Infertility, defined as the failure to achieve pregnancy after 12 months of regular
unprotected sexual intercourse, and spontaneous abortion (SAB) are significant public
health problems, affecting up to 20% of reproductive age couples in the Western World. A
large proportion of couples seek fertility treatment, which is not only an economic
burden for the society, but also associated with adverse health effects among infertile
couples. The causes of both infertility and SAB are multifactorial and identification of
modifiable risk factors is an important public health goal.
According to the Danish Health Authority, adults are recommended to be physically active
for at least 30 minutes per day, to undertake muscle-strengthening activities on two or
more days per week and to reduce sedentary time. The same applies for pregnant women
without complications. However, only 15-38% of pregnant women adhere to the
recommendations for PA and many women reduce their level of exercise during early
pregnancy compared with pre-pregnancy. Yet, maternal health in both the preconception
period and during pregnancy is critical to avoid complications during pregnancy and for
the long-term health of mother and child.
We therefore aim to investigate the association between PA, fecundability (i.e., the
average per-cycle probability of conception), and SAB. An efficient web-based
infrastructure to recruit, follow, and collect comprehensive data has already been
developed. In the ongoing prospective cohort study, SnartForældre.dk (SF), we investigate
fecundability and SAB according to demographic, behavioral, environmental, and medical
factors and have enrolled more than 10,000 women and 1,700 of their male partners who are
trying to conceive without fertility treatment.
In the present SF sub-study, SnartForældre.dk/Aktivitet, we aim to conduct a two-armed
randomized controlled trial with 500 women included, to investigate the effectiveness of
receiving motivational counseling on physical activity (PA) among women trying to
conceive and during the first trimester of the pregnancy if they conceive. We will
further investigate whether PA is associated with fecundability, spontaneous abortion
(SAB) and other birth outcomes, i.e., gestational diabetes, preeclampsia, and birth
weight. As we will be able to combine self-reported data, objectively measured data on
PA, and high-quality Danish registry data, we have a unique possibility to evaluate the
impact of PA on fecundability and SAB, as well as other pregnancy complications and birth
outcomes, in a way that is hardly possible in any other country.
The study will provide important knowledge that will be of interest for the scientific
world, health professionals, and for couples who suffer from infertility or experience
SABs.