A large study of over 23,000 first-time mothers in Denmark found that women who used fertility treatments to get pregnant made significantly healthier choices before and during early pregnancy compared to women who conceived naturally. Women using fertility treatments were much more likely to take folic acid supplements, quit smoking, avoid alcohol, and avoid smoking altogether. However, the study also found that even these highly motivated women didn’t follow all health recommendations perfectly—only about one-third avoided alcohol before pregnancy, and only half exercised enough during early pregnancy. Overall, the research suggests that planning a pregnancy through fertility treatment may help women stick to important health guidelines.

The Quick Take

  • What they studied: Whether women who used medical fertility treatments followed health recommendations before and during early pregnancy better than women who got pregnant naturally.
  • Who participated: 23,334 first-time mothers in Denmark who answered questions about their health habits during their first pregnancy ultrasound between 2012 and 2022. About 15% had used fertility treatments, and 85% conceived naturally.
  • Key finding: Women using fertility treatments were much more likely to follow health recommendations: 11 times more likely to take folic acid, 4.7 times more likely to avoid smoking, and 2.4 times more likely to avoid alcohol compared to women who conceived naturally.
  • What it means for you: If you’re planning to use fertility treatments, you may be more motivated to make healthy choices during pregnancy preparation. However, this study suggests that even with strong motivation, many women still struggle to follow all recommendations, particularly avoiding alcohol and exercising regularly.

The Research Details

Researchers collected information from women at Copenhagen University Hospital in Denmark over a 10-year period (2012-2022). When women came in for their first ultrasound scan during early pregnancy, they filled out an online questionnaire about their health habits. The questionnaire asked about whether they used fertility treatments, what type of treatment they used, and their behaviors including alcohol use, smoking, exercise, and vitamin supplements. The researchers then compared the health behaviors between the two groups of women, adjusting for age and education level to make sure these factors weren’t affecting the results.

This type of study is called a cross-sectional study, which means researchers took a snapshot of people’s behaviors at one point in time rather than following them over many years. The study had a very high response rate—91% of women answered the questionnaire, which is excellent and means the results are likely representative of the actual population.

The researchers used statistical methods to calculate how much more (or less) likely women in the fertility treatment group were to follow each health recommendation compared to the natural conception group.

This research approach is important because it shows real-world behavior in a large group of women rather than just what people say they should do. By comparing women who conceived through different methods, researchers could see whether the planning involved in fertility treatment actually leads to better health choices. The large sample size and high response rate make these findings more reliable and trustworthy.

Strengths of this study include the very large number of participants (over 23,000), the high response rate (91%), and the fact that it was conducted in a single healthcare system, which means consistent data collection. The study adjusted for important factors like age and education. However, because this is a cross-sectional study, it shows associations but cannot prove that fertility treatment causes healthier behaviors—there may be other reasons why women using fertility treatments make different choices. Additionally, the study only included women in Denmark, so results may not apply to other countries with different healthcare systems or cultural attitudes.

What the Results Show

Women who used fertility treatments showed significantly healthier preconception behaviors across multiple measures. They were 11.4 times more likely to take folic acid supplements, 4.7 times more likely to avoid smoking, 1.7 times more likely to quit smoking because of pregnancy planning, and 2.4 times more likely to avoid alcohol compared to women who conceived naturally.

However, even among women using fertility treatments, adherence to all recommendations was not perfect. Only 30.6% of women using fertility treatments completely avoided alcohol before pregnancy—meaning nearly 70% consumed some alcohol during the preconception period. This is important because current health guidelines recommend avoiding alcohol when trying to conceive.

During early pregnancy, women who used fertility treatments continued to show healthier behaviors overall. They were still significantly more likely to avoid smoking and alcohol. Interestingly, women using fertility treatments exercised less than women who conceived naturally—only 46.3% met the recommended weekly exercise hours, compared to a higher percentage in the natural conception group. This was the only major health behavior where the fertility treatment group performed worse.

The study found that the benefits of fertility treatment on health behaviors were consistent across different types of fertility treatments. Women using fertility treatments also showed better adherence to supplement recommendations beyond just folic acid. The healthier behaviors in the fertility treatment group persisted into early pregnancy, suggesting that the motivation from planning a pregnancy may have lasting effects. The lower exercise rates in the fertility treatment group during early pregnancy may reflect concerns about physical activity after fertility treatment or differences in how women in this group perceive exercise safety during early pregnancy.

This study adds important real-world evidence to previous research suggesting that women undergoing fertility treatment are highly motivated to follow health recommendations. Previous studies have shown that women planning pregnancies tend to make healthier choices, and this research confirms that effect is particularly strong in women using fertility treatments. However, the finding that even highly motivated women don’t follow all recommendations—particularly regarding alcohol—suggests that motivation alone may not be enough, and women may need more support and education about specific health behaviors.

This study has several important limitations. First, it only included women in Denmark, so the results may not apply to other countries with different healthcare systems, cultures, or health recommendations. Second, the study relied on women’s self-reported answers about their health behaviors, which means some women may have underreported unhealthy behaviors like alcohol use or smoking. Third, because this is a cross-sectional study, it shows that women using fertility treatments have healthier behaviors, but it cannot prove that the fertility treatment caused these healthier behaviors—women who choose fertility treatment may already be more health-conscious. Fourth, the study only looked at first-time mothers, so results may not apply to women who have been pregnant before. Finally, the study didn’t collect information about why women made certain health choices, so we can’t know whether the motivation came from the fertility treatment itself or from other factors.

The Bottom Line

If you’re planning to use fertility treatment, this research suggests you may be well-positioned to follow important health recommendations. Key recommendations supported by this research include: taking folic acid supplements (very high adherence in this group), avoiding smoking (very high adherence), and avoiding alcohol (moderate adherence—only about one-third fully complied). Additionally, aim to meet exercise recommendations of at least 150 minutes of moderate activity per week, as this was an area where even women using fertility treatments fell short. These recommendations should be discussed with your healthcare provider, who can provide personalized guidance based on your individual health situation.

This research is most relevant to women planning to use fertility treatments and their healthcare providers. It’s also valuable for women conceiving naturally who want to understand how their health behaviors compare to women using fertility treatments. Healthcare providers can use this information to better support all women in following preconception health recommendations, recognizing that even highly motivated women may struggle with certain behaviors like alcohol avoidance and exercise. This research is less relevant to men or to women who are not planning pregnancy.

Health behavior changes can begin immediately when you start planning pregnancy, whether through fertility treatment or natural conception. Some benefits, like improved folic acid intake, can be established within weeks. However, seeing the full benefits of healthy behaviors on pregnancy outcomes typically takes several months. If using fertility treatment, you may see motivation for behavior change increase once treatment begins. Maintaining these healthy behaviors throughout pregnancy and beyond is important for long-term health outcomes for both mother and baby.

Want to Apply This Research?

  • Track daily folic acid supplement intake, weekly exercise minutes (aim for 150 minutes of moderate activity), and alcohol consumption (target: zero drinks). Create a simple daily checklist with these three items to monitor adherence to key recommendations.
  • Use the app to set a specific goal like ‘Take folic acid every morning with breakfast’ and receive daily reminders. Create a weekly exercise schedule with specific activities and times. If planning fertility treatment, use the app to log when treatment begins and set health behavior goals as part of your preparation plan.
  • Review your health behavior tracking weekly to identify patterns. If you notice gaps in adherence (like missing exercise or occasional alcohol use), use the app to adjust your approach—perhaps by changing exercise timing or identifying triggers for alcohol consumption. Share your tracking data with your healthcare provider during preconception visits to discuss areas where you need additional support.

This research describes health behaviors in women using fertility treatments but does not provide medical advice. The findings are based on a study in Denmark and may not apply to all populations. If you are planning pregnancy or considering fertility treatment, consult with your healthcare provider about personalized recommendations for your situation. This study shows associations between fertility treatment and health behaviors but does not prove that fertility treatment causes healthier choices. Always follow your doctor’s specific guidance regarding preconception health, supplements, alcohol, smoking, and exercise.