First effective mHealth nutrition and lifestyle coaching program for subfertile couples undergoing in vitro fertilization treatment: a single-blinded multicenter randomized controlled trial

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Elsje C. Oostingh, M.D., Maria P. H. Koster, Ph.D., Matthijs R. van Dijk, Ph.D., Sten P. Willemsen, Ph.D., Frank J. M. Broekmans, Ph.D., Annemieke Hoek, Ph.D., Marriete Goddijn, Ph.D., Nicole F. Klijn, M.D., Evert J. P. van Santbrink, Ph.D., Eric A. P. Steegers, Ph.D., Joop S. E. Laven, Ph.D., Regine P. M. Steegers-Theunissen, M.D., Ph.D.



To study compliance and effectiveness of the mHealth nutrition and lifestyle coaching program Smarter Pregnancy in couples undergoing in vitro fertilization (IVF) treatment with or without intracytoplasmic sperm injection (ICSI).


Multicenter, single-blinded, randomized controlled trial, conducted from July 2014 to March 2017.


IVF clinics.


A total of 626 women undergoing IVF treatment with or without ICSI and 222 male partners.


Couples were randomly assigned to the light (control group) or regular (intervention group) Smarter Pregnancy program. Both groups filled out a baseline screening questionnaire on nutrition and lifestyle behaviors, and the intervention group received coaching tailored to inadequate behaviors during the 24-week period.

Main Outcome Measure(s)

Difference in improvement of a composite dietary and lifestyle risk score for the intake of vegetables, fruits, folic acid supplements, smoking, and alcohol use after 24 weeks of the program.


Compared with control subjects, women and men in the intervention group showed a significantly larger improvement of inadequate nutrition behaviors after 24 weeks of coaching. At the same time, the women also showed a significantly larger improvement of inadequate lifestyle behaviors.


The mHealth coaching program Smarter Pregnancy is effective and improves the most important nutritional and lifestyle behaviors among couples undergoing IVF/ICSI treatment. International multicenter randomized trials are recommended to study the effect of using Smarter Pregnancy on pregnancy, live birth, and neonatal outcome.

Netherlands Trial Register Number


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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