The impact of lifestyle risk factors on female infertility

BACKGROUND: Over 2 million couples in the United States are infertile. The literature reflects a number of potential lifestyle risks that have been associated with the development of this condition; however, few studies have investigated these risks concurrently.With knowledge of the importance of behavioral threats to fertility, women's health care providers will be in a better position to screen and assist women to modify their fertility risks. OBJECTIVES: The objectives of this study were (1) to identify lifestyle factors associated with infertility in women by comparing a sample of infertile women with a group of fertile women and (2) to offer recommendations to women's health providers, on counseling women at risk for infertility. METHODS: A re-examination of the 1995 National Survey of Family Growth (NSFG) allowed for the investigation of lifestyle factors associated with infertility in women. Using a conceptual model of health behavior to guide the selection of variables, together with multiple logistic regression techniques, an explanatory model of infertility was estimated on a sample of 824 women between the ages of 16 and 45 years. RESULTS: Factors directly related to infertility included increasing age, a history of an ectopic pregnancy, current smoking, obesity, and self reported health status. Protective effects were associated with a history of condom use and having had a Pap smear in the last year. CONCLUSIONS AND IMPLICATIONS: Routine well-women visits offer an excellent opportunity to begin to address the impact of selected risk factors for infertility. Clinicians can utilize these visits to target appropriate interventions for initiating, repeating, and reinforcing messages on fertility risk.