Scientists looked at 24 studies involving nearly 8,000 women to find out which lifestyle changes work best before getting pregnant. They found that while these programs help women lose weight and improve blood sugar, they don’t clearly increase pregnancy rates overall. However, the most successful programs were intensive - meeting 10 or more times and providing actual tools like healthy food or exercise equipment. Face-to-face programs worked better than online ones for weight loss. This research helps us understand what kind of support women need when preparing their bodies for pregnancy.

The Quick Take

  • What they studied: Whether lifestyle programs before pregnancy help women get pregnant and improve their health
  • Who participated: Nearly 8,000 women planning to get pregnant, mostly from wealthy countries, with two-thirds having fertility problems
  • Key finding: Lifestyle programs helped women lose about 8.5 pounds and improve blood sugar, but didn’t clearly increase pregnancy rates overall
  • What it means for you: If you’re planning to get pregnant, intensive face-to-face programs with concrete support may help you get healthier, even if pregnancy rates aren’t guaranteed to improve

The Research Details

Researchers combined results from 24 separate studies that tested lifestyle programs against standard care or no special help. They looked at programs that included diet changes, exercise, or both, and measured outcomes like pregnancy rates, weight loss, and blood sugar levels. The studies were mostly done in wealthy countries and focused on women who were actively trying to conceive.

By combining many studies together, researchers can spot patterns that might not show up in smaller individual studies. This gives us a bigger picture of what really works when helping women prepare for pregnancy.

Most studies were well-designed, though some had minor flaws. Seven studies were considered high quality, 15 had some concerns, and only 2 had major problems. The researchers used strict standards to make sure they only included trustworthy studies.

What the Results Show

Overall, lifestyle programs didn’t significantly increase the chances of getting pregnant or having a live birth compared to standard care. However, programs with 10 or more sessions were much more effective at helping women conceive than shorter programs. The most successful approach was providing concrete tools like healthy food or exercise equipment - this increased pregnancy odds by more than 3 times compared to programs without these resources. Women in lifestyle programs lost an average of 8.5 pounds and had better blood sugar control.

Face-to-face programs were more effective for weight loss than programs mixing in-person and online elements. Programs specifically aimed at weight loss were more successful at helping women lose weight than general lifestyle programs. The benefits were consistent across different types of women, whether they had fertility problems or not.

This is one of the most comprehensive reviews of preconception lifestyle programs to date. Previous smaller studies had mixed results, but this large analysis helps clarify which specific program features make the biggest difference.

Most studies were done in wealthy countries, so results might not apply everywhere. Many participants had fertility problems, so we don’t know if results are the same for all women. The analysis looked at study-level differences, which might not capture individual variations in response to programs.

The Bottom Line

If you’re planning to get pregnant, consider an intensive lifestyle program with at least 10 sessions that provides concrete support like meal plans or exercise equipment. Face-to-face programs appear more effective than online-only options for weight loss. Focus on programs with clear weight loss goals if that’s a priority.

Women actively trying to conceive, especially those who want to lose weight or improve their overall health before pregnancy. Healthcare providers designing preconception care programs should also pay attention to these findings.

The studies typically ran for 3-6 months, suggesting you should plan to commit to a program for at least this long to see meaningful benefits in weight and metabolic health.

Want to Apply This Research?

  • Track your weight weekly and blood sugar levels if possible, along with program attendance and use of provided tools or resources
  • Set up your environment for success by having healthy foods readily available and exercise equipment accessible, mimicking the ‘adding objects to environment’ technique that worked best
  • Monitor adherence to program sessions (aim for 10+ interactions), track weight loss progress over 3-6 months, and note which delivery methods (face-to-face vs. online) work best for you personally

This information is for educational purposes only and should not replace professional medical advice. Consult with your healthcare provider before starting any preconception lifestyle program, especially if you have fertility concerns or underlying health conditions.