Lifestyle and Comorbidities: Do We Take Enough Care of Preconception Health in Assisted Reproduction?

Abstract

Objective: The preconception period is largely neglected, whereas it represents an opportunity to identify and modify clinical and behavioral risks, particularly in infertile women characterized by an unfavorable vascular burden. The present study was performed to strengthen previous findings and to increase the awareness of clinicians who should envision a broader preconception approach in infertile women, beyond their reproductive health. Materials and methods: In this cross-sectional study, we investigated 1003 Caucasian women, referred to the Internal Medicine Clinic at the Assisted Reproductive Technologies Center, Florence. Results: A high prevalence of dyslipidemia (57.4%), overweight/obesity (29.1%) and, smoking habit (26.6%) were found. We provided evidence of unhealthy lifestyle habits, represented by a closer adherence to the Mediterranean diet in the 9.5% only and by a sedentary behavior in 73%. A significant correlation between the Mediterranean Diet score and both anthropometric and metabolic parameters was found. We also observed a lower score adherence with both metabolic syndrome and diabetes (for both p=0.02), but not with hypertension. Conclusion: Before infertility treatment, the correction and the management of modifiable and non-modifiable cardiovascular risk factors are mandatory and represent the main goal for a safe pregnancy, and lifetime women's health.

Keywords: Assisted Reproduction; Cardiovascular Prevention; Lifestyle; Preconception Care; Pregnancy Planning; Women’s Health.

Figure 1

PREDIMED score consists of 14-items which evaluated Mediterraean typically dietary pattern. Three categories of adherence to Mediterranean diet ≤5, 6-9, ≥10 points were considered. Values are expressed as percentage (a), Distribution of percentage of adherence to Mediterranean diet, according to achieved score (b).