Dataset Information

Folate intake and ovarian reserve among women attending a fertility center.

ABSTRACT:

Objective

To examine the association between dietary folate intake and antral follicle count (AFC) among women seeing treatment for infertility.

Design

Cohort study.

Setting

Academic fertility center.

Patients

A total of 552 women attending the Massachusetts General Hospital Fertility Center (2007-2019) who participated in the Environment and Reproductive Health Study.

Interventions

None. Folate intake was measured with a validated food frequency questionnaire at study entry. Multivariable Poisson regression models with robust standard errors were used to estimate the association of folate intake with AFC adjusting for calorie intake, age, body mass index, physical activity, education, smoking status, year of AFC, and intakes of vitamin B₁₂, iron, and vitamin D. Nonlinearity was assessed with restricted cubic splines.

Main outcome measure

AFC as measured by transvaginal ultrasonography as part of routine care.

Results

Among the 552 women (median age, 35.0 years; median folate intake, 1,005 μg/d), total and supplemental folate intake had a significant nonlinear relationship with AFC. There was a positive linear association with AFC up to approximately 1,200 μg/d for total folate intake and up to 800 μg/d for supplemental folate intake; however, there was no additional benefit of higher folate intakes. The magnitude of the association was modest; for example, the predicted adjusted difference in AFC between a woman consuming 400 vs. 800 μg/d of supplemental folate was approximately 1.5 follicles.

Conclusion

Higher intake of folate, particularly from supplements, was associated with modestly higher ovarian reserve as measured by AFC among women attending a fertility center.

Clinical trial registration number

This trial was registered at clinicaltrials.gov as NCT00011713.

SUBMITTER: Kadir M

PROVIDER: S-EPMC8714696 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Publications

Folate intake and ovarian reserve among women attending a fertility center.

Kadir Mumta M Hood Robert B RB Mínguez-Alarcón Lidia L Maldonado-Cárceles Ana Belén AB Ford Jennifer B JB Souter Irene I Chavarro Jorge E JE Gaskins Audrey J AJ

Fertility and sterility 20211119 1

<h4>Objective</h4>To examine the association between dietary folate intake and antral follicle count (AFC) among women seeing treatment for infertility.<h4>Design</h4>Cohort study.<h4>Setting</h4>Academic fertility center.<h4>Patients</h4>A total of 552 women attending the Massachusetts General Hospital Fertility Center (2007-2019) who participated in the Environment and Reproductive Health Study.<h4>Interventions</h4>None. Folate intake was measured with a validated food frequency questionnaire ...[more]

PMID: 34809974

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Project description:ObjectiveTo investigate the association of hair mercury (Hg) levels with antral follicle count (AFC), as a marker of ovarian reserve, and evaluate whether this relationship differed among women with high vs. low total intake of long chain omega-3 polyunsaturated fatty acids (n3PUFA) from foods and supplements.DesignWe included 353 women attending an academic fertility center (2007-2019) who had data on hair Hg levels, total n3PUFA intake, and AFC.MethodsHair Hg levels were assessed using a Direct Mercury Analyser, total n3PUFA intake was estimated using an extensively validated food frequency questionnaire, and AFC was assessed by transvaginal ultrasonography. Poisson regression models adjusted for potential confounders were used to evaluate the association of hair Hg levels (divided into tertiles, and as above vs below EPA reference (1 ppm)) with AFC. Associations were also evaluated after stratification by median n3PUFA intake (≤0.124% vs. >0.125% calories/week).ResultsWomen's median hair Hg level was 0.60 ppm (range = 0.001-8.60 ppm), with more than 30% > 1 ppm (EPA reference level). Hair Hg was positively related to AFC after adjusting for age, BMI, smoking status, infertility diagnosis, and alcohol intake. However, associations became attenuated after adjustment for intake of total n3PUFA. The positive associations of hair Hg and AFC were observed only among women above the median total n3PUFA intake. Specifically, women who consumed >0.125% calories/week of total n3PUFA had mean AFCs of 11.9, 13.2 and 14.1, respectively, across increasing tertiles of hair Hg (p,trend = 0.004). Similar results were found when hair Hg was divided above vs below EPA reference (mean AFC = 12.7 vs. 14.1, p = 0.008).ConclusionsIn these women, positive associations of hair Hg with AFC may be reflective of beneficial effects of n3PUFA on ovarian reserve rather than a beneficial effect of Hg per se. Our findings highlight the importance of considering diet when exploring Hg effects on women's reproductive health in urban settings.

Project description:BackgroundParabens are preservatives commonly used in personal care products, pharmaceuticals, and foods. There is documented widespread human exposure to parabens, and some experimental data suggest that they act as estrogenic endocrine disruptors. As far as we are aware, no epidemiologic studies have assessed female reproductive health effects in relation to paraben exposure.ObjectiveWe examined the association of urinary paraben concentrations with markers of ovarian reserve in a prospective cohort study of women seeking fertility treatment at Massachusetts General Hospital, Boston, Massachusetts.MethodsMeasures of ovarian reserve were day-3 follicle-stimulating hormone (FSH), antral follicle count (AFC), and ovarian volume. Paraben concentrations [methylparaben (MP), propylparaben (PP), and butylparaben (BP)] were measured in spot urine samples collected prior to the assessment of outcome measures. We used linear and Poisson regression models to estimate associations of urinary paraben concentrations (in tertiles) with ovarian reserve measures.ResultsOf the women enrolled in 2004-2010, 192 had at least one ovarian reserve outcome measured (mean age ± SD, 36.1 ± 4.5 years; range, 21.0-46.7 years). MP and PP were detected in > 99% of urine samples and BP in > 75%. We found a suggestive trend of lower AFC with increasing urinary PP tertiles [mean percent change (95% CI) for tertiles 2 and 3 compared with tertile 1, respectively, were -5.0% (-23.7, 18.4) and -16.3% (-30.8, 1.3); trend p-value (ptrend) = 0.07] as well as higher day-3 FSH with higher urinary PP tertiles [mean change (95% CI) for tertiles 2 and 3 compared with tertile 1 were 1.16 IU/L (-0.26, 2.57) and 1.02 IU/L (-0.40, 2.43); ptrend = 0.16]. We found no consistent evidence of associations between urinary MP or BP and day-3 FSH or AFC, or between urinary MP, PP, or BP and ovarian volume.ConclusionsPP may be associated with diminished ovarian reserve. However, our results require confirmation in further studies.

Dataset Information

Folate intake and ovarian reserve among women attending a fertility center.

Objective

Design

Setting

Patients

Interventions

Main outcome measure

Results

Conclusion

Clinical trial registration number

Publications

Folate intake and ovarian reserve among women attending a fertility center.

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