Many women undergoing fertility treatment make poor lifestyle choices that may affect treatment outcome.
OBJECTIVE
What are the lifestyle choices and dietary aspects of women about to undergo fertility treatment in New Zealand?


CONCLUSIONS
A considerable proportion of women about to undergo fertility treatment make poor lifestyle choices, including the consumption of alcohol and caffeine.


BACKGROUND
Women undergoing fertility treatment are highly motivated to achieve pregnancy, but there are relatively few published data on their lifestyle, lifestyle changes or dietary aspects.


METHODS
This was a cross-sectional study of 250 women aged 20-43 years, taking place between March 2010 and August 2011.


METHODS
Women about to undergo IVF or ICSI treatment in two large fertility clinics in Auckland and Hamilton, New Zealand. Lifestyle and dietary intake questionnaires were individually administered once to each participant 35 days (SD = 22) prior to fertility treatment initiation. Outcome measures included incidence of smoking, consumption of alcohol and caffeinated beverages, BMI, detailed intake of dietary supplements and fertility treatment success. Consumption of certain nutrient supplements was compared with the general female New Zealand population.


RESULTS
There were high rates of alcohol (50.8%) and caffeine (86.8%) consumption. Most women (82.8%) reported at least one lifestyle change in preparation for fertility treatment, but less than half of women who consumed alcohol regularly reduced their intake and 60% did not change consumption of caffeinated beverages. Similarly, the majority of women did not change their exercise levels (64.4%) or BMI (83.6%) ahead of fertility treatment. Coffee intake appeared unrelated to treatment outcome, but women who consumed caffeinated herbal tea (36.4% of the study population consumed green tea) had lower odds of becoming pregnant (odds ratio, OR 0.52; P = 0.041 versus those not consuming caffeinated herbal tea). Women who abstained from drinking or reduced alcohol intake had twice the odds of becoming pregnant than those who maintained their drinking habits prior to fertility treatment (OR 2.27; P = 0.049). While 93.2% of women took a folic acid supplement, 16.8% had an inadequate intake compared with the current New Zealand prenatal recommendation of 800 mcg/day. Women who held a university degree or higher qualification had twice the odds of becoming pregnant as women with lower levels of education (OR 2.08; P = 0.017), though this finding appeared to be unrelated to lifestyle or dietary habits.


CONCLUSIONS
The study involved self-reported behaviours that might have been misrepresented by respondents. In addition, our questionnaires covered the period following the first clinical assessment but ∼5 weeks prior to fertility treatment initiation, so that we cannot ascertain whether dietary intakes and lifestyle choices persisted over the course of treatment itself.


CONCLUSIONS
Many women about to undergo fertility treatment make poor lifestyle choices that may negatively affect their chances of becoming pregnant. These findings may be more widely applicable to other women attempting to become pregnant. Specific advice for women regarding healthy lifestyle choices while undergoing fertility treatment is warranted.


BACKGROUND
A.A.G. received financial support from Abbott Nutrition Research & Development Asia-Pacific Center; J.C.P. is a shareholder of Fertility Associates; the other authors have no financial or non-financial conflicts of interest to disclose.
Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand.
Alice A
AA
Gormack
Fertility Associates, Auckland, New Zealand.
John C
JC
Peek
Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand.
José G B
JG
Derraik
Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand.
Peter D
PD
Gluckman
Fertility Associates, Auckland, New Zealand.
Natalie L
NL
Young
Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand w.cutfield@auckland.ac.nz.
Wayne S
WS
Cutfield
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D002110:Caffeine; D005247:Feeding Behavior; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006801:Humans; D008019:Life Style; D009520:New Zealand; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D020554:Sperm Injections, Intracytoplasmic / Q000706:statistics & numerical data; D055815:Young Adult
D002110:Caffeine
alcohol; caffeine; fertility treatment; nutritional supplements; pregnancy