A qualitative study nested within an RCT found that eight women with infertility generally tolerated a medically supervised prolonged fasting intervention (under 500 kcal/day), reporting both challenges like fatigue and benefits like improved mood, though the study provides descriptive data only without efficacy conclusions [C tier: qualitative, small sample].
Infertility creates substantial burden on couples seeking treatment. While conventional fertility interventions exist, their success rates vary, and the physical and psychological demands drive some to explore complementary approaches. This qualitative study emerged from a larger RCT designed to examine whether a medically supervised prolonged fasting protocol might affect fertility-related outcomes. Rather than measure clinical endpoints directly, the researchers wanted to understand how women actually experienced the intervention and whether it felt acceptable as part of their fertility journey.
The study interviewed eight women who completed the fasting intervention between February 2022 and January 2023. The protocol involved fluid-only fasting (under 500 kcal/day) under medical supervision. Interviews occurred after the intervention ended and were analyzed using inductive thematic analysis, a structured approach to identifying patterns in qualitative data. The researchers held regular group discussions to ensure consistency in how they interpreted the data.
Participants reported a mixed but generally manageable experience. On the challenge side, women described fatigue, taste dissatisfaction, and food cravings as expected difficulties during the fasting period. More notably, some experienced low mood and social withdrawal, suggesting fasting's psychological dimensions extend beyond physical discomfort. However, participants identified three factors that helped them navigate these challenges: their own motivation for fertility treatment, coping strategies they developed during the intervention, and support from a dietitian. This combination appeared sufficient for most women to complete the protocol without dropping out.
The reported benefits painted a more positive picture. Women described improved physical well-being, better mood, and what some characterized as a "sense of inner balance." Importantly, participants valued fasting as a way to take an active role in their fertility treatment, rather than remaining passive during medical interventions. Post-fasting, responses diverged: some women reported renewed hope for subsequent fertility treatments, while others shifted their psychological relationship with conception, moving away from the intense focus that had previously dominated their experience. This suggests the intervention may carry psychological meaning beyond any direct biological effects.
This research provides a descriptive picture of tolerability and subjective experience, not evidence of efficacy. Several practical considerations emerge:
On acceptability: Medically supervised fasting appears feasible for women seeking complementary approaches to infertility. The combination of clinical support (dietitian guidance) and participant motivation proved important. If you're considering this, expect fatigue and mood fluctuations, and plan for social flexibility during the fasting window.
On psychological effects: The sense of agency and active participation in treatment appeared valuable to participants independent of any biological outcomes. The shift in psychological focus post-intervention may reflect a reframing benefit even without measurable fertility improvements.
On the evidence gap: This qualitative study describes experiences but doesn't establish whether fasting improves fertility outcomes. The parent RCT would provide that data, though this publication doesn't report those results. Efficacy claims require clinical outcome data, which isn't presented here.
On medical supervision: All participants had dietitian support and medical oversight. Any consideration of prolonged fasting should include this structure; unsupervised extended fasting carries nutritional risks, particularly for women of reproductive age.
The study also highlights that infertility burdens are both physical and psychological. Interventions that address either dimension, or both, may resonate with people navigating this experience.
| Attribute | Details |
|---|---|
| Study type | Qualitative study nested within an RCT |
| Sample size | 8 women interviewed |
| Intervention | Medically supervised prolonged fasting (under 500 kcal/day, fluid-only) |
| Analysis method | Inductive thematic analysis |
| Key outcomes | Acceptability, perceived physical effects, perceived psychological effects, coping strategies |
| Funding source | Not stated in abstract |
| Registration | ClinicalTrials.gov NCT04942457 |
| Study period | February 2022 to January 2023 |
| Limitations | Small sample; qualitative design; no objective fertility outcome data; no control group comparison of experience |
Leise A, et al. Women's experiences of a medically supervised fasting intervention for infertility: a qualitative study. BMC Women's Health. 2024. PubMed: 42855686
ClinicalTrials.gov: NCT04942457
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