Pretreatment maternal lifestyle and outcomes of assisted reproduction: an Italian cohort study

Abstract

ObjectiveWe investigated whether lifestyle affects assisted reproduction technology (ART) outcomes.DesignCohort study.SettingItalian fertility unit.ParticipantsFrom September 2014 to December 2016, women from couples presenting for evaluation and eligible for ART were invited to participate. Information on alcohol intake, current smoking and leisure physical activity (PA) during the year before the interview was collected, using a structured questionnaire. We considered the ART outcomes of the cycle immediately following the interview.Primary and secondary outcome measuresThe primary outcome measure was cumulative pregnancy rate per retrieval. Secondary measures were number of retrieved oocytes, embryo transfer and live birth.ResultsIn 492 women undergoing an ART cycle, 427 (86.8%) underwent embryo transfer, 157 (31.9%) had at least one clinical pregnancy and 121 (24.6%) had live birth. The cumulative pregnancy rate per retrieval was 33.3% (95% CI 28.5% to 38.7%). In women in the third tertile of alcohol intake, adjusted relative risk was 0.97 (95% CI 0.87 to 1.08), 0.90 (95% CI 0.62 to 1.30) and 0.89 (95% CI 0.57 to 1.37) for embryo transfer, clinical pregnancy and live birth, respectively. The corresponding figures in women currently smoking more than 5 cigarettes/day were 1.00 (95% CI 0.88 to 1.16), 0.94 (95% CI 0.60 to 1.48) and 1.14 (95% CI 0.68 to 1.90), and in women with PA ≥5 hours/week were 0.93 (95% CI 0.79 to 1.08), 0.44 (95% CI 0.22 to 0.90) and 0.48 (95% CI 0.22 to 1.05), respectively.ConclusionThere were no significant differences in in vitro fertilisation outcomes among women who used alcohol or tobacco in the year prior to treatment. Conservatively, all women should be advised to limit substance abuse. Moreover, our study suggested that maintaining a moderate, but not high, level of PA could be beneficial.

The association between caffeine and alcohol consumption and IVF/ICSI outcomes: A systematic review and dose–response meta‐analysis

“…All studies were published between 2002 and 2022 and included 26 922 women and/or their spouses who underwent IVF/ICSI treatment. Five studies were conducted in the USA, 10,25–27,29 four in Brazil, 23,24,30,31 three in Denmark, 12,14,16 two in Italy, 15,28 and one in Saudi Arabia 22 . Only six and five studies reported consumption amount to be included in the dose–response analysis 10,12,14–16,22,25,27–30 …”

“…13 In contrast, some studies did not find evidence of a significant relation between female alcohol consumption and ART outcomes. [14][15][16] Considering the widespread consumption of caffeine and alcohol, it is essential to shed more light on the association between these two substances and IVF/ICSI outcomes. For this reason, we conducted a systematic review and dose-response meta-analysis to examine the associations between caffeine and alcohol consumption and IVF/ICSI outcomes.…”

“…A prospective study conducted in Sweden found that high alcohol consumption increased the risk of women's infertility examinations and decreased the number of first and second fetus 13 . In contrast, some studies did not find evidence of a significant relation between female alcohol consumption and ART outcomes 14–16 …”

“… 13 In contrast, some studies did not find evidence of a significant relation between female alcohol consumption and ART outcomes. 14 , 15 , 16 …”

Fatty acids intake and outcomes of assisted reproduction in women referring to an Italian Fertility Service: cross‐sectional analysis of a prospective cohort study

“…Patients were managed according to a standardised clinical protocol as reported in detail elsewhere. 17 Briefly, the protocol for stimulation and drug dosages was decided based on clinical characteristics and biomarkers of ovarian reserve. Hypo-response or abnormal follicular growth were reasons to cancel the cycle before ovum pick up.…”