The rate of obesity among women of reproductive age has risen dramatically. Obesity-related infertility in women of childbearing age can be prevented by a specialized affordable lifestyle intervention called Fit-For-Fertility (FFF) program according to a new study presented at a recent Endocrine Society’s annual meeting.
Infertility is defined as lack of ability or failure to conceive after regular unprotected sexual activity for a certain period, usually for six months over the age of 35 years or for 12 months below the age of 35.
Several factors, including gynecological cancer and endometriosis, in addition to environmental and lifestyle factors, contribute to women’s inability to conceive at their childbearing age.
Lifestyle Factors that Reduce Fertility
Lifestyle factors, such as alcohol, smoking, alcohol, and caffeine consumption, diet, and exposure to electromagnetic fields, significantly reduces pregnancy rate in women (Vitale et al. 2017).
Obesity, which is closely associated with lifestyle factors such as reduced physical activity, sedentary behaviors, and dietary habits, significantly influences fertility risk in women, causing complications of pregnancy and health outcomes for both mother and children.
In the United States alone, the prevalence of obesity is around 48% among women of their childbearing age. Therefore, the first step in treating pregnancy issues in an obese woman has been lifestyle interventions that have improved physical health, mental health, and quality of life (Wekker et al. 2018).
A retrospective cohort study that evaluated the effects of obesity in 127 women (BMI ≥30 kg/m2), found that lower BMI significantly improves pregnancy rates in obese women (Bond et al. 2020).
Another recent study also revealed that higher levels of physical activity are associated with lower pregnancy problems in women. In the study, which included 6130 women who participated in The Australian Longitudinal Study on Women’s Health (ALSWH), those who were overweight had the hazard ratios (HR) of 1.18 (95% CI: 0.99-1.39) while this index was 1.36 (95% CI 1.14-1.63) in obese women (Mena et al. 2020).
Sexual dysfunction is an important disorder that many couples experience that may contribute to their pregnancy problems. Previous studies have shown that a lifestyle intervention in women with obesity and infertility would improve sexual function (Wekker et al. 2018).
In the study, participants in the intervention group were advised to reduce daily intake by 600 kcal/day. They were advised to be more physically active and to take a minimum of 10,000 steps a day.
Recent studies have also investigated the impact of lifestyle factors on pregnancy outcomes. Presented virtually at ENDO 2021A, the Endocrine Society’s annual meeting, research has shown that a lifestyle intervention on women with obesity and infertility is more effective in increasing the pregnancy rate than fertility treatments (Williams 2021).
FFF Programs Improve Pregnancy Rate
The program called the Fit-For-Fertility (FFF) program included several sessions with a kinesiologist and a nutritionist every six weeks. The program is a cost-effective alternative to the standard of care for obese women requiring fertility treatments, according to the lead researcher Matea Belan, Ph.D. of the University of Sherbrooke and the Research Center of the Centre Hospitalier Universitaire de Sherbrooke (RC-CHUS) in Quebec, Canada.
In the study, 130 women receiving treatment at a fertility clinic were randomly divided into two groups. Participants in the FFF group were asked to follow a minimum of 1 of the 12 group sessions, which included 45-minute lessons on nutrition, lifestyle changes, and lifestyle habits.
Then, the participants followed a 45-minute session of different types of physical activity, including walking, circuit training, step exercise, and others. In the control group, women had access to fertility treatments but did not participate in the FFF program (Williams 2021).
The study found that the FFF group participant had a live-birth rate of 51%, which was 36.8% for the control group, among the participants who completed at least six months of the research or became pregnant during the first six months. Also, participants without any fertility treatment had a pregnancy rate of 33.3% in the treatment group, compared with 12.3% in the control group.
“Our study shows that the FFF program can significantly improve the pregnancy rate, especially the spontaneous pregnancy rate when no fertility treatments are required, as well as the live birth rate,” said Matea Belan.
“We hope this research will give women with obesity and infertility affordable access to a tailored lifestyle intervention adapted to their condition and their specific needs in order to improve their chances of having a pregnancy and building a family” (Williams 2021).
Bond, R. T., A. Nachef, et al. (2020). “Obesity and Infertility: A Metabolic Assessment Strategy to Improve Pregnancy Rate.” J Reprod Infertil 21(1): 34-41.
Mena, G. P., G. I. Mielke, et al. (2020). “Do physical activity, sitting time and body mass index affect fertility over a 15-year period in women? Data from a large population-based cohort study.” Human Reproduction 35(3): 676-683.
Vitale, S. G., V. L. La Rosa, et al. (2017). “The Impact of Lifestyle, Diet, and Psychological Stress on Female Fertility.” Oman Med J 32(5): 443-444.
Wekker, V., M. D. A. Karsten, et al. (2018). “A lifestyle intervention improves sexual function of women with obesity and infertility: A 5 year follow-up of a RCT.” PLoS One 13(10): e0205934.
Williams, C. (2021). “Lifestyle program improves fertility for women with obesity, infertility.”