Occupational and Lifestyle Factors of Male and Female Infertility Patients: Do They Impact ART Success?

Of 501 couples undergoing IVF, the only factor linked to pregnancy when both partners were assessed together was taking vitamins, minerals, and trace elements

Journal: Medicina (Kaunas) | Published: 2026-06-10 | Type: Prospective cohort | PMID: 42356144 Authors: Micić J et al. — Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, Belgrade Funding/COI: Not disclosed

Summary

A Serbian tertiary center enrolled 501 infertile couples undergoing ART between 2019 and 2022 and administered lifestyle questionnaires to both partners. Clinical pregnancy occurred in 22.2% of cycles. After sifting through occupational and lifestyle variables, the only couple-level predictor of pregnancy was whether both partners took vitamins, minerals, and trace elements — not smoking, not occupation, not exercise.

Claims

• Clinical pregnancy rate: 22.2% across 501 couples in fresh autologous ART cycles
• For female partners independently: younger age and supplement use were associated with clinical pregnancy
• For male partners independently: younger age and absence of chronic illness were associated
• When couples were analyzed as a unit, only supplement use by both partners correlated with pregnancy — no occupational or other lifestyle factor survived analysis

Study Quality

Consecutive enrollment from a single referral center reduces within-cohort selection bias, and prospective questionnaire collection means lifestyle data weren't recalled after outcomes were known. The restriction to unexplained or primary infertility with BMI ≤ 30 and age ≤ 45 creates a relatively homogeneous cohort — useful for isolating lifestyle effects but a serious limitation on generalizability. The study does not report what statistical model was used to arrive at the couple-level finding, whether corrections for multiple comparisons were applied, or how supplement use was defined and validated.

Funding and conflicts of interest are both undisclosed, which is a gap in transparency for any study whose central positive finding happens to be about supplement use.

Red Flags

• Funding and COI not disclosed — particularly relevant given the main finding involves supplements
• Lifestyle data are self-reported via questionnaire; no objective validation (biomarkers, pharmacy records)
• "Use of vitamins, minerals, and trace elements" is not defined — dose, duration, specific compounds, and compliance are unknown
• Single center in Belgrade; tertiary referral bias likely skews toward more complex cases
• 22.2% clinical pregnancy rate is below typical fresh autologous ART benchmarks, raising questions about case mix
• No correction for multiple comparisons reported; with many lifestyle variables tested, the supplement finding may be a false positive
• Couples assessed "together" method is not described in the abstract; unclear if this is a joint multivariate model or a post-hoc reframe

Strengths

• Both male and female partners were assessed, not just the female — uncommon in ART outcome research
• Consecutive enrollment over three years reduces cherry-picking
• Questionnaire data collected prospectively, before outcome was known
• Moderate sample size (501 couples) for a single-center lifestyle study

Verdict

The paper asks a reasonable question and assembles a reasonably clean cohort, but the headline finding — that taking supplements is the one lifestyle factor that matters for IVF success — rests on undisclosed analytical choices, self-reported exposure data, and a funding statement that's conspicuously absent. The result is hypothesis-generating at best. Without knowing what supplements, at what dose, for how long, or whether a correction for multiple testing was applied, this finding cannot be acted on. Worth reading if you're building a systematic review of lifestyle factors in ART; not worth citing as evidence that supplements improve IVF outcomes.