Dataset Information

Perceived Stress and Fecundability: A Preconception Cohort Study of North American Couples.

ABSTRACT: While some epidemiologic studies support the hypothesis that stress can adversely affect fertility, few prospective studies have assessed the association in couples from the general population. We used data from Pregnancy Study Online, a web-based preconception cohort study of pregnancy planners from the United States and Canada (2013-2018), to examine the association between women's and men's perceived stress levels prior to conception and fecundability. Women (aged 21-45 years) and their male partners (aged ?21 years) who were attempting conception without fertility treatment were eligible. We measured perceived stress using the 10-item Perceived Stress Scale (PSS). We ascertained pregnancy information using bimonthly follow-up questionnaires of female participants. We followed 4,769 couples until self-reported pregnancy, initiation of fertility treatment, loss to follow-up, or 12 menstrual cycles of attempt time, whichever came first. We used proportional probabilities regression models to estimate fecundability ratios and 95% confidence intervals, adjusting for potential confounders. Higher PSS scores among the women were associated with slight reductions in fecundability (comparing PSS scores of ?25 vs. <10, fecundability ratio = 0.87, 95% confidence interval: 0.74, 1.02). PSS scores among the men were not substantially associated with fecundability.

SUBMITTER: Wesselink AK

PROVIDER: S-EPMC6887691 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Perceived Stress and Fecundability: A Preconception Cohort Study of North American Couples.

Wesselink Amelia K AK Hatch Elizabeth E EE Rothman Kenneth J KJ Weuve Jennifer L JL Aschengrau Ann A Song Rebecca J RJ Wise Lauren A LA

American journal of epidemiology 20181201 12

While some epidemiologic studies support the hypothesis that stress can adversely affect fertility, few prospective studies have assessed the association in couples from the general population. We used data from Pregnancy Study Online, a web-based preconception cohort study of pregnancy planners from the United States and Canada (2013-2018), to examine the association between women's and men's perceived stress levels prior to conception and fecundability. Women (aged 21-45 years) and their male ...[more]

PMID: 30137198

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Project description:Intake of conventionally-grown fruits and vegetables with higher levels of pesticide residue contamination has been associated with poorer semen quality and lower probability of live birth among couples undergoing fertility treatment. We examined the association between dietary intake of pesticide residues and fecundability, the per cycle probability of conception, in a preconception cohort of pregnancy planners. We enrolled women aged 21-45 years who were attempting to conceive without use of fertility treatment into Pregnancy Study Online (PRESTO) from June 2013 through September 2019. Participants completed a baseline questionnaire on demographics, lifestyle factors, and medical and reproductive histories, and bimonthly follow-up questionnaires for up to 12 months or until reported conception. Ten days after baseline, participants completed the National Cancer Institute's Diet History Questionnaire II, a validated food frequency questionnaire. Using data from the USDA Pesticide Data Program, we classified fruits and vegetables as having high or low pesticide residues using a validated method. We examined the relation between greater intake of high- and low-pesticide residue fruits and vegetables with fecundability using proportional probabilities regression models, adjusted for potential confounders and accounting for consumption of organic produce. We restricted our analysis to 5234 women who had been attempting conception for ≤6 cycles at study entry, and further stratified by pregnancy attempt time at study entry (<3 vs. 3-6 cycles) to evaluate potential for reverse causation. Intakes of high- and low-pesticide residue fruits and vegetables were not appreciably related to fecundability in the full sample, or among women trying to conceive for <3 cycles at study entry. However, among women trying to conceive for 3-6 cycles at study entry, both high- and low-pesticide residue fruit and vegetable intakes were strongly inversely related to fecundability, indicating potential reverse causation bias. These results do not support the hypothesis that intake of pesticide residues from conventionally-grown fruits and vegetables is harmful to fertility, although non-differential exposure misclassification may have attenuated our findings.

Project description:BackgroundObesity compromises metabolic health and female fertility, yet not all obese women are similar in metabolic status. The extent to which fecundability is influenced by the metabolic health status of women who are overweight or obese before conception is unknown.ObjectiveThis study aimed to: (1) determine the metabolic health status, and (2) examine the association between metabolic health status and fecundability of overweight and obese women trying to conceive in the Singapore PREconception Study of long-Term maternal and child Outcomes cohort study.Study designWe conducted a prospective preconception cohort study of Asian women (Chinese, Malay, and Indian) aged 18 to 45 years trying to conceive who were treated from 2015 to 2017 in KK Women's and Children's Hospital in Singapore (n=834). We defined women to have metabolically unhealthy status if they: (1) met 3 or more modified Joint Interim Statement metabolic syndrome criteria; or (2) had homeostasis model assessment-insulin resistance index ≥2.5. Body mass index was categorized as normal (18.5-22.9 kg/m2), overweight (23-27.4 kg/m2), or obese (≥27.5 kg/m2) on the basis of cutoff points for Asian populations. Fecundability was measured by time to pregnancy in menstrual cycles within a year of enrolment. Discrete-time proportional hazards models were used to estimate fecundability odds ratios, with adjustment for confounders and accounting for left truncation and right censoring.ResultsOf 232 overweight women, 28 (12.1%) and 25 (10.8%) were metabolically unhealthy by metabolic syndrome ≥3 criteria and homeostasis model assessment-insulin resistance ≥2.5, respectively. Of 175 obese women, 54 (30.9%) and 93 (53.1%) were metabolically unhealthy by metabolic syndrome ≥3 criteria and homeostasis model assessment-insulin resistance ≥2.5, respectively. Compared with metabolically healthy normal-weight women, lower fecundability was observed in metabolically unhealthy overweight women on the basis of metabolic syndrome criteria (fecundability odds ratios, 0.38 [95% confidence interval, 0.15-0.92]) and homeostasis model assessment-insulin resistance (fecundability odds ratios, 0.68 [95% confidence interval, 0.33-1.39]), with metabolic syndrome criteria showing a stronger association. Metabolically unhealthy obese women showed lower fecundability than the healthy normal-weight reference group by both metabolic syndrome (fecundability odds ratios, 0.35; 95% confidence interval, 0.17-0.72) and homeostasis model assessment-insulin resistance criteria (fecundability odds ratios, 0.43; 95% confidence interval, 0.26-0.71). Reduced fecundability was not observed in overweight or obese women who showed healthy metabolic profiles by either definition.ConclusionOverweight or obesity was not synonymous with having metabolic syndrome or insulin resistance. In our preconception cohort, metabolically unhealthy overweight and obese women showed reduced fecundability, unlike their counterparts who were metabolically healthy. These findings suggest that metabolic health status, rather than simply being overweight and obese per se, plays an important role in fecundability.

Dataset Information

Perceived Stress and Fecundability: A Preconception Cohort Study of North American Couples.

Publications

Perceived Stress and Fecundability: A Preconception Cohort Study of North American Couples.

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