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Weight Loss Aids Conception in Infertile Obese Women

— Benefit seen irrespective of age, baseline BMI, cycle regularity

MedpageToday

HELSINKI -- Weight loss following a lifestyle intervention boosted conception rates among obese infertile women with irregular menstrual cycles, according to small subgroup analysis presented here.

Obese infertile women suffering from anovulation who had just completed a 6-month lifestyle intervention were more than four times as likely to naturally conceive compared with women who were given fertility treatment alone, who were given standard fertility treatments (adjusted OR 4.15, 95% CI 2.04-8.44, P=0.02), reported , of University Medical Centre in Groningen, The Netherlands, and colleagues.

"We know that obesity is related to infertility and especially anovulatory infertility," said van Oers in an interview released to the media. "As healthcare providers, it's important to optimize pregnancy chances for these women, because overweight women are at increased risk for several pregnancy complications, such as diabetes and hypertension."

, presented at the annual meeting, were part of a subgroup analysis of the LIFEstyle study. This was the largest study to examine the effect of a lifestyle intervention compared with fertility treatment among obese infertile women; main results were recently published in the New England Journal of Medicine. It found overall higher rates of live birth among obese women who immediately received fertility treatment (control group) compared to those who started with a lifestyle intervention.

But the study also found that natural conception of an ongoing pregnancy occurred more frequently among women in the lifestyle intervention group versus the control group.

Van Oers' team wanted to examine if these results were similar for specific subgroups, namely age (over or under 36 years), cycle regularity, and body weight (BMI above or below 35). They examined data from 564 out of the initial 577 patients who had a complete follow-up, but the results were similar to the initial trial.

Other than higher rates of natural conception in women with anovulatory cycles, there were no significant differences between these specific subgroups in rates of vaginal term delivery of a healthy infant or rates of natural conception of an ongoing pregnancy among those who received the lifestyle intervention versus the control group.

"Our finding that lifestyle intervention ... more often leads to natural conception, specifically in anovulatory women, should be used in their counselling before fertility treatment and could reasonably be offered as firstline treatment for anovulation in obese women," said van Oers in a statement.

The authors suggest that further individual analysis could shed more light onto the effectiveness of a lifestyle intervention among other subgroups of obese infertile women.

Primary Source

European Society of Human Reproduction and Embryology

Van Oers A, et al "Is there a different effect of lifestyle intervention in subgroups of infertile obese women? Prespecified subgroup analyses of the LIFEstyle randomised controlled trial" ESHRE 2016; Abstract H16-0524.