Robert L. Barbieri, MD reviewing Mutsaerts MAQ et al. N Engl J Med 2016 May 19.

In a randomized trial, reduced calorie intake and increased physical activity raised the odds of natural conception in obese infertile women.

High body-mass index (BMI) and sedentary lifestyles decrease fertility potential. To test the efficacy of weight loss and increased activity on augmenting fertility, Dutch investigators randomized 574 infertile women (BMI ≥29 kg/m2; median, 36 kg/m2) to a 6-month lifestyle intervention followed by infertility treatment or to immediate treatment (control). The intervention consisted of reduced caloric intake (to lower BMI by ≥5%) and increased activity (10,000 steps daily plus 30 minutes of moderate exercise 2–3 times weekly).

Women in the intervention and control groups lost a mean of 4.4 kg (9.7 lb) and 1.1 kg (2.4 lb), respectively (P<0.001). Natural conception was achieved by 26% of women in the intervention group and 16% of those in the control group (rate ratio, 1.6). However, 22% of women in the intervention group discontinued participation within 3 months — and, overall, only 38% of those in the intervention group achieved weight loss of ≥5%. Within the 2 years after randomization, ongoing pregnancy was achieved with fertility treatments in 28% and 43% of women in the intervention and control groups, respectively. Treatments included ovulation induction, intrauterine insemination, and in vitro fertilization. Ovulation induction resulted in the greatest number of pregnancies in either group.

Citation(s):

Mutsaerts MAQ et al. Randomized trial of a lifestyle program in obese infertile women. N Engl J Med 2016 May 19; 374:1942.

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