Integrating preconceptional care into an IVF programme.
OBJECTIVE
This paper is a report of a mixed method study of the outcomes of integrating preconceptional care into an in-vitro fertilization programme on nurses' and patients' attitudes and patients' weight and smoking behaviour.


BACKGROUND
Increasing evidence points to the significant effect of lifestyle factors on in-vitro fertilization outcomes. Optimizing the health of couples before they commence in-vitro fertilization may improve the chance of achieving success.


METHODS
In 2007, 130 couples attending a university hospital in-vitro fertilization unit and seven nurses were invited to participate in the study. Questionnaires were developed to assess the attitudes of both patients and nurses. Furthermore, the impact of interventions on body mass index and smoking patterns were evaluated.


RESULTS
All nurses (n = 7) and 101 patients (77·7%) returned completed questionnaires. Analysis revealed a considerable degree of scepticism among the nurses at the outset as to the value of the programme and their ability to perform their new role effectively. Patients valued positively the increased attention to adjusting lifestyle factors with the goal to improve fertility outcomes. Of those participants who smoked or had a body mass index >30, 30% (n = 7/23) of the patients quit smoking and 50% lost weight (n = 15/30), mean loss: 6·1 kg.


CONCLUSIONS
Fertility nurses can play a key role in the provision of preconceptional care. Patients with a fertility problem can be motivated to address lifestyle issues before embarking on in-vitro fertilization treatment. The integration of preconceptional care and lifestyle interventions was shown to be feasible in our clinical setting.
Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, The Netherlands. h.d.l.ockhuysen@umcutrecht.nl
Henriëtta D L
HD
Ockhuijsen
Claudia J
CJ
Gamel
Agnes
A
van den Hoogen
Nicholas S
NS
Macklon
D000328:Adult; D001291:Attitude of Health Personnel; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D002985:Clinical Protocols; D003376:Counseling; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009042:Motivation; D009426:Netherlands; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000523:psychology; D017060:Patient Satisfaction; D016742:Preconception Care / Q000379:methods / Q000458:organization & administration*; D011247:Pregnancy; D015397:Program Evaluation; D036301:Qualitative Research; D012307:Risk Factors; D016540:Smoking Cessation; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires