Women with fertility problems who are also seriously overweight do not increase their chances of giving birth to a healthy baby if helped to adopt a healthy lifestyle before undergoing fertility treatment. Their chances of getting pregnant naturally do, however, increase after lifestyle coaching. These are the results of the large-scale LIFEstyle study, which was carried out in 23 Dutch hospitals and headed by gynaecologist Dr Annemieke Hoek from the UMCG. The research findings are published in today’s edition of the scientific journal New England Journal of Medicine.
Severe obesity (BMI>29) in women leads to reduced fertility, a reduced chance of getting pregnant despite fertility treatment and a higher risk of complications for mother and child during pregnancy. Previous research had shown that women who are seriously overweight and experiencing fertility problems have a greater chance of getting pregnant naturally if they undergo lifestyle coaching aimed at helping them to lose weight. However, the studies were too small, they were not compared with women who started fertility treatment immediately and until now, it had not been clear whether lifestyle coaching would increase the chances of the women in this group of giving birth to a healthy child.
The LIFEstyle study examined the effectiveness of lifestyle coaching on the chances of women with fertility problems and severe obesity giving birth to a healthy child in. The lifestyle programme was carried out and supervised by specially trained nurses in the 23 hospitals taking part. A total of 577 women took part in the study, 290 of whom were randomly assigned lifestyle coaching for a maximum of 6 months before undergoing fertility treatment. The remaining women were given the standard care package, comprising fertility treatment without lifestyle coaching. Both groups were monitored for at least 24 months. The lifestyle programme was designed to help women lose at least 5% of their body weight. It involved personal coaching from specially trained nurses, who gave advice about reducing calorie intake and taking exercise, such as walking and participating in moderately intensive sports.
The women in the lifestyle coaching group lost an average of 4.4 kilos in a maximum of 6 months; 38% of them achieved their target of losing 5% of their body weight. The average weight loss in the group who did not take part in the lifestyle programme was one kilo, and none of these women lost 5% of their body weight. Despite the difference in weight loss between the women in the two groups, the research showed that the women in the lifestyle coaching group did not increase their chances of giving birth to a healthy child within 24 months.
The study revealed that 78% of the women with severe obesity and problems getting pregnant were able to adhere to a lifestyle programme, and that their chances of getting pregnant were the same as those for the women who started fertility treatment immediately. Despite intensive coaching, 22% of the women were unable to maintain the 6-month lifestyle programme. These women had a lower chance of getting pregnant. The women who completed the lifestyle programme had a greater chance of getting pregnant naturally than the women who started fertility treatment immediately. As a result, less fertility treatment was needed after the lifestyle programme. No differences between the groups were noted in terms of complications during pregnancy or the health of the babies.
The next step is to find out whether better interventions can be developed to meet the needs of women who find the lifestyle programme too difficult or simply unappealing. The long-term health of the women and children from the LIFEstyle study will also be monitored; Professor T.J. Roseboom from the Academic Medical Center in Amsterdam will head this project, in association with researchers from the UMCG and the VU University Medical Center.
The LIFEstyle study was conducted by two PhD candidates, Meike Mutsaerts and Anne van Oers, working within Consortium 2.0, a national network of hospitals that carry out targeted research under the supervision of the Dutch Association for Obstetrics and Gynaecology.
Read the article in
New England Journal of Medicine
Source: press release UMCG
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