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Pre-Conception Interventions for Subfertile Couples Undergoing Assisted Reproductive Technology Treatment: Modeling
Régine Steegers-Theunissen1, Annemieke Hoek2, Henk Groen3
1Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands.
JMIR Mhealth and Uhealth
|November 23, 2020
Summary
Lifestyle interventions can improve fertility outcomes and reduce assisted reproductive technology costs for subfertile couples. Programs like Smarter Pregnancy and LIFEstyle show cost-effectiveness and positive impacts on reproductive and maternal health.
Area of Science:
- Reproductive Medicine
- Health Economics
- Preventive Healthcare
Background:
- Subfertility affects approximately 1 in 7 couples.
- Lifestyle factors like poor nutrition, obesity, and smoking negatively impact fertility.
- The cost-effectiveness of pre-conception lifestyle interventions is largely unknown.
Purpose of the Study:
- To evaluate reproductive, maternal pregnancy, and birth outcomes.
- To assess the cost-implications of pre-conception lifestyle interventions.
- To analyze interventions for subfertile couples and obese women undergoing assisted reproductive technology (ART).
Main Methods:
- A hypothetical model was developed using published data and expert opinion.
- Evaluated interventions included online tools (Smarter Pregnancy), outpatient support (LIFEstyle), smoking cessation, and mindfulness programs.
- Model population data were based on the Netherlands.
Main Results:
- All modeled lifestyle interventions reduced the need for ART treatments (IVF, ICSI, IUI) for pregnancy and birth.
- Smarter Pregnancy showed the largest increase in spontaneous pregnancy rates (13.0%).
- LIFEstyle intervention for obese subfertile women reduced gestational diabetes (4.4%), hypertensive complications (3.8%), and preterm births (3.0%).
- Significant modeled cost savings per couple per year were observed for all interventions, with LIFEstyle yielding the highest savings (€1163).
Conclusions:
- Modeled lifestyle interventions are likely cost-effective and improve reproductive, maternal, and birth outcomes.
- Further real-world data are needed to confirm the cost-effectiveness of pre-conception lifestyle interventions.
- Implementation of tools like the Smarter Pregnancy app is likely cost-effective and can aid in collecting reproductive health data.
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