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Lifestyle related factors associated with pregnancy outcome after in vitro fertilisation-embryo transfer cycles

      Objective

      Lifestyle factors have a dramatic impact on the reproductive performance of infertile population undergoing Assisted Reproductive Technology. The present study focussed on IVF population and explored association between lifestyle factors primarily during the implantation window and implantation success. This study aims at determining the independent contribution of female lifestyle related factors following embryo transfer leading to ART success. Also, the secondary aim is to compare the differences between pregnant and non-pregnant cycles and to draw strategies to improve ART outcome.

      Design

      Cross sectional questionnaire based study.

      Materials and Methods

      This study was undertaken in our university affiliated and tertiary referral private hospital. We recruited 130 women who underwent frozen /fresh embryo transfer (IVF/ICSI cycles) over a period of 12 months. We categorized lifestyle factors into diet and nutrition related, physical activity related and emotional support related behaviours. A structured questionnaire with 15 questions was framed. The survey was conducted using the computer assisted telephone interviewing system. The women completed the questionnaire based on their lifestyle factors from the time of embryo transfer to serum pregnancy testing. The primary outcomes were the result of Serum beta hCG (>25mIU/mL considered to be positive) on day 14 after embryo transfer.

      Results

      Among the 130 women receiving ET, 50/130(38%) resulted in implantation. The mean age of the study population was 31.23±3.21 years with a mean BMI of 25.2± 3.2kg/sq.m. Age, duration of infertility, previous IVF attempts all showed a correlation with negative outcome. A BMI consistent with being overweight (BMI 25-29.9 kg/m2) and obese (BMI >30 kg/m2) was associated with a lower pregnancy rate compared with women of a BMI of 19 - 24.9(Implantation rate- 23%). A comparison of the physical activity variables among the pregnant and non-pregnant groups yielded no significant differences among them in logistic regression analysis. There was a significant association between plant based diet and inclusion of fresh fruits to successful outcome (P = 0.043). All women responded that they had received adequate emotional/psychological support and there was no statistical differences between two groups (P= 0.521).

      Conclusions

      Women had a tendency to limit physical activity levels post embryo transfer and bed rest has no correlation with ART success and there is a clinical need to emphasize that prolonged bed rest following ET is not necessary. Women maintained a plant based diet showed an association to positive pregnancy outcome. A structured counselling to facilitate lifestyle changes may optimise reproductive performance and improve their chance of success.