title: Dropout is a problem in lifestyle intervention programs for overweight and obese infertile women: a systematic review.
abstract: OBJECTIVE
  What are the dropout rates in lifestyle intervention programs (LIPs) for overweight and obese infertile women and can intervention- or patient-related baseline factors associated with dropout be identified in these women?
  
  
  CONCLUSIONS
  The median dropout rate was 24% in overweight and obese infertile women who participated in a LIP; clinical useful intervention or patient-related factors associated with dropout could not be identified.
  
  
  BACKGROUND
  Overweight and obese infertile women might improve their chance of conception when they improve their lifestyle and lose weight. Dropout from LIPs reduces the chance of losing considerable weight and is therefore considered to be an important limiting factor of the success of LIPs.
  
  
  METHODS
  This systematic review included 15 studies published between January 1980 and December 2012.
  
  
  METHODS
  The included studies investigated the effect of LIPs for overweight and obese infertile women with infertility. From these studies, dropout rates and intervention- and patient-related baseline factors associated with dropout, as well as weight loss and pregnancy rates, were recorded.
  
  
  RESULTS
  There were 15 studies identified, of which 10 reported dropout rates. The median dropout rate was 24% (range: 0-31%). Four studies reported baseline characteristics of women who dropped out, but modifiable predictors of dropout could not be identified. Weight loss and pregnancy rates were lower in women who dropped out than in women who completed the LIPs.
  
  
  CONCLUSIONS
  There were limited numbers of studies investigating patient-related factors associated with dropout. The heterogeneity in the studies precluded us from drawing firm conclusions on the relation between the type of intervention and dropout.
  
  
  CONCLUSIONS
  Dropout from LIPs is a major drawback because it predisposes to less weight loss and lower pregnancy rates. Identification of predictors of dropout is needed to identify overweight and obese infertile women who are prone for dropout. These women might benefit from extra support and monitoring, to potentially increasing adherence rates, weight loss and pregnancy chances.
  
  
  BACKGROUND
  M.A.Q.M. was supported by a research grant from the Dutch Organization for Health Research and Development (ZonMw). The department of obstetrics and gynaecology received research grants from Merck Sharpe and Dohme BV, feering pharmaceuticals, Merck Serono, the Netherlands.
authors: Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands. m.a.q.mutsaerts@umcg.nl
authors: M A Q
authors: MA
authors: Mutsaerts
authors: W K H
authors: WK
authors: Kuchenbecker
authors: B W
authors: BW
authors: Mol
authors: J A
authors: JA
authors: Land
authors: A
authors: A
authors: Hoek
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000150:complications / Q000628:therapy*; D009765:Obesity / Q000150:complications / Q000628:therapy*; D050177:Overweight / Q000150:complications / Q000628:therapy*; D010349:Patient Compliance; D011247:Pregnancy; D018873:Pregnancy Rate; D015431:Weight Loss; D061217:Weight Reduction Programs