Do subfertile women adjust their habits when trying to conceive?

Figures & data

Figure 1. Flow chart of the study procedure.

Table 1. Background characteristics and lifestyles of the 448 women included in the study.

Characteristic	n (%)
Age (years), mean (SD)^a	30.2 (4.8)
Partner’s age (years), mean (SD)	33.4 (6.8)
Duration of current relationship (years),  median (Q1, Q3)	5 (3, 8)
Household income/month (SEK)
Mean (SD)	45,664 (21,541)
Median (Q1, Q3)	47,000 (30,000, 59,000)
Currently working (>50%), n (%)	362 (80.8)
Level of education, n (%)
College/university	242 (54.0)
Non-college/non-university	201 (44.9)
Body mass index (BMI) in kg/m^2, mean (SD)	24.6 (4.9)
Normal, ≤25, n (%)	273 (60.9)
Overweight, 25–29.9, n (%)	107 (23.9)
Obese, ≥30, n (%)	56 (12.5)
Country of birth, n (%)
Born in Sweden	377 (84.2)
Born outside Sweden	63 (14.1)
Parent (one or two) born outside Sweden, n (%)	78 (17.4)
Understanding of Swedish language, n (%)
Very good	408 (91.1)
Quite good/neither good nor bad	33 (7.4)
Duration of infertility (years)
Mean (SD)	1.9 (1.7)
Median (Q1, Q3)	1.4 (1.2, 2.0)
Taking folic acid supplementation, n (%)	216 (48.2)
Taking vitamin supplementation, n (%)	119 (26.6)
Weekly alcohol consumption, n (%)	60 (13.4)
Amount of alcohol consumption/week, n (%)
>1 glass/week	98 (21.9)
>2 glasses/week	52 (11.6)
Using tobacco, n (%)	78 (17.4)
Using tobacco daily, n (%)	59 (13.2)
Eating a balanced diet, n (%)	325 (72.5)
Vegetarian	20 (4.4)
GI diet	15 (3.3)
LCHF	15 (3.3)
Coffee >1 cup/day, n (%)	225 (50.2)
Coffee >3 cups/day, n (%)	61 (13.6)
Weekly physical activity in hours, median (Q1, Q3)	3 (2, 4)
Women who sought information about fertility, n (%)	442 (98.7)
Number of information sites consulted, n (%)
0–1	115 (25.7)
2	134 (29.9)
3–9	198 (44.2)
Type of information site, n (%)^a
Mother care unit	158 (35.3)
Blogs	293 (65.4)
Health care guide (1177)^b	245 (54.7)
Women who obtained professional counseling, n (%)	316 (70.5)
Type of professional counselor, n (%)
Midwife	161 (35.9)
Specialist	138 (30.8)
Other	30 (6.7)
Number of negative lifestyles^c
0	102 (22.8)
1	176 (39.3)
2	110 (24.6)
≥3	60 (13.4)

^a Multiple answer possible.

^b 1177: telephone number for health care guide.

^c Not taking folic acid; using tobacco; consuming alcohol or coffee; BMI ≥25 kg/m².

GI: glycemic index; LCHF: low-carb high-fat diet; SD: standard deviation; SEK: Swedish krona.

Table 2. Reported health-promoting lifestyle changes during the time when the women were trying to conceive.

Reported health-promoting lifestyle changes	n (%)
Started taking folic acid supplement
Yes	266 (59.4)
No	182 (40.6)
Change in coffee-drinking habits
Quit drinking	17 (3.8)
Cut down	93 (20.8)
No change	338 (75.4)
Change in alcohol-drinking habits
Stopped drinking	59 (13.2)
Reduced drinking	105 (23.4)
No change	284 (63.4)
Change in tobacco use^a
Quit tobacco	60 (13.4)
Reduced tobacco use	49 (10.9)
No change	339 (75.7)
Change to more healthy diet
Yes	92 (20.5)
No change in diet	356 (79.5)
Physical activity
More	143 (31.9)
Less	16 (3.6)
No change	289 (64.5)
Number of reported health-promoting lifestyle changes
Few (0–1)	146 (32.6)
Medium (2)	128 (28.6)
Many (3–6)	174 (38.8)

^a Tobacco use = smoking and/or taking snuff.

Table 3. Results for univariate tests with type of health-promoting lifestyle change as outcome in relation to background characteristics.

	Started to take folic acid			Changes in tobacco use (decrease/stop)			Change to more physical activity/healthier diet
	Yes n = 266 (59.4)	No n = 182 (4.6)	P value	Yes n = 105 (23.4)	No n = 343 (76.6)	P value	Yes n = 186 (41.5)	No n = 262 (58.5)	P value
Age (years), mean (SD)	30.6 (4.8)	29.9 (4.9)	0.142	28.9 (4.8)	30.7 (4.8)	0.001	29.9 (5)	30.5 (4.7)	0.204
Duration of infertility (years), mean (SD)	1.5 (3.4)	2.1 (1.9)	0.028	1.74 (4.5)	1.76 (2.3)	0.958	2.0 (3.6)	1.6 (2.3)	0.192
Household income/month (SEK), mean (SD)	48,596 (21,466)	41,321 (20,974)	0.001	38,978 (20,749)	47,719 (21,394)	<0.001	43,193 (22,706)	47,434 (20,532)	0.047
Level of education, n (%)			<0.001			<0.001			0.08
College/university	165 (68.2)	77 (31.8)		36 (14.9)	206 (85.1)		92 (38.0)	150 (62.0)
Non-college/non-university	98 (48.8)	103 (51.2)		68 (33.8)	133 (66.2)		93 (46.3)	108 (53.7)
Occupation, n (%)			0.21			0.005			0.29
Working >50%	220 (60.8)	142 (39.2)		75 (20.7)	287 (79.3)		146 (40.3)	216 (59.7)
Not working	46 (53.5)	40 (46.5)		30 (34.9)	56 (65.1)		40 (46.5)	46 (53.5)
Current BMI (kg/m^2), mean (SD)	24.2 (4.2)	25.3 (5.8)	0.036	24.4 (4.3)	24.8 (5.0)	0.531	26.4 (5.7)	23.4 (3.8)	<0.001
BMI (three categories), n (%)			0.049			0.83			<0.001
Normal	166 (60.8)	107 (39.2)		66 (24.2)	207 (75.8)		81 (29.7)	192 (70.3)
Overweight	68 (63.6)	39 (36.4)		23 (21.5)	84 (78.5)		59 (55.1)	48 (44.9)
Obese	25 (44.6)	31 (55.4)		14 (25.0)	42 (75.0)		42 (75.0)	14 (25.0)
Country of birth, n (%)			0.001			0.899			0.74
Sweden	237 (62.9)	140 (37.1)		87 (23.1)	290 (76.9)		158 (41.9)	219 (58.1)
Born outside Sweden	26 (41.3)	37 (58.7)		15 (23.8)	48 (76.2)		25 (39.7)	38 (60.3)
Parents’ country of birth (one or both), n (%)			0.008			0.31			0.48
Born in Sweden	225 (62.5)	135 (37.5)		86 (23.9)	274 (76.1)		154 (42.8)	206 (57.2)
Born outside Sweden (one or both)	36 (46.2)	42 (53.8)		16 (20.5)	62 (79.5)		30 (38.5)	48 (61.5)
Understanding Swedish, n (%)			0.07			0.58			0.31
Very good	249 (61.0)	159 (39.0)		94 (23.0)	314 (77.0)		173(42.4)	235 (57.6)
Quite good/neither good nor bad	15 (45.5)	18 (54.5)		9 (27.3)	24 (72.7)		11 (33.3)	22 (66.7)
Information searching			<0.001			0.82			0.038
0–1 sites	53 (19.9)	62 (34.3)		29 (27.6)	86 (25.1)		39 (21.0)	76 (29.1)
2 sites	73 (27.4)	61 (33.7)		32 (30.5)	102 (29.8)		52 (28.0)	82 (31.4)
≥ 3 sites	140 (52.6)	58 (32.0)		44 (41.9)	154 (45.0)		95 (51.1)	103 (39.5)

P values (bold information indicates significant values) are from chi-square and Student’s t tests.

BMI: body mass index; SD: standard deviation.

Table 4. Results for multivariate logistic regression model with type of health-promoting lifestyle changes as outcome, given as the odds ratio (OR) with 95% confidence interval (CI).

	OR	95% CI	P
Started taking folic acid supplements (cases included in analysis: 377 (84%)):
Duration of infertility in years (mean)	0.921	(0.840–1.009)	0.078
Household income/month (1,000 SEK)	1.012	(1.001–1.024)	0.040
Level of education
College/university	1.853	(1.151–2.983)	0.011
Non-college/non-university	(Ref.)
BMI
Normal	(Ref.)
Overweight	1.287	(0.752–2.203)	0.357
Obese	0.568	(0.293–1.102)	0.094
Country of birth
Sweden	1.828	(0.659–5.074)	0.247
Born outside Sweden	(Ref.)
Parents’ country of birth
Born in Sweden	1.618	(0.664–3.941)	0.289
Born outside Sweden (one or both)	(Ref.)
Information searching
0–1 sites	(Ref.)
2 sites	1.143	(0.631–2.067)	0.660
≥3 sites	2.172	(1.241–3.801)	0.007
Decrease or stop in tobacco use (cases included in analysis: 412 (92%):
Age (years)	0.950	(0.900–1.002)	0.060
Household income/month (1,000 SEK)	0.991	(0.978–1.005)	0.223
Level of education
College/university	(Ref.)
Non-college/non-university	2.256	(1.352–3.765)	0.002
Occupation
Working >50% of the time	(Ref.)
Not working	1.314	(0.705–2.448)	0.390
Increase in physical activity and/or change to more healthy diet (cases included in analysis: 407 (91%)):
Household income/month (1,000 SEK)	0.996	(0.985–1.007)	0.451
Level of education
College/university	(Ref.)
Non-college/non-university	1.057	(0.673–1.661)	0.810
BMI
Normal	(Ref.)
Overweight	2.931	(1.789–4.800)	<0.001
Obese	7.431	(3.700–14.923)	<0.001
Information searching
0–1 sites	(Ref.)
2 sites	1.114	(0.614–2.023)	0.722
≥3 sites	2.032	(1.184–3.487)	0.010