Faculty of Health Sciences, University of Pécs, Vorosmarty u. 4, Pécs, 7621, Hungary.
MTA-PTE Human Reproduction Scientific Research Group, University of Pécs, Édesanyák u. 17, Pécs, H-7624, Hungary.
BMC Public Health. 2021 Apr 23;21(Suppl 1):1480. doi: 10.1186/s12889-020-09522-7.
National, regional and global trends in prevalence of infertility indicate its public health importance, however it effects various life dimensions of individuals and couples as well. Lifestyle habits may counteract with these factors. The aim of the study was the multicausal analysis of psychosocial and lifestyle factors undergoing assisted reproductive therapy (ART) with special regard to pre-treatment habitual physical activity (PA).
In a cross-sectional, observational cohort study on ART patients (N = 60, age 34.6 ± 5.2 years, BMI 24.2 ± 4.9 kg/m) with follow up on outcome measures a detailed description was given on PA patterns (ActriGraph GT3X, GPAQ-H) and on general and infertility related distress (BDI-13, FPI).
Respondents reported normal mood state (BDI-13) but moderately high infertility-related distress (FPI) in Social- and very high distress in Sexual Concern. It was revealed that time spent with recreational PA (RPA) could counteract with infertility-related distress (Social Concern R = -0.378, p = 0.013; Relationship Concern R = -0.365, p = 0.019). In the presence of clinical pregnancy GPAQ-H RPA MET was significantly higher (p = 0.048), in the non-pregnant group cumulative values and work-related PA were higher. Correlations could be found between RPA time and the number of oocytes (R = 0.315, p = 0.045), matured oocytes (R = 0.339, p = 0.030) and embryos (R = 0.294, p = 0.062) by women who reached at least 150 min RPA (GPAQ-H). Multivariate linear regression revealed that the number of oocytes was positively influenced by the GPAQ-H recreation MET (R = 0.367; F = 10.994, p = 0.004; B = 0.005, p = 0.004, B Constant = 4.604). Regarding the number of embryos (R = 0.757, F = 17.692, p < 0.001, B Constant = 1.342) positive relationship was found with GPAQ-H RPA MET (B = 0.004, p < 0.001) and negative with BMI (B = -0.167, p = 0.038). It was disclosed (R = 0.958, F = 408.479, p < 0.001) that higher Very Vigorous Activity (ActiGraph) was accompanied with higher hCG (B = 63.703, p ≤ 0.001). However, time spent with moderate PA (GPAQ-H) (B = 0.002, SE = 0.001, Wald = 3.944, p = 0.047, OR = 1.002) was significantly associated with live births.
Amount of PA alone did not have a positive effect on outcome of ART. Type and intensity seemed to be more significant. Existing differences in response to infertility due to recreational PA suggest the importance of the development of a specific intervention. The robust overestimation of PA in self-reports highlights the need to improve physical literacy of women undergoing ART.
不孕不育的流行率在国家、地区和全球范围内呈上升趋势，这表明其具有重要的公共卫生意义，但它也会对个体和夫妇的生活的各个方面产生影响。生活方式习惯可能会对这些因素产生影响。本研究的目的是多因素分析接受辅助生殖治疗（ART）的个体的社会心理和生活方式因素，特别关注治疗前习惯性体力活动（PA）。
在一项针对 ART 患者（N=60，年龄 34.6±5.2 岁，BMI 24.2±4.9kg/m2）的横断面、观察性队列研究中，对 PA 模式（ActiGraph GT3X，GPAQ-H）和一般及与不孕相关的困扰（BDI-13，FPI）进行了详细描述。
受访者报告正常的情绪状态（BDI-13），但存在中度高的与不孕相关的困扰（FPI），在社会方面非常高的困扰。研究结果表明，与不孕相关的困扰（社会关注 R=-0.378，p=0.013；关系关注 R=-0.365，p=0.019）可以通过休闲 PA（RPA）时间来抵消。在存在临床妊娠的情况下，GPAQ-H 的 RPA MET 显著更高（p=0.048），而在非妊娠组中，累积值和与工作相关的 PA 更高。研究结果还发现，RPA 时间与女性获得的卵子数量（R=0.315，p=0.045）、成熟卵子（R=0.339，p=0.030）和胚胎（R=0.294，p=0.062）之间存在相关性，前提是女性达到至少 150 分钟的 GPAQ-H RPA。多元线性回归显示，卵子数量受到 GPAQ-H 娱乐代谢当量（R=0.367；F=10.994，p=0.004；B=0.005，p=0.004，B 常数=4.604）的积极影响。关于胚胎数量（R=0.757，F=17.692，p<0.001，B 常数=1.342），与 GPAQ-H RPA MET（B=0.004，p<0.001）呈正相关，与 BMI（B=-0.167，p=0.038）呈负相关。研究结果还揭示（R=0.958，F=408.479，p<0.001），更高的非常剧烈的活动（ActiGraph）伴随着更高的 hCG（B=63.703，p≤0.001）。然而，与中度 PA（GPAQ-H）（B=0.002，SE=0.001，Wald=3.944，p=0.047，OR=1.002）相关的中等强度的 PA 时间与活产显著相关。
PA 的数量本身并没有对 ART 的结果产生积极影响。类型和强度似乎更为重要。由于休闲 PA 而导致的对不孕的反应存在差异，这表明开发特定干预措施的重要性。自我报告中对 PA 的严重高估突出了提高接受 ART 的女性身体素养的必要性。
