Weight reduction intervention for obese infertile women prior to IVF : A randomized controlled trial

• Published in: Human Reproduction
• Main Authors: Einarsson, Snorri, Bergh, Christina, Friberg, Britt, Pinborg, Anja, Klajnbard, Anna, Karlström, Per Olof, Kluge, Linda, Larsson, Ingrid, Loft, Anne, Mikkelsen-Englund, Anne Lis, Stenlöf, Kaj, Wistrand, Anna, Thurin-Kjellberg, Ann
• Format: Article in Journal/Newspaper
• Language: English
• Published: Oxford University Press 2017
• Subjects: Gynaecology; Obstetrics and Reproductive Medicine; infertility; IVF; low calorie diet; obesity; weight loss; Iceland
• Online Access: https://lup.lub.lu.se/record/f8e22a2e-501b-4209-b6cd-92b96ae0b44b; https://doi.org/10.1093/humrep/dex235

STUDY QUESTION Does an intensive weight reduction programme prior to IVF increase live birth rates for infertile obese women? SUMMARY ANSWER An intensive weight reduction programme resulted in a large weight loss but did not substantially affect live birth rates in obese women scheduled for IVF. WHAT IS ALREADY KNOWN Among obese women, fertility and obstetric outcomes are influenced negatively with increased risk of miscarriage and a higher risk of maternal and neonatal complications. A recent large randomized controlled trial found no effect of lifestyle intervention on live birth in infertile obese women. STUDY DESIGN, SIZE, DURATION A prospective, multicentre, randomized controlled trial was performed between 2010 and 2016 in the Nordic countries. In total, 962 women were assessed for eligibility and 317 women were randomized. Computerized randomization with concealed allocation was performed in the proportions 1:1 to one of two groups: weight reduction intervention followed by IVF-treatment or IVF-treatment only. One cycle per patient was included. PARTICIPANTS/MATERIALS, SETTING, METHODS Nine infertility clinics in Sweden, Denmark and Iceland participated. Women under 38 years of age planning IVF, and having a BMI ≥30 and <35 kg/m 2 were randomized to two groups: an intervention group (160 patients) with weight reduction before IVF, starting with 12 weeks of a low calorie liquid formula diet (LCD) of 880 kcal/day and thereafter weight stabilization for 2-5 weeks, or a control group (157 patients) with IVF only. MAIN RESULTS AND ROLE OF CHANCE In the full analysis set (FAS), the live birth rate was 29.6% (45/152) in the weight reduction and IVF group and 27.5% (42/153) in the IVF only group. The difference was not statistically significant (difference 2.2%, 95% CI: 12.9 to -8.6, P = 0.77). The mean weight change was -9.44 (6.57) kg in the weight reduction and IVF group as compared to +1.19 (1.95) kg in the IVF only group, being highly significant (P < 0.0001). Significantly more live births were ...