Integrating preconceptional care into an IVF programme

Ockhuijsen, Henriëtta D. L., Gamel, Claudia J., van den Hoogen, Agnes and Macklon, Nicholas S. (2011) Integrating preconceptional care into an IVF programme. Journal of Advanced Nursing. (doi:10.1111/j.1365-2648.2011.05829.x). (PMID:22032346)

Abstract

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 (77Æ7%) 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: 6Æ1 kg.
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.

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