Majority of Women Undergoing IVF Have Major
A new study published in
the Journal of Advanced Nursing has revealed that more than 96 percent of women
who visit preconception clinic prior to IVF treatment had at least three major lifestyle
problems and risk factors.
Half of the obese women
lost weight and nearly a third of the smokers decided to quit after receiving
advice at the clinic. But the nurses were surprised that some women had no
motivation to lead healthier lifestyles, even though they were prepared to go
through IVF to get pregnant. For example 30% of the smokers refused to quit and
16% of the obese women weren't prepared to lose weight.
Researchers from the
University Medical Center in Utrecht, The Netherlands, analysed the results of
questionnaires completed by 101 women who had received preconception care
before IVF, together with the seven nurses who advised them.
are increasingly recognising that there are important links between preconception
health and positive IVF outcomes, both in terms of the success of the procedure
and the health of the baby" says nurse researcher Henrietta Ockhuijsen
from the Department of Reproductive Medicine and Gynaecology at the Center.
"Despite this, preconception care is rarely offered to couples undergoing
A total of 130 women, aged
from 25 to 42 years, completed an internet-based preconception questionnaire
developed by the Erasmus Medical Center in Rotterdam and 101 of those completed
a further questionnaire after they had received lifestyle advice from one of
the seven nurses. The obese patients and smokers were then followed up for a
further year. The registered nurses ranged from 42 to 51 years-of-age and had
all worked in the fertility clinic for more than five years.
Key findings of the study
The vast majority of the
130 women who completed the lifestyle problems and risks questionnaire faced
three or more risks (96%), with only 4% facing two. These lifestyle problems
and risks included bacterial and parasitic infections, alcohol use, smoking,
obesity and using medication without a prescription.
All of the women were
satisfied with the time spent with them by the nurse providing preconception
advice and 96% were satisfied with the verbal information provided.
The women were also asked
for their views on the preconception site run by the Erasmus Medical Center.
The overall written information scored a satisfaction rate of 94%, the
information and advice about lifestyle problems scored 91% and 89% respectively
and the strategies to improve lifestyles scored 75%.
Women valued the personal
contact and approach from their nurse and the time allocated for preconception
advice. But women with lower risk factors felt the clinic was unnecessary and
that a better selection procedure would increase the efficiency and value of
Half of the 30 women who
were obese lost weight. They had an average BMI of 34.3, weighed an average of
101.3kg and lost an average of 6.1kg. Ten further women said they were
motivated to lose weight, but declined to be followed up, and the remaining
five said they didn't feel motivated to lose weight.
Seven of the 23 patients
counselled for smoking quit, six reduced the number of cigarettes they smoked,
three wanted to quit but declined follow up and seven were not motivated to
The nurses were sceptical
about the clinic to start with, but became more confident about the value of
the programme and their role, scoring it an average of 4.3 out of ten at the
start and 6.3 at the end. More than half (57%) were happy with the training
they received, 86% with the coaching, 86% with the internet-based questionnaire
used, 72% with the evidence-based manual and 57% with the organisation of the
However only 42% were
satisfied with the fact that all the women were referred to the preconception
clinic, arguing that it was more important for women who were obese, smoked,
lacked knowledge and had multiple lifestyle problems to attend.
Less than half (42%) were
satisfied with the knowledge and skills they had to counsel women with obesity.
The nurses also felt awkward about talking about issues such as weight loss and
smoking cessation with women who were already facing the stress of IVF.
"The results of our study
show that preconception care was well received by the patients and that it
motivated some women to lose weight and quit smoking" concludes Henrietta
Ockhuijsen. "We feel that such care should be incorporate into IVF programmes and that nurses could play a key role in running special clinics, as
long as they were provided with additional education and clear protocols."