The association between the use of fertility indicators and fecundability in a Danish preconception cohort.

Autor: Pedersen ES; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus University, Aarhus N, Denmark., Mikkelsen EM; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus University, Aarhus N, Denmark., Sørensen HT; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus University, Aarhus N, Denmark., Hatch EE; Boston University School of Public Health, Boston, Massachusetts, USA., Wise LA; Boston University School of Public Health, Boston, Massachusetts, USA., Rothman KJ; Boston University School of Public Health, Boston, Massachusetts, USA., Stanford JB; Division of Public Health, Department of Family and Preventive Medicine, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, Utah, USA., Laursen ASD; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus University, Aarhus N, Denmark.
Jazyk: angličtina
Zdroj: Paediatric and perinatal epidemiology [Paediatr Perinat Epidemiol] 2024 Aug 07. Date of Electronic Publication: 2024 Aug 07.
DOI: 10.1111/ppe.13108
Abstrakt: Background: The use of fertility indicators to predict ovulation has largely been studied for contraceptive purposes, while less so as fertility-promoting tools.
Objective: To investigate the association between fertility indicators and fecundability in Danish women trying to conceive.
Methods: Web-based preconception cohort study. We analysed data from 11,328 females aged 18-49 years trying to conceive without fertility treatment for ≤6 menstrual cycles, from the Danish SnartGravid.dk and SnartForældre.dk cohorts (2007-2023). Participants reported the use of fertility indicators (counting days since the last menstrual period, cervical fluid monitoring, urinary ovulation testing, feeling ovulation, using a smartphone fertility app and measuring basal body temperature [BBT]). Time to pregnancy was measured in menstrual cycles ascertained by self-reported pregnancy status. We estimated fecundability ratios (FR) and 95% confidence intervals (CIs) using proportional probabilities regression models adjusted for age, socio-economic position, health indicators, reproductive history and gynaecological factors.
Results: Fertility indicators were used by 63.3% of participants at study entry. Counting days was the most common (46.9%), while measuring BBT was the least (3.0%). Other indicators ranged from 17.0% to 23.6%, with 69.7% using more than one indicator. Compared with non-use, use of any fertility indicator was associated with greater fecundability (adjusted FR 1.14, 95% CI 1.08, 1.19). Cervical fluid monitoring showed the strongest association (aFR 1.46, 95% CI 1.03, 2.07), followed by urinary ovulation testing (aFR 1.35, 95% CI 1.16, 1.58) and counting days (aFR 1.18, 95% CI 1.09, 1.29). Feeling ovulation and fertility apps were modestly associated with fecundability, while measuring BBT was not associated. Sensitivity analysis restricting to ≤2 cycles of attempt time and two cycles of follow-up showed an aFR for any indicator use of 1.21 (95% CI 1.13, 1.31).
Conclusion: In this Danish preconception cohort, use of fertility indicators was associated with a higher fecundability, varying by type of indicator.
(© 2024 The Author(s). Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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