Belgian fertility clinic staff value healthy lifestyle promotion but lack access to a structured lifestyle modification programme: an observational study

Objectives: Guidelines advise promoting a healthy lifestyle among patients with fertility problems as the lifestyle of women and men proved to be associated with their fertility. Australian fertility nurses were shown to lack access to structured lifestyle modification programmes although they value healthy lifestyle promotion. This study aimed to examine whether gynecologists also value promoting a healthy lifestyle and whether structured lifestyle modification programmes are available in Belgian fertility clinics.Design: An observational study was conducted among health care professionals (HCPs) working in Belgian fertility clinics.Participants/Materials, Setting, Methods: An Australian questionnaire on attitudes and practices related to promoting a healthy lifestyle among patients with fertility problems was reciprocally back-to-back translated and three open-ended questions were added. All HCPs of Belgian fertility clinics, including gynecologists, fertility nurses/midwives, psychologists and embryologists, were invited by email to complete the questionnaire online. Responses to closed and open-ended questions were analysed with, respectively: descriptive statistics and qualitative thematic analysis. Finally, differences in perspectives between different groups of HCPs were explored. Results: A total of 50 fertility nurses/midwives, 42 gynecologists and 19 other HCPs completed the survey (n=111). Regarding attitudes, all respondents valued informing patients about the impact of lifestyle on fertility. The vast majority of HCPs (n=96; 86%) stated that fertility clinics have the responsibility to address unhealthy lifestyles prior to offering fertility treatment. Fertility nurses/midwives were significantly more likely than gynecologists to state that fertility clinics have this responsibility (p=.040). Regarding practices, patient's lifestyle was most commonly discussed by gynecologist (n=107; 96%) during the first appointment (n=105; 95%). The lifestyle factors that were being addressed according to the vast majority of respondents were smoking, weight, age, alcohol and recreational drugs. Only three HCPs (from three different clinics) stated that their clinic offered a structured lifestyle modification programme. HCPs explained that they lacked the resources and expertise for offering a structured lifestyle modification programme. Limitations: Response rates were limited but the responding Belgian gynecologists and fertility nurses/midwives confirmed the findings of the previous study in Australian fertility nurses. Conclusions: Health care professionals working in Belgian fertility clinics value healthy lifestyle promotion but lack access to structured lifestyle modification programmes to implement in their daily clinical practice. Future studies should focus on developing and evaluating structured lifestyle modification programmes for patients with fertility problems.

Automated summary

This study investigated the attitudes of healthcare professionals in Belgian fertility clinics towards promoting a healthy lifestyle and the availability of structured lifestyle modification programs. The results showed that all respondents believed in informing patients about the impact of lifestyle on fertility, and the majority of healthcare professionals agreed that fertility clinics have a responsibility to address unhealthy lifestyles before offering fertility treatment. However, only a few clinics offered structured lifestyle modification programs due to limited resources and expertise. Future studies should focus on developing and evaluating such programs for patients with fertility problems.