FRI418 A 6-month Lifestyle Intervention Program Improves Quality Of Life And Motivation In Women With Obesity And Infertility
Authors: Brûlé Kathryne , Thibodeau Alexandra , Maillet Daniel , Belan Matea , Jean-Denis Farrah , Pesant Marie-Hélène , Carranza-Mamane Belina , Baillargeon Jean-Patrice 
Published: October 2023

Abstract
Disclosure: K. Brûlé: None. A. Thibodeau: None. D. Maillet: None. M. Belan: None. F. Jean-Denis: None. M. Pesant: None. B. Carranza-Mamane: None. J. Baillargeon: Grant Recipient; Self; Ferring Pharmaceuticals.
Introduction Infertility is the incapacity to conceive after 12 months of regular and unprotected sexual intercourse, affecting 11 to 16% of couples. Obesity affects fertility, increases fertility treatment costs, diminishes their efficacy, predisposes to many complications during pregnancy and presents risks for the offspring. To prevent those consequences, many organizations recommend that women with obesity be assisted in adopting healthy lifestyle habits before conception and maintain them during pregnancy. Also, women with infertility and those living with obesity score lower on the quality of life (QoL) scales. Therefore, our objective was to assess the impact of a lifestyle intervention on QoL and stages of change (based on the transtheoretical model) in women with obesity and seeking fertility treatments. Methods Women 18-40 years old with infertility and obesity (body mass index (BMI) ≥ 30 kg/m2 or BMI ≥ 27 kg/m2 for those with polycystic ovary syndrome), consulting at the fertility clinic of an academic center, were enrolled and randomized to usual fertility care (control group, CG) or the intervention program (lifestyle group, LSG) alone for 6 months and then combined to usual care. The lifestyle program focused on improving physical activity and nutrition and was based on motivational communication. It involved individual follow-ups with a nutritionist and a kinesiologist at weeks 0, 3, 6 and then every 6 weeks for 18 months. Also, participants needed to attend 12 group sessions, including workshops and physical activities. QoL scores from the SF-6D and FertiQol, levels of conviction (visual analog scales on 100), and stages of change were collected at baseline and at 6 months. Proportions were compared by Pearson chi-square tests and means by Student’s t tests or ANCOVA (correcting for the baseline value of the result). Results Among 127 women, 85 had available data at 6 months (CG=43, LSG=42). After 6 months, and compared to the CG, women in the LSG improved more their SF-6D (+0.029 ± 0.076 vs -0.017 ± 0.082, p = 0.009, p ANCOVA &lt;0.001) and FertiQoL total score (+0.35 ± 6.85 vs -2.70 ± 11.80, p = 0.18, p ANCOVA = 0.02). A higher proportion of women in LSG improved their stage of change by ≥2 categories compared to CG (40.0% vs 13.2%, p=0.008). They better maintained their level of conviction about the need to improve their food habits (+4.0 ± 13.4 vs -2.7 ± 17.7, p ANCOVA=0.02) or their physical activity (+2.5 ± 10.2 vs -5.1 ± 13.8, p=0.006, p ANCOVA=0.01). Conclusion A lifestyle program targeting women with obesity and infertility significantly helped maintain or increase their QoL, levels of conviction for food habits and physical activity, and stages of change regarding lifestyle habits compared to usual fertility care. These results suggest that such lifestyle intervention can contribute to the well-being and maintenance of lifestyle changes in women with obesity who seek fertility treatments.
Presentation: Friday, June 16, 2023