Women's experience and long‐term perspectives: A qualitative substudy of a randomised controlled trial on weight reduction prior to in vitro fertilisation

Abstract

AbstractIntroductionObesity is associated with impaired results after in vitro fertilisation (IVF). Consequently, several fertility clinics have set limits of body mass index (BMI) and obese infertile women are thus obliged to lose weight before treatment. Randomised controlled trials (RCTs) have not been able to show an increase in live birth rate after weight reduction before fertility treatment. The purpose of this study was to investigate the patients' experiences and views of participating in a RCT on weight reduction for obese women before IVF, in a long‐term perspective.MethodsA qualitative follow‐up interview study including 17 women was performed between September and December 2020. The interviewed women had all been included in an RCT around 6 years earlier. Semistructured interviews were conducted, the interviews were audio recorded, transcribed verbatim, and analysed using thematic content analysis.ResultsDuring the analysis two main themes emerged; ‘Pros and cons related to trial participation’ and ‘Message to health care’. Several women were excited about the prospect of possibly receiving weight reduction before IVF. The women appreciated the support during the intervention but expressed that the diet was tough, and it was hard to maintain the weight loss. Their views regarding BMI limits differed. They advocated an individual assessment regardless of the woman's BMI and expressed that it could be of value to offer weight reduction treatment before IVF.ConclusionsEven though the RCT and a 2‐year follow‐up could not show an increase in live birth rate in the intervention group most women had a positive attitude to weight reduction treatment before IVF. The importance of this study is that the views of the women have been highlighted and their opinions can add valuable information for fertility clinics in their care of obese infertile women.