The LIFESTYLE study: Costs and effects of a structured lifestyle program in overweight and obese subfertile women to reduce the need for fertility treatment and improve reproductive outcome. A randomised controlled trial

Meike A Q Mutsaerts, Henk Groen, Nancy C W ter Bogt, Johanna H T Bolster, Jolande A. Land, Wanda J E Bemelmans, Walter K H Kuchenbecker, Peter G A Hompes, Nick S. Macklon, Ronald P. Stolk, Fulco van der Veen, Jacques W M Maas, Nicole F. Klijn, Eugenie M. Kaaijk, Gerrit J E Oosterhuis, Peter X J M Bouckaert, Jaap M. Schierbeek, Yvonne M. van Kasteren, Annemiek W. Nap, Frank J. Broekmans & 10 others Egbert A. Brinkhuis, Carolien A M Koks, Jan M. Burggraaff, Adrienne S. Blankhart, Denise A M Perquin, Marie H. Gerards, Robert J A B Mulder, Ed T C M Gondrie, Ben W J Mol, Annemieke Hoek

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Background: In the Netherlands, 30% of subfertile women are overweight or obese, and at present there is no agreement on fertility care for them. Data from observational and small intervention studies suggest that reduction of weight will increase the chances of conception, decrease pregnancy complications and improve perinatal outcome, but this has not been confirmed in randomised controlled trials. This study will assess the cost and effects of a six-months structured lifestyle program aiming at weight reduction followed by conventional fertility care (intervention group) as compared to conventional fertility care only (control group) in overweight and obese subfertile women. We hypothesize that the intervention will decrease the need for fertility treatment, diminish overweight-related pregnancy complications, and will improve perinatal outcome.Methods/Design: Multicenter randomised controlled trial in subfertile women (age 18-39 year) with a body mass index between 29 and 40 kg/m2. Exclusion criteria are azoospermia, use of donor semen, severe endometriosis, premature ovarian failure, endocrinopathies or pre-existent hypertensive disorders.In the intervention group the aim is a weight loss of at least 5% to10% in a six-month period, to be achieved by the combination of a diet, increase of physical activity and behavioural modification. After six months, in case no conception has been achieved, these patients will start fertility treatment according to the Dutch fertility guidelines. In the control group treatment will be started according to Dutch fertility guidelines, independently of the patient's weight.Outcome measures and analysis: The primary outcome measure is a healthy singleton born after at least 37 weeks of gestation after vaginal delivery. Secondary outcome parameters including pregnancy outcome and complications, percentage of women needing fertility treatment, clinical and ongoing pregnancy rates, body weight, quality of life and costs.Data will be analysed according to the intention to treat principle, and cost-effectiveness analysis will be performed to compare the costs and health effects in the intervention and control group.Discussion: The trial will provide evidence for costs and effects of a lifestyle intervention aiming at weight reduction in overweight and obese subfertile women and will offer guidance to clinicians for the treatment of these patients.Trial registration: Dutch Trial Register NTR1530.

LanguageEnglish
Article number22
JournalBMC Women's Health
Volume10
DOIs
Publication statusPublished - 25 Jun 2010
Externally publishedYes

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

Cite this

Mutsaerts, Meike A Q ; Groen, Henk ; ter Bogt, Nancy C W ; Bolster, Johanna H T ; Land, Jolande A. ; Bemelmans, Wanda J E ; Kuchenbecker, Walter K H ; Hompes, Peter G A ; Macklon, Nick S. ; Stolk, Ronald P. ; van der Veen, Fulco ; Maas, Jacques W M ; Klijn, Nicole F. ; Kaaijk, Eugenie M. ; Oosterhuis, Gerrit J E ; Bouckaert, Peter X J M ; Schierbeek, Jaap M. ; van Kasteren, Yvonne M. ; Nap, Annemiek W. ; Broekmans, Frank J. ; Brinkhuis, Egbert A. ; Koks, Carolien A M ; Burggraaff, Jan M. ; Blankhart, Adrienne S. ; Perquin, Denise A M ; Gerards, Marie H. ; Mulder, Robert J A B ; Gondrie, Ed T C M ; Mol, Ben W J ; Hoek, Annemieke. / The LIFESTYLE study : Costs and effects of a structured lifestyle program in overweight and obese subfertile women to reduce the need for fertility treatment and improve reproductive outcome. A randomised controlled trial. In: BMC Women's Health. 2010 ; Vol. 10.
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abstract = "Background: In the Netherlands, 30{\%} of subfertile women are overweight or obese, and at present there is no agreement on fertility care for them. Data from observational and small intervention studies suggest that reduction of weight will increase the chances of conception, decrease pregnancy complications and improve perinatal outcome, but this has not been confirmed in randomised controlled trials. This study will assess the cost and effects of a six-months structured lifestyle program aiming at weight reduction followed by conventional fertility care (intervention group) as compared to conventional fertility care only (control group) in overweight and obese subfertile women. We hypothesize that the intervention will decrease the need for fertility treatment, diminish overweight-related pregnancy complications, and will improve perinatal outcome.Methods/Design: Multicenter randomised controlled trial in subfertile women (age 18-39 year) with a body mass index between 29 and 40 kg/m2. Exclusion criteria are azoospermia, use of donor semen, severe endometriosis, premature ovarian failure, endocrinopathies or pre-existent hypertensive disorders.In the intervention group the aim is a weight loss of at least 5{\%} to10{\%} in a six-month period, to be achieved by the combination of a diet, increase of physical activity and behavioural modification. After six months, in case no conception has been achieved, these patients will start fertility treatment according to the Dutch fertility guidelines. In the control group treatment will be started according to Dutch fertility guidelines, independently of the patient's weight.Outcome measures and analysis: The primary outcome measure is a healthy singleton born after at least 37 weeks of gestation after vaginal delivery. Secondary outcome parameters including pregnancy outcome and complications, percentage of women needing fertility treatment, clinical and ongoing pregnancy rates, body weight, quality of life and costs.Data will be analysed according to the intention to treat principle, and cost-effectiveness analysis will be performed to compare the costs and health effects in the intervention and control group.Discussion: The trial will provide evidence for costs and effects of a lifestyle intervention aiming at weight reduction in overweight and obese subfertile women and will offer guidance to clinicians for the treatment of these patients.Trial registration: Dutch Trial Register NTR1530.",
author = "Mutsaerts, {Meike A Q} and Henk Groen and {ter Bogt}, {Nancy C W} and Bolster, {Johanna H T} and Land, {Jolande A.} and Bemelmans, {Wanda J E} and Kuchenbecker, {Walter K H} and Hompes, {Peter G A} and Macklon, {Nick S.} and Stolk, {Ronald P.} and {van der Veen}, Fulco and Maas, {Jacques W M} and Klijn, {Nicole F.} and Kaaijk, {Eugenie M.} and Oosterhuis, {Gerrit J E} and Bouckaert, {Peter X J M} and Schierbeek, {Jaap M.} and {van Kasteren}, {Yvonne M.} and Nap, {Annemiek W.} and Broekmans, {Frank J.} and Brinkhuis, {Egbert A.} and Koks, {Carolien A M} and Burggraaff, {Jan M.} and Blankhart, {Adrienne S.} and Perquin, {Denise A M} and Gerards, {Marie H.} and Mulder, {Robert J A B} and Gondrie, {Ed T C M} and Mol, {Ben W J} and Annemieke Hoek",
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Mutsaerts, MAQ, Groen, H, ter Bogt, NCW, Bolster, JHT, Land, JA, Bemelmans, WJE, Kuchenbecker, WKH, Hompes, PGA, Macklon, NS, Stolk, RP, van der Veen, F, Maas, JWM, Klijn, NF, Kaaijk, EM, Oosterhuis, GJE, Bouckaert, PXJM, Schierbeek, JM, van Kasteren, YM, Nap, AW, Broekmans, FJ, Brinkhuis, EA, Koks, CAM, Burggraaff, JM, Blankhart, AS, Perquin, DAM, Gerards, MH, Mulder, RJAB, Gondrie, ETCM, Mol, BWJ & Hoek, A 2010, 'The LIFESTYLE study: Costs and effects of a structured lifestyle program in overweight and obese subfertile women to reduce the need for fertility treatment and improve reproductive outcome. A randomised controlled trial', BMC Women's Health, vol. 10, 22. https://doi.org/10.1186/1472-6874-10-22

The LIFESTYLE study : Costs and effects of a structured lifestyle program in overweight and obese subfertile women to reduce the need for fertility treatment and improve reproductive outcome. A randomised controlled trial. / Mutsaerts, Meike A Q; Groen, Henk; ter Bogt, Nancy C W; Bolster, Johanna H T; Land, Jolande A.; Bemelmans, Wanda J E; Kuchenbecker, Walter K H; Hompes, Peter G A; Macklon, Nick S.; Stolk, Ronald P.; van der Veen, Fulco; Maas, Jacques W M; Klijn, Nicole F.; Kaaijk, Eugenie M.; Oosterhuis, Gerrit J E; Bouckaert, Peter X J M; Schierbeek, Jaap M.; van Kasteren, Yvonne M.; Nap, Annemiek W.; Broekmans, Frank J.; Brinkhuis, Egbert A.; Koks, Carolien A M; Burggraaff, Jan M.; Blankhart, Adrienne S.; Perquin, Denise A M; Gerards, Marie H.; Mulder, Robert J A B; Gondrie, Ed T C M; Mol, Ben W J; Hoek, Annemieke.

In: BMC Women's Health, Vol. 10, 22, 25.06.2010.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The LIFESTYLE study

T2 - BMC Women's Health

AU - Mutsaerts, Meike A Q

AU - Groen, Henk

AU - ter Bogt, Nancy C W

AU - Bolster, Johanna H T

AU - Land, Jolande A.

AU - Bemelmans, Wanda J E

AU - Kuchenbecker, Walter K H

AU - Hompes, Peter G A

AU - Macklon, Nick S.

AU - Stolk, Ronald P.

AU - van der Veen, Fulco

AU - Maas, Jacques W M

AU - Klijn, Nicole F.

AU - Kaaijk, Eugenie M.

AU - Oosterhuis, Gerrit J E

AU - Bouckaert, Peter X J M

AU - Schierbeek, Jaap M.

AU - van Kasteren, Yvonne M.

AU - Nap, Annemiek W.

AU - Broekmans, Frank J.

AU - Brinkhuis, Egbert A.

AU - Koks, Carolien A M

AU - Burggraaff, Jan M.

AU - Blankhart, Adrienne S.

AU - Perquin, Denise A M

AU - Gerards, Marie H.

AU - Mulder, Robert J A B

AU - Gondrie, Ed T C M

AU - Mol, Ben W J

AU - Hoek, Annemieke

PY - 2010/6/25

Y1 - 2010/6/25

N2 - Background: In the Netherlands, 30% of subfertile women are overweight or obese, and at present there is no agreement on fertility care for them. Data from observational and small intervention studies suggest that reduction of weight will increase the chances of conception, decrease pregnancy complications and improve perinatal outcome, but this has not been confirmed in randomised controlled trials. This study will assess the cost and effects of a six-months structured lifestyle program aiming at weight reduction followed by conventional fertility care (intervention group) as compared to conventional fertility care only (control group) in overweight and obese subfertile women. We hypothesize that the intervention will decrease the need for fertility treatment, diminish overweight-related pregnancy complications, and will improve perinatal outcome.Methods/Design: Multicenter randomised controlled trial in subfertile women (age 18-39 year) with a body mass index between 29 and 40 kg/m2. Exclusion criteria are azoospermia, use of donor semen, severe endometriosis, premature ovarian failure, endocrinopathies or pre-existent hypertensive disorders.In the intervention group the aim is a weight loss of at least 5% to10% in a six-month period, to be achieved by the combination of a diet, increase of physical activity and behavioural modification. After six months, in case no conception has been achieved, these patients will start fertility treatment according to the Dutch fertility guidelines. In the control group treatment will be started according to Dutch fertility guidelines, independently of the patient's weight.Outcome measures and analysis: The primary outcome measure is a healthy singleton born after at least 37 weeks of gestation after vaginal delivery. Secondary outcome parameters including pregnancy outcome and complications, percentage of women needing fertility treatment, clinical and ongoing pregnancy rates, body weight, quality of life and costs.Data will be analysed according to the intention to treat principle, and cost-effectiveness analysis will be performed to compare the costs and health effects in the intervention and control group.Discussion: The trial will provide evidence for costs and effects of a lifestyle intervention aiming at weight reduction in overweight and obese subfertile women and will offer guidance to clinicians for the treatment of these patients.Trial registration: Dutch Trial Register NTR1530.

AB - Background: In the Netherlands, 30% of subfertile women are overweight or obese, and at present there is no agreement on fertility care for them. Data from observational and small intervention studies suggest that reduction of weight will increase the chances of conception, decrease pregnancy complications and improve perinatal outcome, but this has not been confirmed in randomised controlled trials. This study will assess the cost and effects of a six-months structured lifestyle program aiming at weight reduction followed by conventional fertility care (intervention group) as compared to conventional fertility care only (control group) in overweight and obese subfertile women. We hypothesize that the intervention will decrease the need for fertility treatment, diminish overweight-related pregnancy complications, and will improve perinatal outcome.Methods/Design: Multicenter randomised controlled trial in subfertile women (age 18-39 year) with a body mass index between 29 and 40 kg/m2. Exclusion criteria are azoospermia, use of donor semen, severe endometriosis, premature ovarian failure, endocrinopathies or pre-existent hypertensive disorders.In the intervention group the aim is a weight loss of at least 5% to10% in a six-month period, to be achieved by the combination of a diet, increase of physical activity and behavioural modification. After six months, in case no conception has been achieved, these patients will start fertility treatment according to the Dutch fertility guidelines. In the control group treatment will be started according to Dutch fertility guidelines, independently of the patient's weight.Outcome measures and analysis: The primary outcome measure is a healthy singleton born after at least 37 weeks of gestation after vaginal delivery. Secondary outcome parameters including pregnancy outcome and complications, percentage of women needing fertility treatment, clinical and ongoing pregnancy rates, body weight, quality of life and costs.Data will be analysed according to the intention to treat principle, and cost-effectiveness analysis will be performed to compare the costs and health effects in the intervention and control group.Discussion: The trial will provide evidence for costs and effects of a lifestyle intervention aiming at weight reduction in overweight and obese subfertile women and will offer guidance to clinicians for the treatment of these patients.Trial registration: Dutch Trial Register NTR1530.

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U2 - 10.1186/1472-6874-10-22

DO - 10.1186/1472-6874-10-22

M3 - Article

VL - 10

JO - BMC Women's Health

JF - BMC Women's Health

SN - 1472-6874

M1 - 22

ER -