Women's experiences of a medically supervised fasting intervention for infertility: a qualitative study

Infertility affects couples in Germany and worldwide, with impacts on quality of life. Although fertility treatments are available, success rates often remain limited, and treatments are associated with physical and psychological burdens. Consequently, many seek alternative or complementary approaches to support fertility. To investigate one such approach, an RCT was conducted to examine the effects of a medically supervised prolonged, fluid-only fasting intervention (< 500 kcal/day) on fertility-related outcomes. Nested within this trial, this qualitative study explores women's experiences with the intervention, focusing on its acceptability and its perceived physical and psychological effects.

The study accompanied a randomized controlled trial in which fasting served as an intervention to assess its potential effects on fertility. Semi-structured individual interviews were conducted after the intervention and analysed using inductive thematic analysis, with regular research group discussions ensuring consistency and rigor. All participants available and willing to participate in the qualitative study were interviewed. In total, eight women were interviewed between February 2022 and January 2023.

Fasting was generally well-received. Challenges included fatigue, taste dissatisfaction, and cravings, low mood and social withdrawal. Participants' motivation, coping strategies, and dietitian support helped manage these difficulties. Reported benefits included physical well-being, improved mood, and a sense of inner balance. Fasting was valued for offering an active role in fertility treatment. Post-fast, some expressed a renewed hope for fertility treatment, while others described a shift away from their formerly intense focus on conception.

Medically supervised prolonged fluid-only fasting was perceived as acceptable by women experiencing infertility, with both benefits and challenges reported throughout the fasting experience.

Registry: ClinicalTrials.gov, TRN: NCT04942457, Registration date: 10 May 2021.