8570 Association Between Preconception Lifestyle and Anthropometric Modifications and Fertility outcomes in Women with Infertility and Obesity
Authors: Thibodeau Alexandra , Richer dit Laflèche Christophe , Ngueta Gérard , Belan Matea , Jean-Denis Farrah , Langlois Marie-France , Pesant Marie-Helene , Mamane Belina Carranza , Baillargeon Jean-Patrice 
Published: October 2024

Abstract
Disclosure: A. Thibodeau: None. C. Richer dit Laflèche: None. G. Ngueta: None. M. Belan: None. F. Jean-Denis: None. M. Langlois: None. M. Pesant: None. B. Carranza Mamane: None. J. Baillargeon: Grant Recipient; Self; Ferring Pharmaceuticals.
Introduction: Infertility is a common problem that is affected by many lifestyle behaviors, and preconception lifestyle modifications are recommended in women with infertility and obesity. This study thus aims to explore whether preconception lifestyle or anthropometric changes are associated with a viable pregnancy or a live birth in this population. Methods: This prospective cohort study, nested within a randomized controlled trial that recruited 127 women with infertility and obesity at an academic fertility clinic, reports on 70 women who had at least one research visit during their follow-up until the onset of pregnancy or a maximum of 18 months. Lifestyles were assessed using a questionnaire. Logistic regression was used to examine the association between changes in lifestyle or anthropometry and the occurrence of a viable pregnancy or live birth. Changes were defined by the incremental area under the curve (divided by follow-up time; iAUC) and the difference between baseline and the minimum or maximum measure achieved during follow-up. Regressions were corrected for baseline measures of the age of both partners, waist circumference, multiparity, socioeconomic status and multivitamin use. Results: The odds of a pregnancy and live birth were higher among women who had a greater minimum change (improvement) in their weekly consumption of fruits (p=.028/.014) or dairy products (p=.005/.003), in their reduction of tobacco use (p=.038/NS), in their sleep duration (p=.044/NS), or in their loss of weight, waist circumference or fat mass (p=.007/.007; .006/.006; .045/.019). Unexpectedly, a higher maximum change in energy expenditure was associated with lower odds of pregnancy (p=.013). Multivariate analyses showed that a higher minimum change in fruit consumption (p=.008), in tobacco use reduction (p=.033), and waist circumference loss (p=.002), and a lower maximum change in energy expenditure (p=.008) were all independently associated with the occurrence of pregnancy, after adjustment for the abovementioned potential confounders. For live birth, a higher minimum change in dairy products consumption (p=.012), in tobacco use reduction (p=.017), and in weight loss (p=.003) were all independently associated with a live birth. Conclusion: Our exploratory analyses are among the first to show that preconception lifestyle improvements are associated with the occurrence of a viable pregnancy and live birth in women with infertility and obesity, particularly higher minimal and sustained changes in fruit and dairy product intake and tobacco reduction. Higher minimal and sustained weight or waist circumference losses also contributed to improve their fertility, as expected. However, the negative association between higher energy expenditure and pregnancy was unexpected and requires further evaluation.
Presentation: 6/1/2024