HealthDay News — Preconception weight loss prior to infertility therapy does not improve live birth or healthy live birth rates in women who were obese or overweight, according to a study published online in PLOS Medicine.

Richard S. Legro, MD, from Penn State College of Medicine in Hershey, and colleagues randomly assigned (1:1) 379 women with obesity (body mass index, ≥30 kg/m2) and unexplained infertility to 1 of 2 preconception lifestyle modification groups: increased physical activity and weight loss (target 7%) through meal replacements and medication (Orlistat; intensive group) compared to increased physical activity alone without weight loss (standard group). Interventions lasted 16 weeks and were followed by infertility therapy.

The researchers observed no significant differences in the incidence of healthy live births (15.2% in the standard group vs 12.2% in the intensive group; rate ratio 0.81; 95% confidence interval, 0.48 to 1.34; P = 0.40). Women randomly assigned to the intensive group had significant weight loss compared with those in the standard group (−6.6 vs −0.3). Improvements in metabolic health were observed in both groups, including a marked decrease in the incidence of metabolic syndrome (baseline to 16 weeks: standard, 53.6% to 49.4%; intensive, 52.8% to 32.2%). The intensive group had significantly more gastrointestinal side effects, and there was a higher rate of first-trimester pregnancy loss in the intensive group (33.3% vs 23.7%; rate ratio, 1.40; 95% confidence interval, 0.79 to 2.50), but the difference between the groups was not statistically significant.

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“There is not strong evidence to recommend weight loss prior to conception in women who are obese with unexplained infertility,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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