Association between combined healthy lifestyles and infertility: a cross-sectional study in US reproductive-aged women

Abstract Background Infertility is a widespread problem for couples worldwide, and lifestyle factors are the cornerstone of infertility prevention. This research seeks to explore the association between combined healthy lifestyles and infertility risk among women of reproductive age. Methods This st...

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Main Authors: Xiaofeng Ye, Xiaoxia Song, Sihang Zhou, Guoqing Chen, Liping Wang
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-21395-2
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author Xiaofeng Ye
Xiaoxia Song
Sihang Zhou
Guoqing Chen
Liping Wang
author_facet Xiaofeng Ye
Xiaoxia Song
Sihang Zhou
Guoqing Chen
Liping Wang
author_sort Xiaofeng Ye
collection DOAJ
description Abstract Background Infertility is a widespread problem for couples worldwide, and lifestyle factors are the cornerstone of infertility prevention. This research seeks to explore the association between combined healthy lifestyles and infertility risk among women of reproductive age. Methods This study analyzed data from the National Health and Nutrition Examination Survey (NHANES, 2013–2018), concentrating on 2,154 women aged 18 to 44. A healthy lifestyle score was created based on healthy diet (top two-fifths of the Healthy Eating Index-2015 score), low-to-moderate alcohol drinking (1–14 g/day), optimal waist circumference (less than 80 cm), adequate physical activity (at least 150 min of moderate-to-vigorous leisure-time exercise per week), and current nonsmoking. Weighted logistic regression analysis was applied to assess the link between healthy lifestyle scores and the risk of infertility, adjusting for potential confounders. Results After adjusting for potential confounders, women exhibiting 4 to 5 healthy lifestyle factors demonstrated a 59% decrease in the likelihood of infertility (OR: 0.41, 95% CI: 0.23–0.76) relative to those with 0 to 1 healthy lifestyle factors. Additionally, each increment in healthy lifestyle factors corresponded to a 21% decrease in infertility risk (OR: 0.79, 95% CI: 0.68–0.92). Analysis of subgroups indicated that the inverse association was more pronounced in females younger than 30. Additionally, optimal waist circumference is the foremost factor contributing to this inverse relationship. Conclusion Adhering to healthy lifestyles significantly lowers the likelihood of infertility among reproductive-aged women. Public health initiatives could consider enhancing access to healthy diets, physical activity, and resources to reduce alcohol consumption and smoking. Further research is required to clarify their relationship and the underlying mechanisms.
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spelling doaj-art-613d61093da9462f9d1fb09812f10fa12025-01-19T12:42:10ZengBMCBMC Public Health1471-24582025-01-012511810.1186/s12889-025-21395-2Association between combined healthy lifestyles and infertility: a cross-sectional study in US reproductive-aged womenXiaofeng Ye0Xiaoxia Song1Sihang Zhou2Guoqing Chen3Liping Wang4Reproductive Medicine Centre, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, School of Biomedical Engineering, Shenzhen University Medical SchoolReproductive Medicine Centre, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s HospitalReproductive Medicine Centre, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s HospitalReproductive Medicine Centre, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s HospitalReproductive Medicine Centre, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s HospitalAbstract Background Infertility is a widespread problem for couples worldwide, and lifestyle factors are the cornerstone of infertility prevention. This research seeks to explore the association between combined healthy lifestyles and infertility risk among women of reproductive age. Methods This study analyzed data from the National Health and Nutrition Examination Survey (NHANES, 2013–2018), concentrating on 2,154 women aged 18 to 44. A healthy lifestyle score was created based on healthy diet (top two-fifths of the Healthy Eating Index-2015 score), low-to-moderate alcohol drinking (1–14 g/day), optimal waist circumference (less than 80 cm), adequate physical activity (at least 150 min of moderate-to-vigorous leisure-time exercise per week), and current nonsmoking. Weighted logistic regression analysis was applied to assess the link between healthy lifestyle scores and the risk of infertility, adjusting for potential confounders. Results After adjusting for potential confounders, women exhibiting 4 to 5 healthy lifestyle factors demonstrated a 59% decrease in the likelihood of infertility (OR: 0.41, 95% CI: 0.23–0.76) relative to those with 0 to 1 healthy lifestyle factors. Additionally, each increment in healthy lifestyle factors corresponded to a 21% decrease in infertility risk (OR: 0.79, 95% CI: 0.68–0.92). Analysis of subgroups indicated that the inverse association was more pronounced in females younger than 30. Additionally, optimal waist circumference is the foremost factor contributing to this inverse relationship. Conclusion Adhering to healthy lifestyles significantly lowers the likelihood of infertility among reproductive-aged women. Public health initiatives could consider enhancing access to healthy diets, physical activity, and resources to reduce alcohol consumption and smoking. Further research is required to clarify their relationship and the underlying mechanisms.https://doi.org/10.1186/s12889-025-21395-2Combined healthy lifestylesNational Health and Nutrition Examination Survey (NHANES)InfertilitySmokingWaist circumferenceAlcohol drinking
spellingShingle Xiaofeng Ye
Xiaoxia Song
Sihang Zhou
Guoqing Chen
Liping Wang
Association between combined healthy lifestyles and infertility: a cross-sectional study in US reproductive-aged women
BMC Public Health
Combined healthy lifestyles
National Health and Nutrition Examination Survey (NHANES)
Infertility
Smoking
Waist circumference
Alcohol drinking
title Association between combined healthy lifestyles and infertility: a cross-sectional study in US reproductive-aged women
title_full Association between combined healthy lifestyles and infertility: a cross-sectional study in US reproductive-aged women
title_fullStr Association between combined healthy lifestyles and infertility: a cross-sectional study in US reproductive-aged women
title_full_unstemmed Association between combined healthy lifestyles and infertility: a cross-sectional study in US reproductive-aged women
title_short Association between combined healthy lifestyles and infertility: a cross-sectional study in US reproductive-aged women
title_sort association between combined healthy lifestyles and infertility a cross sectional study in us reproductive aged women
topic Combined healthy lifestyles
National Health and Nutrition Examination Survey (NHANES)
Infertility
Smoking
Waist circumference
Alcohol drinking
url https://doi.org/10.1186/s12889-025-21395-2
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