Integrating preconceptional care into an IVF programme

Aim: This paper is a report of a mixed method study of the outcomes of integrating preconceptional care into an in-vitro fertilization programme on nurses' and patients' attitudes and patients' weight and smoking behaviour. Background. Increasing evidence points to the significant effect of lifestyle factors on in-vitro fertilization outcomes. Optimizing the health of couples before they commence in-vitro fertilization may improve the chance of achieving success. Method. In 2007, 130 couples attending a university hospital in-vitro fertilization unit and seven nurses were invited to participate in the study. Questionnaires were developed to assess the attitudes of both patients and nurses. Furthermore, the impact of interventions on body mass index and smoking patterns were evaluated. Results. All nurses (n=7) and 101 patients (77·7%) returned completed questionnaires. Analysis revealed a considerable degree of scepticism among the nurses at the outset as to the value of the programme and their ability to perform their new role effectively. Patients valued positively the increased attention to adjusting lifestyle factors with the goal to improve fertility outcomes. Of those participants who smoked or had a body mass index >30, 30% (n=7/23) of the patients quit smoking and 50% lost weight (n=15/30), mean loss: 6·1kg. Conclusion. Fertility nurses can play a key role in the provision of preconceptional care. Patients with a fertility problem can be motivated to address lifestyle issues before embarking on in-vitro fertilization treatment. The integration of preconceptional care and lifestyle interventions was shown to be feasible in our clinical setting.