for that question is insufficient, not negative — and most miscarriages are nobody's fault. Miscarriage is common (about one pregnancy in four ends in one), and roughly half of tested first-trimester losses are caused by chromosomal errors that no food, habit or supplement can prevent. Health authorities do advise a few things — not smoking, avoiding alcohol, folic acid — but those recommendations rest on broader pregnancy health, not on preventing miscarriage.","snapshot_population_and_fertility_context":"Women whose pregnancies ended in first-trimester loss (the chromosomal evidence) and pregnant or trying-to-conceive women in general (the public-health guidance). Not specifically women with recurrent pregnancy loss, who have their own evaluation path.","risk_tier":"high","rubric_evaluators":2,"snapshot_evidence_question_and_decision_boundary":"Can lifestyle changes reduce miscarriage risk? The decision is what is actually controllable, and when the right move is clinical care rather than self-management.","review_state":"machine_verified; clinical_review pending","snapshot_intervention_comparator_and_dose":"No prevention intervention was tested against a comparator in these records. The guidance items — quitting smoking, avoiding alcohol, folic acid — are public-health recommendations for pregnancy overall, not trialed miscarriage-prevention treatments.","question_id":"T049-Q8B51FC01B1","release_status":"released (operator_deferred: comprehension_not_passed,clinical_review_pending @2026-09-03)","correction_state":"none","demand_provenance":"T-049 v1.0 registry rank 17, two source classes (google_autocomplete and structured_quiz_response), 21 signals, observed 2026-08-28","updated_on":"2026-09-01","content_version":1,"snapshot_applicability":"Describes loss in general populations, mostly first trimester. Does not describe recurrent pregnancy loss, losses after fertility treatment, or later-pregnancy loss. The smoking and alcohol guidance applies to anyone pregnant or trying to conceive; the folic-acid figure is a clinician's call when history changes it.","snapshot_review_state":"machine_verified; clinical_review pending","certainty":"high that chromosomal errors cause about half of early losses and that miscarriage is common; insufficient for the question as asked — no record establishes that any lifestyle change reduces miscarriage risk, and the guidance items are supported for other pregnancy outcomes, not this one","snapshot_search_date_and_records":"Last evidence search 2026-08-25. Records: REG:crs_d7b0fee429@2026-08-25, REG:crs_665a749296@2026-08-25, REG:crs_44237398f6@2026-08-25, REG:crs_8e5767bb9a@2026-08-25, REG:crs_9b7b7089f2@2026-08-25, REG:crs_c6a876d290@2026-08-25, REG:crs_f05dba99f4@2026-08-25.","object_id":"AL-PILOT-0003","source_strength":"multi_authority_consensus on one record, emerging_evidence on one; insufficient_partial on the other five — the register's own grades, shown as recorded rather than upgraded","snapshot_studies_and_participants":"Not reliably reported in the evidence.","snapshot_direction_and_magnitude":"About one in four pregnancies ends in miscarriage (WHO), and roughly half of tested first-trimester losses show a chromosomal abnormality — the single largest known cause. For lifestyle: quitting smoking at any point in pregnancy improves the baby's chances of growing without complications, and heavy drinking is linked to ovulation problems and loss. No absolute risk reduction for any lifestyle change on miscarriage specifically is reliably reported anywhere in these records.","question":"Can lifestyle changes reduce miscarriage risk?","evidence_refs":["REG:crs_d7b0fee429@2026-08-25","REG:crs_665a749296@2026-08-25","REG:crs_44237398f6@2026-08-25","REG:crs_8e5767bb9a@2026-08-25","REG:crs_9b7b7089f2@2026-08-25","REG:crs_c6a876d290@2026-08-25","REG:crs_f05dba99f4@2026-08-25"],"last_searched_on":"2026-08-25","comprehension_state":"missing","canonical_url":"https://gyna.com/answers/lifestyle-and-miscarriage-risk","sensitivity":"high","snapshot_source_strength":"multi_authority_consensus on one record, emerging_evidence on one; insufficient_partial on the other five — the register's own grades, shown as recorded rather than upgraded","snapshot_harms_and_care_boundary":"The harm this page exists to prevent is self-blame: the evidence says most losses could not have been prevented by anything the person did or did not do. False reassurance is the other edge — \"not your fault\" does not mean \"nothing matters\", and not smoking and avoiding alcohol remain worth doing on strong general-pregnancy grounds. Heavy bleeding, severe pain or fainting in pregnancy is urgent care immediately. After two or more losses, ask for a recurrent-loss evaluation rather than a lifestyle overhaul.","snapshot_consistency_and_conflicts":"The chromosomal figure is consistent across reviews (50 to 70% of tested first-trimester losses). The lifestyle evidence is consistent in direction but almost never measured against miscarriage as its outcome; where loss appears, the evidence is observational and confounded. Nothing conflicts with the central point — most losses are not caused by behaviour — but the size of the modifiable slice is genuinely unknown.","rubric_state":"pass","withdrawal_state":"none","snapshot_certainty":"high that chromosomal errors cause about half of early losses and that miscarriage is common; insufficient for the question as asked — no record establishes that any lifestyle change reduces miscarriage risk, and the guidance items are supported for other pregnancy outcomes, not this one","snapshot_outcome_and_horizon":"Cause-of-loss distributions in first-trimester miscarriage, plus broader pregnancy outcomes — birth defects, fetal growth, complications. No record measures miscarriage rate after a lifestyle change, which is the outcome the question actually asks about, and the outcomes are kept distinct here rather than pooled into \"risk\".","intent":"What is controllable is narrow, and worth doing for reasons larger than miscarriage risk: not smoking (quitting helps at any point in pregnancy, on multi-authority consensus), avoiding alcohol while trying and during pregnancy, and folic acid at the figure the NHS and your clinician state — which is established for preventing certain birth defects, a different outcome from miscarriage. What the evidence cannot support is a prevention protocol. After two or more losses, the supported next step is a clinical evaluation for treatable causes — not a harder look at your habits."},{"snapshot_source_hierarchy_and_evidence_types":"Self-selected public reviews, counted first-party from a dated archive of the Trustpilot profile. No study, no authority guidance — the lowest evidence tier on any question, which is why this page answers a buying decision and no clinical one.","direct_answer":"Across 2,747 Trustpilot reviews through August 2026, about three in four rate Gyna 4 or 5 stars and about one in five rate it 1 or 2 stars — and most of the negative reviews are about subscription billing and cancellation, not the program's content. Reviews can tell you what members praised or regretted, but they are written by people who chose to write them, and they cannot tell you whether the program will improve your chance of getting pregnant.","snapshot_population_and_fertility_context":"People who chose to write a public Trustpilot review of Gyna (2,747 through 2026-08-18) — self-selected customers, not a random sample and not a clinical population. Read by prospective customers.","risk_tier":"moderate","rubric_evaluators":2,"snapshot_evidence_question_and_decision_boundary":"What do Gyna's public reviews say, and is the subscription worth buying? The decision is whether to buy; this page cannot and does not decide it.","review_state":"machine_verified; no independent or clinical review","snapshot_intervention_comparator_and_dose":"Not applicable to this question.","question_id":"T049-Q8BC1EB1580","release_status":"released (operator_deferred: comprehension_not_passed,clinical_review_pending @2026-09-03)","correction_state":"none","demand_provenance":"T-049 v1.0 registry rank 1, four source classes (in-product chat, private Facebook archive, public reviews, Search Console queries), observed 2026-08-28","updated_on":"2026-09-02","content_version":1,"snapshot_applicability":"Describes the public review record as of the dated archive, for a purchase decision. Does not describe outcomes for any member, does not apply once the live profile materially diverges from the archive, and never applies as medical information.","snapshot_review_state":"machine_verified; no independent or clinical review","certainty":"high that these are the archive's counts (raw, re-derivable, checkable against the live profile) — low as a predictor of any one member's experience, because review samples self-select — and insufficient, by construction, as evidence about fertility outcomes","snapshot_search_date_and_records":"Last evidence search 2026-09-02. Records: MSR:trustpilot_star_distribution@2026-09-02, MSR:trustpilot_recent_12mo@2026-09-02, MSR:trustpilot_negative_billing_share@2026-09-02, MSR:trustpilot_positive_theme_shares@2026-09-02.","object_id":"AL-0004","source_strength":"self_selected_public_reviews on every figure — no authority, guideline or study stands behind any number on this page, and none is implied","snapshot_studies_and_participants":"2,747 reviews (459 in the trailing twelve months). These are reviews, not study participants.","snapshot_direction_and_magnitude":"All-time: 74.0% rate 4–5 stars (55.9% five-star), 20.3% rate 1–2 stars, 5.6% three stars. Trailing twelve months (n = 459): 76.3% positive, 19.8% negative. Of negative reviews, 87.7% carry billing/subscription/refund/cancellation vocabulary. Of positive reviews, 71.4% mention learning/courses/information, 13.6% recipes or meals, 12.4% pregnancy (testimony, not effectiveness evidence), 3.8% support or community. Theme shares are keyword matches and overlap.","question":"What do Gyna reviews say, and is it worth it?","evidence_refs":["MSR:trustpilot_star_distribution@2026-09-02","MSR:trustpilot_recent_12mo@2026-09-02","MSR:trustpilot_negative_billing_share@2026-09-02","MSR:trustpilot_positive_theme_shares@2026-09-02"],"last_searched_on":"2026-09-02","comprehension_state":"missing","canonical_url":"https://gyna.com/reviews","sensitivity":"ordinary","snapshot_source_strength":"self_selected_public_reviews on every figure — no authority, guideline or study stands behind any number on this page, and none is implied","snapshot_harms_and_care_boundary":"The concrete consumer risk the record itself surfaces is billing surprise — the dominant negative theme — so the supported caution is to read the current price and renewal terms before buying and to know cancellation is self-serve at gyna.co/billing. The harm this page guards against in the other direction is treating testimonials as treatment evidence: they are not, and a fertility concern belongs with a clinician without delay.","snapshot_consistency_and_conflicts":"The two measured windows — all-time and the trailing twelve months — have the same shape, so the split is not an artifact of one product era in either cut we measured. The two halves of the record are internally consistent: praise concentrates on content, complaints concentrate on billing mechanics — no measured cut reverses either finding.","rubric_state":"pass","withdrawal_state":"none","snapshot_certainty":"high that these are the archive's counts (raw, re-derivable, checkable against the live profile) — low as a predictor of any one member's experience, because review samples self-select — and insufficient, by construction, as evidence about fertility outcomes","snapshot_outcome_and_horizon":"Reviewer satisfaction and stated experience, 2022-02-16 → 2026-08-18. Not conception, not clinical pregnancy, not live birth — reviews measure experience and cannot measure any fertility outcome.","intent":"\"Worth it\" depends on what you want. Satisfied reviewers overwhelmingly describe the structured learning — courses and fertility-nutrition information (mentioned in about 71% of positive reviews) — plus recipes and meal planning (about 14%); both figures are keyword matches and the classes overlap, so they do not add up. Dissatisfied reviewers overwhelmingly describe billing: renewals they did not expect, and cancellation friction. So the fit test is: if structured fertility-nutrition education with meal planning is what you are after, the people who liked Gyna liked it for exactly that; before you buy, read the current price and renewal terms, and know that cancellation is self-serve at gyna.co/billing. No review can show whether the program improves anyone's chance of conceiving, and we make no such promise."},{"snapshot_source_hierarchy_and_evidence_types":"Ratified internal fact register (each fact carrying a verdict and public-use ruling, each checkable against the public records it points at: state incorporation records, app-store listings) plus first-party raw counts over the dated public review archive. No study and no authority guidance — none is needed for existence facts, and none is implied.","direct_answer":"Gyna is a real product from an identifiable company: Lily Health USA, Inc., a Delaware corporation founded in 2018 that has worked in women's reproductive health since it began, and the seller of record on Gyna's app-store listings. Legitimate does not mean endorsed — no clinician has reviewed Gyna's published statements, no health authority endorses it, and being a real company says nothing about whether the program will work for you.","snapshot_population_and_fertility_context":"Prospective customers evaluating the company. The underlying facts concern the legal operator (Lily Health USA, Inc.) and the public review record (2,747 self-selected reviews); no clinical population is involved.","risk_tier":"moderate","rubric_evaluators":2,"snapshot_evidence_question_and_decision_boundary":"Is Gyna a legitimate operation — a real, identifiable, accountable company behind a real product? The decision is whether to trust or buy; this page equips the verification, not the verdict.","review_state":"machine_verified; no independent or clinical review","snapshot_intervention_comparator_and_dose":"Not applicable to this question.","question_id":"T049-Q6A43E7E6A0","release_status":"released (operator_deferred: comprehension_not_passed,clinical_review_pending @2026-09-03)","correction_state":"none","demand_provenance":"T-049 v1.0 registry rank 2, four source classes (in-product chat, private Facebook archive, public reviews, Search Console queries), observed 2026-08-28","updated_on":"2026-09-02","content_version":1,"snapshot_applicability":"Applies to the trust/purchase decision as of the dated register read and review archive. Does not apply as evidence of program quality, does not describe outcomes for any member, and expires for any fact whose register verdict changes.","snapshot_review_state":"machine_verified; no independent or clinical review","certainty":"high on the existence facts (public-record class: incorporation, seller-of-record, founding year, each independently checkable) and on the review counts being the archive's counts — insufficient, by construction, on everything legitimacy is often taken to imply: content quality, clinical soundness, or any effect on fertility","snapshot_search_date_and_records":"Last evidence search 2026-09-02. Records: FCT:T070-F002@2026-09-02, FCT:T070-F003@2026-09-02, FCT:T070-F004@2026-09-02, FCT:T070-F005@2026-09-02, FCT:T070-F008@2026-09-02, FCT:T070-F009@2026-09-02, FCT:T070-F013@2026-09-02, FCT:T070-F014@2026-09-02, FCT:T070-F017@2026-09-02, FCT:T070-F018@2026-09-02, MSR:trustpilot_star_distribution@2026-09-02, MSR:trustpilot_negative_billing_share@2026-09-02.","object_id":"AL-0005","source_strength":"ratified_fact_register on the company facts; self_selected_public_reviews on the scale figures — no authority, guideline or study stands behind any of it, and none is implied","snapshot_studies_and_participants":"10 ratified register facts and 2,747 public reviews — cited through twelve pins: ten fact pins and two measurement pins. Facts and reviews, not studies or participants.","snapshot_direction_and_magnitude":"The company: incorporated in Delaware, founded 2018, with the evidence supporting continuity of legal operator and reproductive-health mission from then to today — its first product, Lily, delivered reproductive-health information to women in Kenya over SMS and messaging; ChatLily is a former company name; the same legal operator runs Gyna today. Current iOS app first released 2025-07-24, led by the same CEO. The customer base: 2,747 public Trustpilot reviews through 2026-08-18 — 74.0% at 4–5 stars, 20.3% at 1–2 stars, with 87.7% of negative reviews about billing/subscription mechanics rather than content.","question":"Is Gyna legitimate?","evidence_refs":["FCT:T070-F002@2026-09-02","FCT:T070-F003@2026-09-02","FCT:T070-F004@2026-09-02","FCT:T070-F005@2026-09-02","FCT:T070-F008@2026-09-02","FCT:T070-F009@2026-09-02","FCT:T070-F013@2026-09-02","FCT:T070-F014@2026-09-02","FCT:T070-F017@2026-09-02","FCT:T070-F018@2026-09-02","MSR:trustpilot_star_distribution@2026-09-02","MSR:trustpilot_negative_billing_share@2026-09-02"],"last_searched_on":"2026-09-02","comprehension_state":"missing","canonical_url":"https://gyna.com/trust","sensitivity":"ordinary","snapshot_source_strength":"ratified_fact_register on the company facts; self_selected_public_reviews on the scale figures — no authority, guideline or study stands behind any of it, and none is implied","snapshot_harms_and_care_boundary":"Two harms guarded here. Consumer: the dominant complaint in the public record is billing surprise, so the supported caution is to read price and renewal terms before paying — cancellation is self-serve at gyna.co/billing. Health: treating a legitimacy page as a quality or medical endorsement — it is neither; no clinician has reviewed Gyna's published statements, and a fertility concern belongs with a clinician without delay.","snapshot_consistency_and_conflicts":"The register's ratified facts are internally consistent, and each names the public record a reader can check it against. Facts the internal ratification could NOT clear — an earlier founding-date variant, 'rebrand' shorthand, a Kenya founding claim — are omitted from this page entirely rather than smoothed over; their existence is the reason the register has verdicts.","rubric_state":"pass","withdrawal_state":"none","snapshot_certainty":"high on the existence facts (public-record class: incorporation, seller-of-record, founding year, each independently checkable) and on the review counts being the archive's counts — insufficient, by construction, on everything legitimacy is often taken to imply: content quality, clinical soundness, or any effect on fertility","snapshot_outcome_and_horizon":"Verifiable existence and accountability: legal operator, incorporation, founding year, operating history 2018 → today, app-store seller identity, customer scale. Not program quality, not content accuracy, not any fertility outcome — none of those can be established by the facts on this page.","intent":"For the trust decision, verify rather than take our word: the operator (Lily Health USA, Inc.) is on your app-store receipt and in Delaware's public corporation records; the review record — 2,747 public reviews, about three in four positive and one in five negative — is on the live Trustpilot profile; and the commercial terms are readable before you pay, on the pricing page and terms, with cancellation self-serve at gyna.co/billing. The honest caution the record itself supplies: most negative reviews are about subscription billing, so read the renewal terms first. What none of this can tell you is whether the program is right for you — company facts and review counts are evidence of existence, not of results."},{"snapshot_source_hierarchy_and_evidence_types":"Two ASRM committee opinions and one ASRM patient fact sheet; two Cochrane systematic reviews of randomized trials; an ACOG patient FAQ; an NIH NICHD condition page; an NHS advice page; two peer-reviewed systematic reviews read at abstract level; one multi-authority register record.","direct_answer":"Personalize on the few things the evidence actually turns on: whether you ovulate regularly and whether you have polycystic ovary syndrome (PCOS, a common cause of irregular ovulation), whether your weight is at either extreme, and how much time you have before you would seek treatment, because age costs more than weight and delaying care to diet is the one change the weight-loss trials run before fertility treatment argue against. For a woman of normal weight with regular periods, no diet pattern is proven to improve natural fertility: general healthy eating and a daily folic acid supplement of at least 400 micrograms still stand, but the fertility benefit of any particular pattern is an association from observational studies, not a tested effect, and no trial has compared a personalized plan with general advice.","snapshot_population_and_fertility_context":"Women trying to conceive naturally (cohorts of ovulatory-disorder infertility); women with obesity and infertility (body mass index above 29, median about 36) in randomized weight-loss trials before treatment; women with PCOS who carry extra weight (guideline advice); women undergoing IVF (dietary-pattern cohorts).","risk_tier":"moderate","rubric_evaluators":2,"snapshot_evidence_question_and_decision_boundary":"Which diet changes, if any, are supported for a given woman trying to conceive, and by what. The decision is which changes apply to her, not whether diet can fix fertility, and never whether to delay care.","review_state":"machine_verified; clinical_review pending; dietitian_review pending","snapshot_intervention_comparator_and_dose":"Dietitian-led, calorie-restricted weight-loss programmes with physical activity, versus routine care or immediate fertility treatment; preconception lifestyle advice versus routine care; dietary patterns (a so-called fertility diet, the Mediterranean pattern) compared by adherence, not assigned. No trial assigned a personalized plan against general advice.","question_id":"T049-QDC30084FDC","release_status":"released (operator_deferred: comprehension_not_passed,clinical_review_pending @2026-09-03)","correction_state":"none","demand_provenance":"T-049 v1.0 registry rank 3, four source classes (google_autocomplete, in_product_chat, private_facebook_archive, structured_quiz_response), 13 signals, observed 2026-08-28","updated_on":"2026-09-03","content_version":1,"snapshot_applicability":"Describes women trying naturally, women with obesity and infertility before treatment, women with PCOS carrying extra weight, and women in IVF. Changes if you are older or already in treatment (time outweighs weight), if you are underweight (the direction reverses), or if you have diabetes, coeliac disease, prior bariatric surgery or a weight-affecting medication (a clinician's plan, not a website's). Does not describe men or any specific meal plan.","snapshot_review_state":"machine_verified; clinical_review pending; dietitian_review pending","certainty":"four states, and the split is the answer: moderate that weight at either extreme lowers fertility and that modest weight loss can restore ovulation in overweight women with PCOS or who are not ovulating (consistent guideline statements, trial-confirmed ovulation); low that any dietary pattern improves the chance of conceiving for a woman who ovulates regularly (observational and inconsistent); low to very low that weight loss before treatment improves live birth (the trials did not show it); insufficient for personalization beyond these variables, because no trial has tested a tailored plan against general advice","snapshot_search_date_and_records":"Last evidence search 2026-09-03. Records: LIB:src_962671851d7c@2026-09-02, LIB:src_1a609d9e9a22@2026-09-02, LIB:src_0599906abaca@2026-09-02, LIB:src_01aaa02ea6c0@2026-09-02, LIB:src_61933d99fd77@2026-09-02, LIB:src_720738bf9928@2026-09-02, LIB:src_76bec21c38de@2026-09-02, LIB:src_9cc5275ac51b@2026-09-02, LIB:pmid_37506751@2026-09-02, LIB:pmid_42119548@2026-09-02, REG:crs_58db2482e2@2026-08-25.","object_id":"AL-0006","source_strength":"guideline-stated and systematic-review-supported for the weight and PCOS statements (ASRM, Cochrane, ACOG, NICHD); observational cohorts for dietary patterns; two peer-reviewed systematic reviews read at abstract level; one evidence-register statement graded multi-authority consensus (several authorities make it), shown as graded, which says nothing by itself about how certain the answer is","snapshot_studies_and_participants":"Cochrane preconception advice: 7 randomized trials, 2,130 participants. Cochrane obesity and subfertility: 10 trials; the live-birth pooling covers 918 women in 3 studies. The Mediterranean-diet review: 32 studies, 103,204 predominantly White women, mostly on pregnancy fertility outcomes; for fertility outcomes its own conclusion is that the evidence is suggestive yet limited. The review of diet in assisted reproduction (ART, treatments such as IVF): 39 studies. These reviews overlap, so a grand total is not reliably derivable and is not given.","snapshot_direction_and_magnitude":"Weight loss before treatment in women with obesity: more unassisted conceptions (26 versus 16 per 100 women in the largest trial, the Dutch LIFEstyle trial of 577 women) but no gain in live birth. In that trial fewer women had a live birth within 24 months (27 versus 35 per 100; rate ratio 0.77, 95% confidence interval 0.60 to 0.99; every interval on this page is a 95% confidence interval), a difference that disappeared once pregnancies conceived in the window but born after it were counted; pooled across three trials (918 women) the odds ratio was 0.85, interval 0.65 to 1.11. The fertility-diet pattern: highest versus lowest adherence carried about a third the risk of ovulatory-disorder infertility (infertility from not releasing an egg) in one cohort (relative risk 0.34, interval 0.23 to 0.48), with no association with pregnancy or live birth in IVF. Combined-topic preconception advice: little or no difference in live birth in the one trial that measured it (626 women; risk ratio 0.93, interval 0.79 to 1.10).","question":"How should a fertility diet plan be personalized for me?","evidence_refs":["LIB:src_962671851d7c@2026-09-02","LIB:src_1a609d9e9a22@2026-09-02","LIB:src_0599906abaca@2026-09-02","LIB:src_01aaa02ea6c0@2026-09-02","LIB:src_61933d99fd77@2026-09-02","LIB:src_720738bf9928@2026-09-02","LIB:src_76bec21c38de@2026-09-02","LIB:src_9cc5275ac51b@2026-09-02","LIB:pmid_37506751@2026-09-02","LIB:pmid_42119548@2026-09-02","REG:crs_58db2482e2@2026-08-25"],"last_searched_on":"2026-09-03","comprehension_state":"missing","canonical_url":"https://gyna.com/answers/fertility-diet","sensitivity":"high","snapshot_source_strength":"guideline-stated and systematic-review-supported for the weight and PCOS statements (ASRM, Cochrane, ACOG, NICHD); observational cohorts for dietary patterns; two peer-reviewed systematic reviews read at abstract level; one evidence-register statement graded multi-authority consensus (several authorities make it), shown as graded, which says nothing by itself about how certain the answer is","snapshot_harms_and_care_boundary":"Two harms to guard: delaying care to diet, because age costs more than weight and the weight-loss trials did not raise live birth; and restrictive or very-low-calorie eating without supervision, which the trials ran under dietitian care. A possible increase in miscarriage after intensive weight loss is unresolved. Weight-loss medications are not for use while trying to conceive; after bariatric surgery, wait 12 to 18 months and have nutrition assessed. Absent or irregular periods, diabetes, coeliac disease or being underweight are clinician conversations.","snapshot_consistency_and_conflicts":"Mixed, and reported as mixed. Weight loss reliably lowers body mass index and improves ovulation in women who were not ovulating, but did not improve live birth in trials, and one meta-analysis of eight trials found a possible increase in miscarriage (risk ratio 1.50, interval 1.04 to 2.16) where the Cochrane pooling was uncertain (odds ratio 1.54, interval 0.99 to 2.39). Mediterranean-diet cohorts in IVF point both ways. ASRM's own summary is that robust evidence that dietary changes improve natural fertility is lacking.","rubric_state":"pass","withdrawal_state":"none","snapshot_certainty":"four states, and the split is the answer: moderate that weight at either extreme lowers fertility and that modest weight loss can restore ovulation in overweight women with PCOS or who are not ovulating (consistent guideline statements, trial-confirmed ovulation); low that any dietary pattern improves the chance of conceiving for a woman who ovulates regularly (observational and inconsistent); low to very low that weight loss before treatment improves live birth (the trials did not show it); insufficient for personalization beyond these variables, because no trial has tested a tailored plan against general advice","snapshot_outcome_and_horizon":"Ovulation (releasing an egg), unassisted conception, clinical pregnancy and live birth within about 24 months in the trials; ovulatory-disorder infertility over years of follow-up in the cohort; pregnancy and live birth per IVF cycle in the pattern studies; miscarriage where reported. Ovulation, conception and live birth are kept separate throughout, because the evidence moves one without moving the others.","intent":"If your periods are regular and your weight is in the normal range, the evidence does not support reorganizing your diet for fertility (ASRM's committee opinion and patient fact sheet): eat well for your own health, take at least 400 micrograms of folic acid a day (ASRM, NHS), and go easy on high-mercury fish, because a seafood-heavy, mercury-rich diet is associated with infertility (ASRM). If you have PCOS or irregular periods and carry extra weight, a modest, sustainable weight loss is the one dietary change with a directional result: it can restore ovulation, the monthly release of an egg (ACOG, NIH). If you are older, or already heading to treatment, do not spend months on a diet before seeking care; the trials of weight loss before fertility treatment did not raise live-birth rates, in the largest one fewer women had a baby within the trial window, and time matters more (ASRM's obesity opinion, Cochrane). Diabetes, coeliac disease, prior weight-loss surgery, being underweight, or a medication that affects your weight all move this from a website to a dietitian or your clinician."}],"schema":"gyna.answer-library.v1"}