{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T08:16:50Z","timestamp":1793175410439,"version":"4.5.0"},"reference-count":80,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:00:00Z","timestamp":1715644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Centre of Research Excellence Health in Preconception & Pregnancy"},{"DOI":"10.13039\/501100000925","name":"NHMRC","doi-asserted-by":"publisher","award":["2009767"],"award-info":[{"award-number":["2009767"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Veski Fellowship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>While there is a recognized role of optimizing lifestyle (diet and physical activity) behaviours in the management of infertility, the best practice remains unknown and factors influencing the lifestyle of people with infertility are not well understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>OBJECTIVE AND RATIONALE<\/jats:title><jats:p>This systematic review evaluated barriers and enablers to a healthy lifestyle in people with infertility, from the perspectives of people with infertility and health professionals, in order to inform optimal behavioural change strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>SEARCH METHODS<\/jats:title><jats:p>Ovid MEDLINE(R), PsycINFO, EMBASE, EBM Reviews, and CINAHL were searched from inception to 28 August 2023. Eligible studies were qualitative and quantitative primary studies that explored barriers and\/or enablers to lifestyle for infertility management. Quality assessment was performed using the Centre for Evidence-Based Management Critical Appraisal of a Survey Tool and the Critical Appraisal Skills Programme Qualitative Checklist. Data were analysed by thematic analysis with themes mapped to the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF).<\/jats:p><\/jats:sec><jats:sec><jats:title>OUTCOMES<\/jats:title><jats:p>After screening 12\u00a0326 abstracts and 99 full-texts, 27 studies were included (12 quantitative, 6 qualitative and 9 mixed-methods) with 22 studies of women with infertility (n\u2009=\u20092524), 11 studies of men with infertility (n\u2009=\u20091407), and 6 studies of health professionals (n\u2009=\u2009372). We identified barriers and enablers relating to capability (e.g. strategies for behaviour change), opportunity (e.g. limited time, resources, and money), and motivation (e.g. interplay between lifestyle and emotional state). Based on the identified themes, suggested intervention components to integrate into lifestyle management of infertility include facilitating development of self-management skills to support lifestyle change (e.g. self-monitoring, action planning, and goal setting) and incorporating mental health strategies (e.g. providing information about the benefits of healthy lifestyle behaviours for mental health and encouraging patients to reframe healthy lifestyle behaviours as self-care strategies).<\/jats:p><\/jats:sec><jats:sec><jats:title>WIDER IMPLICATIONS<\/jats:title><jats:p>The findings have identified important factors that influence lifestyle management in people with infertility and have suggested relevant intervention components to consider when designing interventions. Given the paucity of qualitative studies identified, more research is needed to further understand the complex and interacting factors that shape lifestyle during the fertility journey.<\/jats:p><\/jats:sec>","DOI":"10.1093\/humupd\/dmae011","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T16:04:24Z","timestamp":1715702664000},"page":"569-583","source":"Crossref","is-referenced-by-count":25,"title":["Barriers and enablers to a healthy lifestyle in people with infertility: a mixed-methods systematic review"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5126-3570","authenticated-orcid":false,"given":"Sophia","family":"Torkel","sequence":"first","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Monash University , Clayton, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6622-8134","authenticated-orcid":false,"given":"Rui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Monash University , Clayton, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3118-3896","authenticated-orcid":false,"given":"Robert J","family":"Norman","sequence":"additional","affiliation":[{"name":"Robinson Research Institute, The University of Adelaide , Adelaide, SA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6134-5235","authenticated-orcid":false,"given":"Lijun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Adelaide Medical School, The University of Adelaide , Adelaide, SA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Liu","sequence":"additional","affiliation":[{"name":"Adelaide Medical School, The University of Adelaide , Adelaide, SA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Boden","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Monash University , Clayton, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wentong","family":"Xu","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Monash University , Clayton, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5772-6484","authenticated-orcid":false,"given":"Lisa","family":"Moran","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Monash University , Clayton, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6731-4221","authenticated-orcid":false,"given":"Stephanie","family":"Cowan","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Monash University , Clayton, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,14]]},"reference":[{"key":"2024090305552670400_dmae011-B1","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1093\/humupd\/dmad018","article-title":"Assessing the influence of preconception diet on female fertility: a systematic scoping review of observational studies","volume":"29","author":"Alesi","year":"2023","journal-title":"Hum Reprod Update"},{"key":"2024090305552670400_dmae011-B2","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s13012-017-0605-9","article-title":"A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems","volume":"12","author":"Atkins","year":"2017","journal-title":"Implement Sci"},{"key":"2024090305552670400_dmae011-B3","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1093\/humrep\/13.6.1532","article-title":"Smoking and female infertility: a systematic review and meta-analysis","volume":"13","author":"Augood","year":"1998","journal-title":"Hum Reprod"},{"key":"2024090305552670400_dmae011-B4","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1111\/1467-9566.12395","article-title":"\u2018I don\u2019t consider a cup performance; 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