Barriers and enablers to a healthy lifestyle in people with infertility: a qualitative descriptive study

Background: While there is a recognised role of lifestyle (diet and physical activity) in management of infertility, there is limited research exploring the perspectives of people with infertility in relation to lifestyle management. The aim of this study was to understand the barriers and enablers affecting uptake of lifestyle intervention in people with infertility who were using or seeking fertility treatment. Methods: A qualitative descriptive study was performed. Online interviews were conducted with people with infertility who were using or seeking fertility treatment. Interviews explored barriers and enablers to a healthy lifestyle while attempting conception. Interview questions were informed by the Capability, Opportunity, Motivation and Behaviour (COM-B) model and theoretical domains framework (TDF). Interview transcripts were analysed using template analysis. Themes were mapped to the COM-B and TDF, and suggested interventions were developed using the behaviour change wheel method. Results: Nine women and two men completed the interviews. The median age was 38 years (interquartile range 33 to 42 years). Barriers and enablers related to capability (e.g. managing whole-body health and disease), opportunity (e.g. unmet needs from the healthcare system) and motivation (e.g. interplay between lifestyle and emotional state). Suggested intervention components included delivering inclusive programs which accommodate individual needs and providing engaging information which debunks myths and explains the mechanism by which lifestyle promotes fertility. Conclusions: Our study provides novel and rich insights into the unique needs of people with infertility, and has identified several interacting factors which influence their lifestyle behaviours. Our findings highlight that changes at the organisational and policy level are essential to overcome major barriers to lifestyle management by improving access to trustworthy resources with actionable advice, and by improving service provision to deliver multidisciplinary patient-centred care. Future studies should use these findings to co-design interventions and resources to support lifestyle management of infertility. Trial registration: Not applicable. © The Author(s) 2025.