Preconception Perceived Stress Is Associated with Reproductive Hormone Levels and Longer Time to Pregnancy.

Background: Women who experience pregnancy loss are especially prone to high stress, though the effects of stress on reproductive outcomes in this vulnerable population are unknown. We assessed relationships between perceived stress and hormones, anovulation, and fecundability among women with prior loss.

Methods: One thousand two hundred fourteen women with 1-2 prior losses were followed for ≤6 cycles while attempting pregnancy and completed end-of-cycle stress assessments.

Associations Between Preconception Plasma Fatty Acids and Pregnancy Outcomes.

Background: Although fatty acids are involved in critical reproductive processes, the relationship between specific fatty acids and fertility is uncertain. We investigated the relationship between preconception plasma fatty acids and pregnancy outcomes.

Methods: We included 1,228 women attempting pregnancy with one to two previous pregnancy losses from the EAGeR trial (2007-2011).

A prospective study of physical activity and fecundability in women with a history of pregnancy loss.

Study Question: Is physical activity (PA) associated with fecundability in women with a history of prior pregnancy loss?

Summary Answer: Higher fecundability was related to walking among overweight/obese women and to vigorous PA in women overall.

What Is Known Already: PA may influence fecundability through altered endocrine function. Studies evaluating this association have primarily utilized Internet-based recruitment and self-report for pregnancy assessment and have yielded conflicting results.

C-Reactive protein in relation to fecundability and anovulation among eumenorrheic women.

Objective: To assess systemic inflammation in relation to fecundability and anovulation.

Design: Prospective cohort study among participants in the Effects of Aspirin in Gestation and Reproduction trial who were assigned to the placebo.

Setting: Academic medical centers.

The Effects of Aspirin in Gestation and Reproduction (EAGeR) Trial: A Story of Discovery.

Human reproduction is an inefficient process. There are several drivers of complications along the path to and during pregnancy, one of which is inflammation. Treatments to mitigate the deleterious effects of aberrant inflammation with something inexpensive and widely available like aspirin could have dramatic global impact.

Prevalence and Contributors to Low-grade Inflammation in Three U.S. Populations of Reproductive Age Women.

Background: Inflammation, measured by high-sensitivity C-reactive protein (hsCRP), is linked to adverse reproductive outcomes. However, prevalence and predictors of low-grade inflammation are poorly understood among reproductive age women. Therefore, the current aim was to characterize: (i) the prevalence of elevated hsCRP and (ii) whether the association of various demographic, anthropometric, life style, and metabolic characteristics with higher hsCRP varies across populations of reproductive age women with varying risk profiles for adverse reproductive outcomes.

Preconception Low-Dose Aspirin Restores Diminished Pregnancy and Live Birth Rates in Women With Low-Grade Inflammation: A Secondary Analysis of a Randomized Trial.

Context: Inflammation is linked to causes of infertility. Low-dose aspirin (LDA) may improve reproductive success in women with chronic, low-grade inflammation.

Objective: To investigate the effect of preconception-initiated LDA on pregnancy rate, pregnancy loss, live birth rate, and inflammation during pregnancy.

Low-Dose Aspirin and Sporadic Anovulation in the EAGeR Randomized Trial.

Context: Among women with a single, recent pregnancy loss, daily preconception low-dose aspirin (LDA) increased the live birth rate with no effect on pregnancy loss. Ovulation is a potential mechanism underlying this effect.

Objective: We estimated the effect of LDA on the per-cycle risk of anovulation among eumenorrheic women.

Association of Nausea and Vomiting During Pregnancy With Pregnancy Loss: A Secondary Analysis of a Randomized Clinical Trial.

Importance: Nausea and vomiting during pregnancy have been associated with a reduced risk for pregnancy loss. However, most prior studies enrolled women with clinically recognized pregnancies, thereby missing early losses.

Objective: To examine the association of nausea and vomiting during pregnancy with pregnancy loss.

Brief Report: Cesarean Delivery and Subsequent Fecundability.

Background: Studies have shown that cesarean delivery is associated with fewer subsequent births relative to vaginal delivery, but it is unclear whether confounding by pregnancy intention or indication for surgery explained these results. We evaluated the association between cesarean delivery and subsequent fecundability among 910 primiparous women after singleton live birth.

Methods: In a cohort of Danish women planning pregnancy (2007-2012), obstetrical history was obtained via registry linkage; time-to-pregnancy and covariate data were collected via questionnaire.

Serum caffeine and paraxanthine concentrations and menstrual cycle function: correlations with beverage intakes and associations with race, reproductive hormones, and anovulation in the BioCycle Study.

Background: Clinicians often recommend limiting caffeine intake while attempting to conceive; however, few studies have evaluated the associations between caffeine exposure and menstrual cycle function, and we are aware of no previous studies assessing biological dose via well-timed serum measurements.

Objectives: We assessed the relation between caffeine and its metabolites and reproductive hormones in a healthy premenopausal cohort and evaluated potential effect modification by race.

Design: Participants (n = 259) were followed for ≤2 menstrual cycles and provided fasting blood specimens ≤8 times/cycle.

Trying to Conceive After an Early Pregnancy Loss: An Assessment on How Long Couples Should Wait.

Objective: To compare time to pregnancy and live birth among couples with varying intervals of pregnancy loss date to subsequent trying to conceive date.

Methods: In this secondary analysis of the Effects of Aspirin in Gestation and Reproduction trial, 1,083 women aged 18-40 years with one to two prior early losses and whose last pregnancy outcome was a nonectopic or nonmolar loss were included. Participants were actively followed for up to six menstrual cycles and, for women achieving pregnancy, until pregnancy outcome.

Dietary fat intake and reproductive hormone concentrations and ovulation in regularly menstruating women.

Background: Emerging evidence suggests potential links between some dietary fatty acids and improved fertility, because specific fatty acids may affect prostaglandin synthesis and steroidogenesis.

Objective: The objective of this exploratory study was to evaluate associations between total and specific types of dietary fat intake and 1) hormone concentrations and 2) the risk of sporadic anovulation in a cohort of 259 regularly menstruating women in the BioCycle Study.

Design: Endogenous reproductive hormones were measured up to 8 times/cycle for up to 2 cycles, with visits scheduled with the use of fertility monitors.

Antimüllerian hormone and pregnancy loss from the Effects of Aspirin in Gestation and Reproduction trial.

Objective: To evaluate if antimüllerian hormone (AMH) is associated with pregnancy loss.

Design: Prospective cohort study within a block-randomized, double-blind, placebo-controlled trial of low-dose aspirin.

Setting: Not applicable.

Serum Antioxidants Are Associated with Serum Reproductive Hormones and Ovulation among Healthy Women.

Background: Evidence is growing that the equilibrium between reactive oxygen species and antioxidants plays a vital role in women's reproductive health.

Objective: The objective of this study was to evaluate variations in serum antioxidant concentrations across the menstrual cycle and associations between antioxidants and reproductive hormones and anovulation among healthy women.

Methods: The BioCycle Study, a prospective cohort, followed 259 women aged 18-44 y for up to 2 menstrual cycles.

Maternal Recall Error in Retrospectively Reported Time-to-Pregnancy: an Assessment and Bias Analysis.

Background: Epidemiologic studies of fecundability often use retrospectively measured time-to-pregnancy (TTP), thereby introducing potential for recall error. Little is known about how recall error affects the bias and precision of the fecundability odds ratio (FOR) in such studies.

Methods: Using data from the Danish Snart-Gravid Study (2007-12), we quantified error for TTP recalled in the first trimester of pregnancy relative to prospectively measured TTP among 421 women who enrolled at the start of their pregnancy attempt and became pregnant within 12 months.

Sex ratio following preconception low-dose aspirin in women with prior pregnancy loss.

Background: Several lines of evidence suggest that male embryos may have greater vulnerability than female embryos to disordered inflammation; therefore, antiinflammatory drugs, such as low-dose aspirin (LDA), may alter the sex ratio. Here, we assessed the effect of LDA on male live birth and male offspring, incorporating pregnancy losses (n = 56) via genetic assessment, as part of a parallel-design, block-randomized, placebo-controlled trial of preconception LDA.

Methods: Participants (615 treated with LDA, 613 treated with placebo) ranged in age from 18 to 40 years of age, with 1 to 2 prior pregnancy losses.

History of uterine leiomyomata and incidence of breast cancer.

Purpose: Uterine leiomyomata (UL), benign tumors of the myometrium, are influenced by sex steroid hormones. A history of UL diagnosis has been associated with a higher risk of uterine malignancies. The relation between UL and breast cancer, another hormonally responsive cancer, has not been studied.

Dietary factors and luteal phase deficiency in healthy eumenorrheic women.

Study Question: Are prospectively assessed dietary factors, including overall diet quality, macronutrients and micronutrients, associated with luteal phase deficiency (LPD) in healthy reproductive aged women with regular menstrual cycles?

Summary Answer: Mediterranean Diet Score (MDS), fiber and isoflavone intake were positively associated with LPD while selenium was negatively associated with LPD after adjusting for age, percentage body fat and total energy intake.

What Is Known Already: LPD may increase the risk of infertility and early miscarriage. Prior research has shown positive associations between LPD and low energy availability, either through high dietary restraint alone or in conjunction with high energy expenditure via exercise, but few studies with adequate sample sizes have been conducted investigating dietary factors and LPD among healthy, eumenorrheic women.

Active and passive smoking and fecundability in Danish pregnancy planners.

Objective: To investigate the extent to which fecundability is associated with active smoking, time since smoking cessation, and passive smoking.

Design: Prospective cohort study.

Setting: Denmark, 2007-2011.

Prospective study of dietary fat and risk of uterine leiomyomata.

Background: Uterine leiomyomata (UL) are the primary indication for hysterectomy and are 2-3 times more common in black than white women. High dietary fat intake has been associated with increased endogenous concentrations of estradiol, a sex steroid hormone that is known to influence UL risk.

Objective: We assessed the relation of dietary fat intake (total, subtypes, and selected food sources) with UL incidence.

African ancestry and genetic risk for uterine leiomyomata.

Rates of uterine leiomyomata (UL) are 2-3 times higher in African Americans than in European Americans. It is unclear whether inherited factors explain the ethnic disparity. To investigate the presence of risk alleles for UL that are highly differentiated in frequency between African Americans and European Americans, the authors conducted an admixture-based genome-wide scan of 2,453 UL cases confirmed by ultrasound or surgery in the Black Women's Health Study (1997-2009), a national prospective cohort study.

Association of intrauterine and early life factors with uterine leiomyomata in black women.

Purpose: Uterine leiomyomata (UL) are the primary indication for hysterectomy and are 2-3 times more common in black than white women. Previous studies indicate that early life may be a critical time window of susceptibility to UL. We assessed the association of UL with selected intrauterine and early life factors, expanding on previous research by using a prospective design and validated data on exposure and disease.

Predictors of recall certainty of dates of analgesic medication use in pregnancy.

Purpose: Recalled dates of medication use are difficult to validate, particularly for over-the-counter (OTC) medications. We evaluated mothers' recall certainty as an approximation of the accuracy of their recalled exposures.

Methods: We used data from the Slone Epidemiology Center Birth Defects Study collected by retrospective interview of women about pregnancy medication use.