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Scime NV, Brown HK, Shea AK, Brennand EA. Association of infertility with type and timing of menopause: a prospective cohort study. Hum Reprod 2023; 38:1843-1852. [PMID: 37451681 PMCID: PMC10477942 DOI: 10.1093/humrep/dead143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
STUDY QUESTION What is the association between past infertility and the type and timing of menopause in midlife women? SUMMARY ANSWER Women with a history of infertility were more likely to experience surgical menopause overall and had elevated risk of earlier surgical menopause until age 43 years but experienced no differences in the timing of natural menopause. WHAT IS KNOWN ALREADY Infertility is experienced by 12-25% of women and is thought to reveal a propensity for poor health outcomes, such as chronic illness, later in life. However, little is known about whether infertility is linked with characteristics of the menopausal transition as women age, despite possible shared underlying pathways involving ovarian function and gynecologic disease. STUDY DESIGN, SIZE, DURATION Secondary analysis of a prospective cohort study of 13 243 midlife females recruited in Phase 1 of the Alberta's Tomorrow Project (Alberta, Canada) and followed approximately every 4 years (2000-2022). PARTICIPANTS/MATERIALS, SETTING, METHODS Data were collected through standardized self-report questionnaires. History of infertility, defined as ever trying to become pregnant for more than 1 year without conceiving, was measured at baseline. Menopause characteristics were measured at each study follow-up. Menopause type was defined as premenopause, natural menopause, surgical menopause (bilateral oophorectomy), or indeterminate menopause (premenopausal hysterectomy with ovarian conservation). Timing of natural menopause was defined as the age at 1 full year after the final menstrual period, and timing of surgical and indeterminate menopause was defined as the age at the time of surgery. We used flexible parametric survival analysis for the outcome of menopause timing with age as the underlying time scale and multinomial logistic regression for the outcome of menopause type. Multivariable models controlled for race/ethnicity, education, parity, previous pregnancy loss, and smoking. Sensitivity analyses additionally accounted for birth history, menopausal hormone therapy, body mass index, chronic medical conditions, and age at baseline. MAIN RESULTS AND THE ROLE OF CHANCE Overall, 18.2% of women reported a history of infertility. Past infertility was associated with earlier timing of surgical menopause exclusively before age 43 years (age 35: adjusted hazard ratio 3.13, 95% CI 1.95-5.02; age 40: adjusted hazard ratio 1.83, 95% CI 1.40-2.40; age 45: adjusted hazard ratio 1.13, 95% CI 0.87-1.46) as well as greater odds of experiencing surgical menopause compared to natural menopause (adjusted odds ratio 1.40, 95% CI 1.18-1.66). Infertility was not associated with the timing of natural or indeterminate menopause. LIMITATIONS, REASONS FOR CAUTION Information on the underlying cause of infertility and related interventions was not collected, which precluded us from disentangling whether associations differed by infertility cause and treatment. Residual confounding is possible given that some covariates were measured at baseline and may not have temporally preceded infertility. WIDER IMPLICATIONS OF THE FINDINGS Women with a history of infertility were more likely to experience early surgical menopause and may therefore benefit from preemptive screening and treatment for gynecologic diseases to reduce bilateral oophorectomy, where clinically appropriate, and its associated health risks in midlife. Moreover, the lack of association between infertility and timing of natural menopause adds to the emerging knowledge that diminishing ovarian reserve does not appear to be a primary biological mechanism of infertility nor its downstream implications for women's health. STUDY FUNDING/COMPETING INTEREST(S) Alberta's Tomorrow Project is only possible due to the commitment of its research participants, its staff and its funders: Alberta Health, Alberta Cancer Foundation, Canadian Partnership Against Cancer and Health Canada, and substantial in-kind funding from Alberta Health Services. The views expressed herein represent the views of the author(s) and not of Alberta's Tomorrow Project or any of its funders. This secondary analysis is funded by Project Grant Priority Funding in Women's Health Research from the Canadian Institutes of Health Research (Grant no. 491439). N.V.S. is supported by a Banting Postdoctoral Fellowship from the Canadian Institutes of Health Research. H.K.B. is supported by the Canada Research Chairs Program. E.A.B. is supported by an Early Career Investigator Award in Maternal, Reproductive, Child and Youth Health from the Canadian Institutes of Health Research. A.K.S. has received honoraria from Pfizer, Lupin, Bio-Syent, and Eisai and has received grant funding from Pfizer. N.V.S., H.K.B., and E.A.B. have no conflicts of interest to report. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Natalie V Scime
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Hilary K Brown
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Alison K Shea
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
- McMaster Institute for Research on Aging (MIRA), McMaster University, Hamilton, ON, Canada
| | - Erin A Brennand
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB, Canada
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Maksimovic JM, Vlajinac HD, Maksimovic MZ, Lalic NM, Vujcic IS, Pejovic BD, Sipetic Grujicic SB, Obrenovic MR, Kavecan II. Oral contraceptive use, coffee consumption, and other risk factors of type 2 diabetes in women: a case–control study. JOURNAL OF SUBSTANCE USE 2023. [DOI: 10.1080/14659891.2023.2173090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Jadranka M. Maksimovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Hristina D. Vlajinac
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milos Z. Maksimovic
- Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nebojsa M. Lalic
- Faculty of Medicine, Clinic for Endocrinology, Diabetes, and Metabolic Disorders, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia
| | - Isidora S. Vujcic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Branka D. Pejovic
- Department for Diabetes, Primary Health Care Centre “Savski Venac”, Belgrade, Serbia
| | | | - Milan R. Obrenovic
- Center for Medical Genetics, Institute for Children and Youth Health Care of Vojvodina, Novi Sad, Serbia
| | - Ivana I. Kavecan
- Department of Pediatrics, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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Mínguez-Alarcón L, Hammer KC, Williams PL, Souter I, Ford JB, Rexrode KM, Hauser R, Chavarro JE. Self-reported history of comorbidities and markers of ovarian reserve among subfertile women. J Assist Reprod Genet 2022; 39:2719-2728. [PMID: 36322231 PMCID: PMC9790841 DOI: 10.1007/s10815-022-02643-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/19/2022] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To investigate whether history of comorbidities is associated with markers of ovarian reserve among subfertile women. METHODS This observational study includes 645 women seeking fertility care at the Massachusetts General Hospital who enrolled in the Environment and Reproductive Health (EARTH) study (2005-2019). Women completed a comprehensive questionnaire including medical diagnosis of comorbidities. Ovarian reserve markers including antral follicle count (AFC), assessed by transvaginal ultrasound, and circulating serum levels of day 3 FSH and AMH, are assessed by immunoassays. We fit linear regression models to evaluate the association between history of comorbidities and markers of ovarian reserve while adjusting for confounders. RESULTS Self-reported history of hypertension, cancer, and neurological disorders was negatively associated with AFC in unadjusted models and in adjusted models for age, smoking, physical activity, comorbidity count, and BMI. Adjusted mean AFC (95% CI) was lower among women with history of hypertension, compared to women with no self-reported history of hypertension (11.5 vs 15.6, p value 0.0001). In contrast, day 3 FSH levels were positively related to history of eating disorders in both unadjusted and adjusted models (10.8 vs. 7.43 IU/L, p value ≤ 0.0001). Self-reported history of other comorbidities was unrelated to AFC, day 3 FSH, and AMH levels. CONCLUSIONS History of hypertension, cancer, and neurological disorders was negatively associated with AFC, and eating disorders were positively related to day 3 FSH levels. The prevention of common comorbidities among women in reproductive age may help increase women's fertility given the declining birth rates and increasing use of assisted reproductive technologies in the past years.
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Affiliation(s)
- Lidia Mínguez-Alarcón
- Channing Division of Network Medicine, Harvard Medical School & Brigham and Women's Hospital, Boston, MA, USA.
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA.
| | - Karissa C Hammer
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Paige L Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Irene Souter
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jennifer B Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA
| | - Kathryn M Rexrode
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, MA, Boston, USA
| | - Jorge E Chavarro
- Channing Division of Network Medicine, Harvard Medical School & Brigham and Women's Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Mascarenhas M, Jeve Y, Polanski L, Sharpe A, Yasmin E, Bhandari HM. Management of recurrent implantation failure: British Fertility Society policy and practice guideline. HUM FERTIL 2022; 25:813-837. [PMID: 33820476 DOI: 10.1080/14647273.2021.1905886] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Recurrent implantation failure (RIF) is defined as the absence of a positive pregnancy test after three consecutive transfers of good quality embryos. There remains significant variation in clinical practice in the management of RIF. This British Fertility Society (BFS) Policy and Practice guideline analyses the evidence for investigations and therapies that are employed in RIF and provides recommendations for clinical practice and for further research. Evidence for investigations of sperm and egg quality, uterine and adnexal factors, immunological factors and thrombophilia, endocrine conditions and genetic factors and for associated therapies have been evaluated. This guideline has been devised to assist reproductive medicine specialists and patients in making shared decisions concerning management of RIF. Finally, suggestions for research towards improving understanding and management of RIF have also been provided.
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Affiliation(s)
- Mariano Mascarenhas
- Leeds Fertility, Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Glasgow Centre for Reproductive Medicine, The Fertility Partnership, Glasgow, UK
| | - Yadava Jeve
- Birmingham Women's Fertility Centre, Birmingham Women's Hospital, Birmingham, UK
| | - Lukasz Polanski
- Assisted Conception Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Abigail Sharpe
- Leeds Fertility, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Ephia Yasmin
- Department of Women's Health, University College London Hospitals, London, UK
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Hood RB, Liang D, Tan Y, Ford J, Souter I, Jones DP, Hauser R, Gaskins AJ. Characterizing the follicular fluid metabolome: quantifying the correlation across follicles and differences with the serum metabolome. Fertil Steril 2022; 118:970-979. [PMID: 36175211 PMCID: PMC9938636 DOI: 10.1016/j.fertnstert.2022.07.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To compare the variability in metabolomes between the serum and follicular fluid, as well as across 3 dominant follicles. DESIGN Prospective cohort study. SETTING An academic fertility clinic in the northeastern United States, 2005-2015. PATIENTS One hundred thirty-five women undergoing in vitro fertilization treatment who provided a serum sample during ovarian stimulation and up to 3 follicular fluid samples during oocyte retrieval. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Samples were analyzed using liquid chromatography with high-resolution mass spectrometry and 2 chromatography columns (C18 hydrophobic negative and hydrophilic interaction chromatography [HILIC] positive). We calculated overall, feature-specific, and subject-specific correlation coefficients to describe how strongly the intensity of overlapping metabolic features were associated between the serum and follicular fluid and between the 1st-2nd, 1st-3rd, and 2nd-3rd follicles. Feature-specific correlations were adjusted for age, body mass index, infertility diagnosis, ovarian stimulation protocol, and year. RESULT(S) From the C18-negative column and the high-resolution mass spectrometry, 7,830 serum features and 10,790 follicular fluid features were detected in ≥20% of samples. After screening retention times and checking for 1:1 matching, 1,928 features overlapped between the 2 metabolomes. From the HILIC-positive column and the high-resolution mass spectrometry, after applying the same exclusion criteria, there were 9,074 serum features, 5,542 follicular fluid features, and 1,149 features that overlapped. When comparing the feature intensity of overlapping metabolites in the serum and the follicular fluid, the overall (C18, 0.45; HILIC, 0.63), median feature-specific (C18, 0.35; HILIC, 0.37), and median subject-specific (C18, 0.42; HILIC, 0.59) correlations were low to moderate. In contrast, among the overlapping features across all 3 follicles, the overall (C18, all 0.99; HILIC, all 0.99), median feature-specific (C18, 0.74-0.81; HILIC, 0.79-0.85), and median subject-specific (C18, 0.88-0.89; HILIC, 0.90-0.91) correlations between follicular fluid metabolomics features within a woman were high. CONCLUSION(S) We observed minimal overlap and weak-to-moderate correlation between metabolomic features in the serum and follicular fluid but a large overlap and strong correlation between metabolomic features across follicles within a woman. The follicular fluid appears to represent a novel matrix, distinct from serum, which may be a rich source of biologic predictors of female fertility and reproductive outcomes.
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Affiliation(s)
- Robert B Hood
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia.
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Youran Tan
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Jennifer Ford
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Irene Souter
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Dean P Jones
- Division of Pulmonary, Allergy, & Critical Care Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Russ Hauser
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Audrey J Gaskins
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
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Yan X, Feng Y, Hao Y, Zhong R, Jiang Y, Tang X, Lu D, Fang H, Agarwal M, Chen L, Zhao Y, Zhang H. Gut-Testis Axis: Microbiota Prime Metabolome To Increase Sperm Quality in Young Type 2 Diabetes. Microbiol Spectr 2022; 10:e0142322. [PMID: 36214691 PMCID: PMC9603910 DOI: 10.1128/spectrum.01423-22] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/20/2022] [Indexed: 12/30/2022] Open
Abstract
Young type 2 diabetes (T2D) affects 15% of the population, with a noted increase in cases, and T2D-related male infertility has become a serious issue in recent years. The current study aimed to explore the improvements of alginate oligosaccharide (AOS)-modified gut microbiota on semen quality in T2D. The T2D was established in young mice of 5 weeks of age with a blood glucose level of 21.2 ± 2.2 mmol/L, while blood glucose was 8.7 ± 1.1 mM in control animals. We discovered that fecal microbiota transplantation (FMT) of AOS-improved microbiota (A10-FMT) significantly decreased blood glucose, while FMT of gut microbiota from control animals (Con-FMT) did not. Sperm concentration and motility were decreased in T2D to 10% to 20% of those in the control group, while A10-FMT brought about a recovery of around 5- to 10-fold. A10-FMT significantly increased small intestinal Allobaculum, while it elevated small intestinal and cecal Lactobacillus in some extent, blood butyric acid and derivatives and eicosapentaenoic acid (EPA), and testicular docosahexaenoic acid (DHA), EPA, and testosterone and its derivatives. Furthermore, A10-FMT improved liver functions and systemic antioxidant environments. Most importantly, A10-FMT promoted spermatogenesis through the improvement in the expression of proteins important for spermatogenesis to increase sperm concentration and motility. The underlying mechanisms may be that A10-FMT increased gut-beneficial microbes Lactobacillus and Allobaculum to elevate blood and/or testicular butyric acid, DHA, EPA, and testosterone to promote spermatogenesis and thus to ameliorate sperm concentration and motility. AOS-improved gut microbes could emerge as attractive candidates to treat T2D-diminished semen quality. IMPORTANCE A10-FMT benefits gut microbiota, liver function, and systemic environment via improvement in blood metabolome, consequently to favor the testicular microenvironment to improve spermatogenesis process and to boost T2D-diminished semen quality. We established that AOS-improved gut microbiota may be used to boost T2D-decreased semen quality and metabolic disease-related male subfertility.
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Affiliation(s)
- Xiaowei Yan
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, People’s Republic of China
- College of Life Sciences, Qingdao Agricultural University, Qingdao, People’s Republic of China
| | - Yanni Feng
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, People’s Republic of China
| | - Yanan Hao
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, People’s Republic of China
- College of Life Sciences, Qingdao Agricultural University, Qingdao, People’s Republic of China
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
| | - Ruqing Zhong
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, People’s Republic of China
| | - Yue Jiang
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, People’s Republic of China
| | - Xiangfang Tang
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, People’s Republic of China
| | - Dongxin Lu
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, People’s Republic of China
- College of Life Sciences, Qingdao Agricultural University, Qingdao, People’s Republic of China
| | - Hanhan Fang
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, People’s Republic of China
- College of Life Sciences, Qingdao Agricultural University, Qingdao, People’s Republic of China
| | - Manjree Agarwal
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
- Scientific Service Division, ChemCentre, Government of Western Australia, Bentley, Australia
| | - Liang Chen
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, People’s Republic of China
| | - Yong Zhao
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, People’s Republic of China
| | - Hongfu Zhang
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, People’s Republic of China
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Soria-Contreras DC, Oken E, Tellez-Rojo MM, Rifas-Shiman SL, Perng W, Chavarro JE. History of infertility and long-term weight, body composition, and blood pressure among women in Project Viva. Ann Epidemiol 2022; 74:43-50. [PMID: 35777630 PMCID: PMC9509485 DOI: 10.1016/j.annepidem.2022.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 04/01/2022] [Accepted: 06/20/2022] [Indexed: 01/28/2023]
Abstract
PURPOSE To evaluate the association of a history of infertility with long-term weight, body composition, and blood pressure. METHODS We studied 1581 women from the prospective cohort Project Viva. History of infertility was based on self-reported time to pregnancy ≥12 months or use of medical treatment to conceive for the index or any prior pregnancy; a diagnosis of infertility; claims for infertility treatments/prescriptions abstracted from medical records. The outcomes were weight, waist circumference, and body fat assessed through 12 years postpartum; and blood pressure assessed through 3 years postpartum. We used linear mixed-effect models adjusted for age, race/ethnicity, income, education, marital status, parity, and age at menarche. RESULTS Three hundred forty-two women (21.6%) had a history of infertility. In adjusted models, women with versus without infertility, had higher average weight (3.29 kg, 95% confidence interval [CI]: 1.35-5.24), waist circumference (2.46 cm, 95% CI: 0.78-4.13) and body fat (1.76 kg, 95% CI: 0.09-3.43). Among younger (18-29 years), but not older (≥30 years) women, infertility was associated with higher systolic (4.08 mmHg, 95% CI: 0.93, 7.23) and diastolic blood pressure (2.16 mmHg, 95% CI: 0.11-4.20). CONCLUSIONS A history of infertility may serve as a marker to identify women at higher cardiometabolic risk.
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Affiliation(s)
- Diana C Soria-Contreras
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Martha Maria Tellez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Wei Perng
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
| | - Jorge E Chavarro
- Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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Mínguez-Alarcón L, Frueh L, Williams PL, James-Todd T, Souter I, Ford JB, Rexrode KM, Calafat AM, Hauser R, Chavarro JE. Pregnancy urinary concentrations of bisphenol A, parabens and other phenols in relation to serum levels of lipid biomarkers: Results from the EARTH study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 833:155191. [PMID: 35421480 PMCID: PMC9662174 DOI: 10.1016/j.scitotenv.2022.155191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 06/14/2023]
Abstract
The epidemiologic literature on associations between urinary phenol concentrations and lipid profiles during pregnancy is limited. We examined whether urinary concentrations of phenol and phenol replacement biomarkers were associated with serum lipid levels among pregnant women. This cross-sectional study included 175 women attending the Massachusetts General Hospital Fertility Center who enrolled in the Environment and Reproductive Health (EARTH) Study between 2005 and 2017 and had data available on urinary phenol biomarkers and serum lipids during pregnancy. We used linear regression models to assess the relationship between groups of urinary phenol and phenol replacement biomarkers and serum lipid levels [total cholesterol, high density lipoprotein (HDL), non-HDL, low-density lipoprotein (LDL) cholesterol, and triglycerides], while adjusting for age at sample collection, pre-pregnancy BMI, education, race, infertility diagnosis, cycle type, number of fetuses, trimester and specific gravity. In adjusted models, pregnant women with urinary propylparaben concentrations in the highest tertile had 10% [22 (95% CI = 5, 40) mg/dL], 12% [19 (95% CI = 2, 36) mg/dL] and 16% [19 (95% CI = 3, 35) mg/dL] higher mean total, non-HDL and LDL cholesterol, respectively, compared to women with concentrations in the lowest tertile. Similar elevations were observed for urinary bisphenol A concentrations. Urinary bisphenol S, benzophenone-3, triclosan, methylparaben, ethylparaben, and butylparaben were unrelated to serum lipids. Among pregnant women, urinary concentrations of bisphenol A and propylparaben were associated with higher serum levels of total, non-HDL and LDL cholesterol.
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Affiliation(s)
- Lidia Mínguez-Alarcón
- Channing Division of Network Medicine, Harvard Medical School & Brigham and Women's Hospital, Boston, USA; Department of Environmental Health Epidemiology, Boston, USA.
| | - Lisa Frueh
- Channing Division of Network Medicine, Harvard Medical School & Brigham and Women's Hospital, Boston, USA; Department of Environmental Health Epidemiology, Boston, USA
| | - Paige L Williams
- Department of Biostatistics, Boston, USA; Departments of Nutrition, Boston, USA
| | - Tamarra James-Todd
- Department of Environmental Health Epidemiology, Boston, USA; Department of Biostatistics, Boston, USA
| | - Irene Souter
- Massachusetts General Hospital Fertility Center, Harvard Medical School, Boston, MA, USA
| | - Jennifer B Ford
- Department of Environmental Health Epidemiology, Boston, USA
| | - Kathryn M Rexrode
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Russ Hauser
- Department of Environmental Health Epidemiology, Boston, USA; Department of Biostatistics, Boston, USA; Department of Obstetrics, Gynaecology and Reproductive Biology, Harvard Medical School, Boston, USA
| | - Jorge E Chavarro
- Channing Division of Network Medicine, Harvard Medical School & Brigham and Women's Hospital, Boston, USA; Department of Biostatistics, Boston, USA; Departments of Harvard T.H. Chan School of Public Health, Boston, USA
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9
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Association of Urinary Phthalate and Phthalate Replacement Metabolite Concentrations with Serum Lipid Biomarker Levels among Pregnant Women Attending a Fertility Center. TOXICS 2022; 10:toxics10060292. [PMID: 35736901 PMCID: PMC9227340 DOI: 10.3390/toxics10060292] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/21/2022] [Accepted: 05/22/2022] [Indexed: 02/06/2023]
Abstract
We examined whether urinary concentrations of phthalate and phthalate replacement metabolites were associated with lipid biomarker levels among pregnant women. This cross-sectional study included 175 women who enrolled in the Environment and Reproductive Health (EARTH) Study (2005–2017). We used linear regression models to assess the relationship between urinary phthalates and lipid biomarkers [triglycerides, total cholesterol, high density lipoprotein (HDL), non-HDL, and low-density lipoprotein (LDL) cholesterol] levels while adjusting for confounders. Pregnant women in the highest quartile of urinary mono(2-ethyl-5-carboxypentyl) phthalate (MECPP) had, overall, 14% [31 (95% CI = 6.56) mg/dL], 21% [33 (95% CI = 9.57) mg/dL] and 25% [30 (95% CI = 8.53) mg/dL] higher serum total, non-HDL and LDL cholesterol, respectively, compared to women in the lowest quartile of MECPP. Similar positive associations were found for urinary concentrations of other metabolites of di(2-ethylhexyl) phthalate, mono(2-ethylhexyl) phthalate, and mono(2-ethyl-5-oxohexyl) phthalate. Pregnant women with urinary mono-n-butyl phthalate (MBP) in the highest quartile had higher triglycerides and non-HDL cholesterol compared to women with MBP in the lowest quartile. Women with detectable concentrations of two phthalate replacement metabolites had lower HDL cholesterol compared to women with non-detectable concentrations. Gestational urinary concentrations of certain phthalate and phthalate replacement metabolites were associated with lipid levels among these women.
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Huang YM, Chien WC, Cheng CG, Chang YH, Chung CH, Cheng CA. Females with Diabetes Mellitus Increased the Incidence of Premenstrual Syndrome. Life (Basel) 2022; 12:life12060777. [PMID: 35743808 PMCID: PMC9224876 DOI: 10.3390/life12060777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/10/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Premenstrual syndrome (PMS) is a multifactorial disorder caused by hormone and autonomic imbalance. In our study, hyperglycemia-induced insulin secretion increased progesterone secretion and progressive autonomic imbalance. The young patients with diabetes mellitus (DM) revealed hypo-parasympathetic function and hypersympathetic function compared with nondiabetic controls. Young female patients with DM with higher blood sugar and autonomic malfunction may be associated with PMS. However, there is a lack of evidence about DM in females related to PMS. We evaluated female patients with DM who subsequently followed PMS in a retrospective cohort study. Methods: We retrieved data from the National Health Insurance Research Database in Taiwan. Female patients with DM between 20 and 50 years old were assessed by the International Classification of Disease, 9 Revision, Clinical Modification (ICD-9-CM) disease code of 250. Patients who were DM-free females were fourfold matched to the control group by age and disease index date. The ICD-9-CM disease code of 625.4 identified the incidence of PMS followed by the index date as events. The possible risk factors associated with PMS were detected with a Cox proportional regression. Results: DM was a significant risk factor for PMS incidence with an adjusted hazard ratio of 1.683 (95% confidence interval: 1.104−2.124, p < 0.001) in females after adjusting for age, other comorbidities, season, urbanization status of patients and the hospital status of visiting. Conclusions: This study noted an association between DM and PMS in female patients. Healthcare providers and female patients with DM must be aware of possible complications of PMS, aggressive glycemic control, decreased hyperglycemia and autonomic dysfunction to prevent this bothersome disorder.
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Affiliation(s)
- Yao-Ming Huang
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, National Defense Medical Center, Taoyuan 32549, Taiwan; (Y.-M.H.); (C.-G.C.)
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (W.-C.C.); (C.-H.C.)
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, National Defense Medical Center, Taoyuan 32549, Taiwan; (Y.-M.H.); (C.-G.C.)
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Emergency Department, Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yin-Han Chang
- Department of Psychology, National Taiwan University, Taipei 10621, Taiwan;
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (W.-C.C.); (C.-H.C.)
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence: ; Tel.: +886-2-87927173
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Powell MJ, Fuller S, Gunderson EP, Benz CC. Reduced cardiovascular risks in women with endometriosis or polycystic ovary syndrome carrying a common functional IGF1R variant. Hum Reprod 2022; 37:1083-1094. [PMID: 35362533 PMCID: PMC9071223 DOI: 10.1093/humrep/deac059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/03/2022] [Indexed: 11/28/2022] Open
Abstract
STUDY QUESTION Is the increased future cardiovascular risk seen in women with endometriosis or polycystic ovary syndrome (PCOS) mitigated by functional insulin-like growth factor-1 receptor (IGF1R) single-nucleotide polymorphism (SNP) rs2016347 as previously shown in women with hypertensive disorders of pregnancy? SUMMARY ANSWER This cohort study found that women with endometriosis or PCOS who carry a T allele of IGF1R SNP rs2016347 had a reduced future risk of developing cardiovascular disease (CVD) and associated risk factors, with risk reduction dependent on cohort era. WHAT IS KNOWN ALREADY Women with endometriosis or PCOS have been shown to have an increased future risk of CVD and associated risk factors with limited predictive ability. STUDY DESIGN, SIZE, DURATION This retrospective cohort study took place in the Nurses' Health Study 2 (NHS2), which enrolled 116 430 participants in 1989 who were followed through 2015. The study population was analyzed in its entirety, and subdivided into entry (pre-1989) and after entry (post-1989) exposure cohorts. All NHS2 participants were eligible for inclusion in the study, 9599 (8.2%) were excluded for missing covariates. PARTICIPANTS/MATERIALS, SETTING, METHODS The NHS2 enrolled female registered nurses from 14 different states who ranged in age from 25 to 42 years at study entry. Data were collected from entry and biennial questionnaires, and analysis conducted from November 2020 to June 2021. Cox proportional hazard models were used to assess risk of CVD, hypertension (HTN), hypercholesterolemia (HC) and type 2 diabetes, both with and without genotyping for rs2016347. MAIN RESULTS AND THE ROLE OF CHANCE While women without endometriosis or PCOS, as a whole, demonstrated no impact of genotype on risk in either cohort, women with endometriosis carrying a T allele had a lower risk of CVD (hazard ratio (HR), 0.48; 95% CI, 0.27-0.86, P = 0.02) and HTN (HR, 0.80; 95% CI, 0.66-0.97, P = 0.03) in the pre-1989 cohort, while those in the post-1989 cohort had a decrease in risk for HC (HR, 0.76; 95% CI, 0.62-0.94, P = 0.01). Women with PCOS in the post-1989 cohort showed a significant protective impact of the T allele on HTN (HR, 0.44; 95% CI, 0.27-0.73, P = 0.002) and HC (HR, 0.62; 95% CI, 0.40-0.95, P = 0.03). LIMITATIONS, REASONS FOR CAUTION Data on specific endometriosis lesion locations or disease stage, as well as on PCOS phenotypes were lacking. In addition, data on systemic medical treatments beyond the use of oral contraceptives were missing, and these treatments may have confounded the results. WIDER IMPLICATIONS OF THE FINDINGS These findings implicate systemic dysregulation of the insulin-like growth factor-1 axis in the development of HTN, HC and clinical CVD in endometriosis and PCOS, suggesting a common underlying pathogenetic mechanism. STUDY FUNDING/COMPETING INTEREST(S) The NHS2 infrastructure for questionnaire data collection was supported by National Institute of Health (NIH) grant U01CA176726. This work was also supported in part by NIH and National Cancer Institute grant U24CA210990; as well, research effort and publication costs were supported by the Elizabeth MA Stevens donor funds provided to the Buck Institute for Research on Aging. The authors declare they have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Mark J Powell
- Buck Institute for Research on Aging, Novato, CA, USA
| | - Sophia Fuller
- Graduate Group in Biostatistics, University of California, Berkeley, School of Public Health, Berkeley, CA, USA
| | - Erica P Gunderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
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Al-Lami RA, Taha SA, Jalloul RJ, Taylor HS. High-sensitivity C-reactive protein is not independently associated with self-reported infertility in National Health and Nutrition Examination Survey 2015–2018 data. F S Rep 2021; 3:63-70. [PMID: 35386498 PMCID: PMC8978077 DOI: 10.1016/j.xfre.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/08/2021] [Accepted: 12/16/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To study the association between high-sensitivity C-reactive protein (hs-CRP) and infertility among reproductive-age women while controlling for obesity and other metabolic markers. Previous studies found a link between infertility and cardiovascular diseases (CVDs). C-reactive protein is a sensitive marker of CVDs, and its levels are affected by obesity. Design/Setting We conducted a cross-sectional study using national data from 2015 through 2018. Patients A total of 940 women aged 20–45 years who self-reported infertility, had hs-CRP values measured, and did not have CRP >10 mg/L, asthma, arthritis, bronchitis, thyroid disease, bilateral oophorectomy, hysterectomy, and who were not breastfeeding or pregnant, premenarchal at the time of study or had menarche after the age of 20. Interventions N/A. Main outcome measure(s) Infertility status (ever reporting inability to conceive with 12 months of trying to become pregnant). Results In comparison to noninfertile women, self-reported infertile women had higher mean of hs-CRP (3.11 mg/L vs. 2.40 mg/L) and higher percentage of moderate/high hs-CRP values (77.0% vs 58.8%). However, after adjusting for metabolic markers, there was a nonsignificant association between moderate/high hs-CRP and self-reported infertility in the multivariable logistic regression analysis. Odds ratio estimates of the association between hs-CRP and infertility increased over 40% after removing obesity measures and/or high-density lipoprotein from regression models. Conclusion There was no association between hs-CRP and self-reported infertility after controlling for obesity measures and other risk factors for CVDs in a sample of U.S. women aged 20–45 years.
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Ahrenfeldt LJ, Möller S, Wensink MJ, Eisenberg ML, Christensen K, Jensen TK, Lindahl-Jacobsen R. Impaired fecundity as a marker of health and survival: a Danish twin cohort study. Hum Reprod 2021; 36:2309-2320. [PMID: 34009293 PMCID: PMC8496092 DOI: 10.1093/humrep/deab077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/05/2021] [Indexed: 12/11/2022] Open
Abstract
STUDY QUESTION Is fecundity, measured as self-reported time to first pregnancy (TTP), a marker for subsequent health and survival? SUMMARY ANSWER Long TTP was a marker for increased mortality among women and higher hospitalization rates for both women and men. WHAT IS KNOWN ALREADY Poor semen quality has been linked to increased mortality and morbidity from a wide range of diseases. Associations among fecundity, health and survival among women are still uncertain and studies on actual measures of fecundity and health outcomes are rare. STUDY DESIGN, SIZE, DURATION We performed a prospective cohort study of 7825 women and 6279 men, aged 18 and above with measures on first TTP, who participated in one of the Danish nation-wide twin surveys in 1994 (twins born 1953-1976) and 1998 (twins born 1931-1952). They were followed-up for mortality and hospital admissions from the interview until 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS Twins were identified in the Danish Twin Registry and linked to Danish registers. TTP was restricted to the first pregnancy as a categorical outcome with cut-off points at 2, 10 and 18 months. We analysed the association between TTP and survival using a Cox proportional hazards model estimating hazards ratios (HRs) with 95% confidence intervals (CIs). Fine-Gray survival models were used to estimate sub-hazard ratios for specific causes of death allowing for competing risks. Using negative binomial regression, we estimated incidence rate ratios (IRRs) with 95% CIs for all-cause and cause-specific hospitalizations. All analyses were stratified by sex and adjusted for age at interview, birth cohorts, age at first attempt to become pregnant, smoking, years in school and BMI. MAIN RESULTS AND THE ROLE OF CHANCE In the total study population, 49.9% of women and 52.7% of men reported a TTP of less than 2 months, 30.8% of women and 29.6% of men reported a TTP of 2-9 months, 6.6% of women and 5.7% of men reported a TTP of 10-17 months, and 13.3% of women and 12.0% of men reported a TTP of 18 months or more. Among 1305 deaths, we found a higher mortality for women (HR = 1.46; 95% CI 1.15, 1.87) with a TTP of ≥18 months relative to those with a TTP of <2 months, while the highest mortality was indicated for men with a TTP of 10-17 months (HR = 1.31; 95% CI 0.98, 1.74). Among 53 799 hospitalizations, we found an increased hospitalization rate among women (HR = 1.21; 95% CI 1.0-1.41) and men (HR = 1.16; 95% CI 1.00-1.35) with a TTP of ≥18 months, and for men with a TTP of 2-9 months (HR = 1.14; 95% CI 1.01-1.30). A dose-response relationship was found for women regarding both mortality (P = 0.022) and hospitalizations (P = 0.018). Impaired fecundity was associated with a wide range of diseases and some causes of death, indicating a multi-factorial causal influence on fecundity, especially among women. LIMITATIONS, REASONS FOR CAUTION A major limitation was that fecundity depends on both partners, which was not considered in this study. Moreover, we could not obtain information on a number of potential confounders. WIDER IMPLICATIONS OF THE FINDINGS Fecundity seems positively correlated with overall health and may be a universal marker of future health and survival. These results add knowledge to the limited findings showing that reduced fecundity in women and poor semen quality in men may reflect worse health and a shorter life, particularly among women. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by NIH grant HD096468 (M.L.E., T.K.J. and R.L.J.). The authors declare that they have no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- L J Ahrenfeldt
- Unit of Epidemiology, Biostatistics and
Biodemography, Department of Public Health, University of Southern
Denmark, Odense, Denmark
- The Danish Twin Registry, Department of Public
Health, University of Southern Denmark, Odense, Denmark
| | - S Möller
- OPEN—Open Patient data Explorative Network,
Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of
Southern Denmark, Odense, Denmark
| | - M J Wensink
- Unit of Epidemiology, Biostatistics and
Biodemography, Department of Public Health, University of Southern
Denmark, Odense, Denmark
- Interdisciplinary Centre on Population Dynamics
(CPop), University of Southern Denmark, Odense, Denmark
| | - M L Eisenberg
- Male Reproductive Medicine and Surgery, Department
of Urology and Obstetrics & Gynecology, Stanford University School of
Medicine, Stanford, CA, USA
| | - K Christensen
- Unit of Epidemiology, Biostatistics and
Biodemography, Department of Public Health, University of Southern
Denmark, Odense, Denmark
- The Danish Twin Registry, Department of Public
Health, University of Southern Denmark, Odense, Denmark
- Department of Clinical Biochemistry and
Pharmacology, Odense University Hospital, Odense, Denmark
- Department of Clinical Genetics, Odense University
Hospital, Odense, Denmark
| | - T K Jensen
- Department of Clinical Pharmacology, Farmacy and
Environmental Medicine, University of Southern Denmark, Odense,
Denmark
| | - R Lindahl-Jacobsen
- Unit of Epidemiology, Biostatistics and
Biodemography, Department of Public Health, University of Southern
Denmark, Odense, Denmark
- Interdisciplinary Centre on Population Dynamics
(CPop), University of Southern Denmark, Odense, Denmark
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Glycemic status and fertility-implications for preconception care. Fertil Steril 2021; 115:80. [PMID: 33413961 DOI: 10.1016/j.fertnstert.2020.10.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 11/24/2022]
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Bosdou JK, Anagnostis P, Lainas GT, Kolibianakis EM. Female Infertility and Cardiovascular Risk - A Hype or an Underestimated Reality? Curr Pharm Des 2021; 26:5551-5555. [PMID: 32954997 DOI: 10.2174/1381612826666200821114552] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 07/23/2020] [Indexed: 11/22/2022]
Abstract
Infertility may be an early indicator of later-life health risk development, such as cardiovascular disease (CVD), the leading cause of death globally. Various infertility-associated factors such as female age, polycystic ovarian syndrome, endometriosis and metabolic syndrome are also risk factors for CVD. Whether there is a real association between female infertility and CVD, given that common pathways lead to both entities, or since both female infertility and CVD share a common basis, needs to be further investigated. If such an association is confirmed, infertile women might benefit from the initiation of preventive strategies aiming to control CVD risk factors. Thus, female infertility may represent an early indicator of future CVD and concomitantly a unique opportunity to identify women at increased risk for developing CVD. It is therefore imperative that large population- based studies are performed to elucidate this issue further and promote public awareness, if necessary.
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Affiliation(s)
- Julia K Bosdou
- Unit for Human Reproduction, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis Anagnostis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Efstratios M Kolibianakis
- Unit for Human Reproduction, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Farland LV, Degnan WJ, Harris HR, Tobias DK, Missmer SA. A prospective study of endometriosis and risk of type 2 diabetes. Diabetologia 2021; 64:552-560. [PMID: 33399910 PMCID: PMC8609862 DOI: 10.1007/s00125-020-05347-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/26/2020] [Indexed: 01/16/2023]
Abstract
AIMS/HYPOTHESIS The objective of this study was to investigate the association between laparoscopically confirmed endometriosis and risk of type 2 diabetes. METHODS We used data from the Nurses' Health Study II, a prospective cohort of female nurses followed for >25 years (N = 112,037). We used Cox proportional hazards models to estimate the HRs and 95% CIs of incident, confirmed type 2 diabetes (n = 8496 participants) adjusted a priori for confounding factors. We additionally investigated differences in the relationship between endometriosis and type 2 diabetes by age (<50 or ≥50 years), BMI (<30 or ≥30 kg/m2), infertility history, menopausal status and history of gestational diabetes mellitus (GDM; restricted to parous women). RESULTS We saw no association between laparoscopically confirmed endometriosis and risk of type 2 diabetes in multivariable confounder-adjusted models (HR 1.06 [95% CI 0.98, 1.13]) or models accounting for potential mediating factors (HR 0.94 [95% CI 0.87, 1.00]). However, we observed modest differences in the association between endometriosis and type 2 diabetes by BMI group, history of infertility and history of GDM. Among non-obese women (HR 1.17 [95% CI 1.02, 1.35]), women who never experienced infertility (HR 1.14 [95% CI 1.04, 1.25]) and women who never experienced GDM (HR 1.11 [95% CI 1.01, 1.22]), endometriosis was associated with greater risk of type 2 diabetes. CONCLUSIONS/INTERPRETATION Overall, women with endometriosis were not at increased risk of type 2 diabetes. However, among subgroups at low risk for type 2 diabetes (i.e. non-obese women and women with no prior history of infertility or GDM), endometriosis was associated with a modest increased risk of type 2 diabetes.
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Affiliation(s)
- Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
| | - William J Degnan
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Holly R Harris
- Epidemiology, Public Health Science Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Deirdre K Tobias
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Stacey A Missmer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
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Bolouki A, Zal F, Bordbar H. Ameliorative effects of quercetin on folliculogenesis in diabetic mice: a stereological study. Gynecol Endocrinol 2020; 36:864-868. [PMID: 31889455 DOI: 10.1080/09513590.2019.1707796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
A high risk of reproductive disorders can be seen in diabetic pregnancy. Reproductive disorders associated with diabetes may result from alterations in the function of the ovary. In this study, we investigated the ameliorative effects of quercetin as a phytoestrogen and antidiabetic agent on the folliculogenesis in diabetic mice. Streptozotocin-induced diabetic mice were treated with 30 mg/kg/day quercetin for four weeks. The volume of ovary, follicles, and corpus luteum were significantly decreased in the diabetic mice. The number of growing follicles (secondary, antral, and Graafian follicles) and corpus luteum was significantly decreased in the diabetic mice. Also, the volume of oocytes was significantly decreased in antral and Graafian follicles. Our results indicated that the administration of quercetin in diabetic mice increased the volume of the ovary and growing follicles, the number of growing follicles and corpus luteum. It also significantly decreased the number of atretic follicles. As a result, it may be concluded that the impaired follicular growth and development caused by hyperglycemia in diabetic mice can be alleviated by quercetin treatment.
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Affiliation(s)
- Ayeh Bolouki
- Biochemistry Department, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Zal
- Biochemistry Department, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Bordbar
- Department of Anatomy, Medical School, Shiraz University of Medical Sciences, Shiraz Iran
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Creţu D, Cernea S, Onea CR, Pop RM. Reproductive health in women with type 2 diabetes mellitus. Hormones (Athens) 2020; 19:291-300. [PMID: 32613536 DOI: 10.1007/s42000-020-00225-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 06/21/2020] [Indexed: 01/12/2023]
Abstract
As type 2 diabetes mellitus (T2DM) reaches epidemic proportions in the developed world and the age at diagnosis decreases, more women of reproductive age are being affected. In this article, we provide a synoptic view on potential mechanisms and relevant factors underlying menstrual cycle disorders and fertility issues in women with T2DM. The article discusses the function of the hypothalamic-pituitary-ovarian (HPO) axis, the central role of the hypothalamus in the homeostasis of this system, the central modulators of the axis, and the peripheral metabolic signals involved in neuroendocrine control of reproduction. The available literature on the relationship between T2DM and the female reproductive lifespan, menstrual cycle disorders, fertility issues, and gestational health in women with T2DM are also discussed. The data so far indicate that there is a "U-shaped" relationship between menarche, menopause, and T2DM, both early and late menarche/menopause being risk factors for T2DM. Hyperglycemia and its consequences may be responsible for the effects of T2DM on reproductive health in women, but the exact mechanisms are not as yet fully understood; thus, more studies are needed in order to identify factors causing disruption of the HPO axis.
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Affiliation(s)
- Doina Creţu
- Mureș County Clinical Hospital, 38 Gheorghe Marinescu Street, 540139, Târgu-Mureș, Romania
| | - Simona Cernea
- Department M4/Internal Medicine IV, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu-Mureș, 38 Gheorghe Marinescu Street, 540139, Târgu-Mureș, Romania
- Diabetes, Nutrition and Metabolic Diseases Outpatient Unit, Emergency County Clinical Hospital, 50 Gheorghe Marinescu Street, 540136, Târgu-Mureş, Romania
| | - Corina Roxana Onea
- Emergency County Clinical Hospital, 50 Gheorghe Marinescu Street, 540136, Târgu-Mureş, Romania
| | - Raluca-Monica Pop
- Research Methodology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu-Mureș, 38 Gheorghe Marinescu Street, 540139, Târgu-Mureș, Romania.
- Endocrinology Department, Mureș County Clinical Hospital, 38 Gheorghe Marinescu Street, 540139, Târgu-Mureș, Romania.
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Lorzadeh N, Kazemirad N, Kazemirad Y. Human immunodeficiency: Extragonadal comorbidities of infertility in women. IMMUNITY INFLAMMATION AND DISEASE 2020; 8:447-457. [PMID: 32621331 PMCID: PMC7416027 DOI: 10.1002/iid3.327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/21/2020] [Indexed: 12/12/2022]
Abstract
Introduction Infertility is mediated by several changes system‐wide. These changes are likely to cause other systems‐related pathologies, such as changes in systemic immune response, particularly inflammatory response can lead to cardiovascular diseases and breast cancer. Methods These morbidities can exist immediately or years after the diagnosis of infertility. Therefore, understanding the mechanism is important to move toward therapeutic interventions. Results Several extragonadal pathologies are reported due to infertility, as well as, how these might also contribute to reproductive disabilities. Detailed evidence are still not present that can give stronger result. Conclusion This review highlights some of the most frequent comorbidities that are seen in infertile women, hence requiring a need for complete clinical screening and care, as well as diagnosis and treatment in early stages.
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Affiliation(s)
- Nahid Lorzadeh
- Department of Obstetrics and Gynecology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Nastaran Kazemirad
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Sun C, Rong X, Cai Y, Qiu S, Farzaneh M. Mini review: The FDA-approved prescription drugs that induce ovulation in women with ovulatory problems. Drug Dev Res 2020; 81:815-822. [PMID: 32428356 DOI: 10.1002/ddr.21687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 04/11/2020] [Accepted: 05/04/2020] [Indexed: 01/26/2023]
Abstract
Infertility is defined as not being able to become pregnant after 12 months or more of unprotected sexual intercourse. Female infertility as a serious health issue can result from ovulation disorders, menstrual cycle problems, structural problems, and environmental factors. Ovulation occurs once a month between the time of menarche and menopause. The release of a mature egg from the ovary is controlled with the hypothalamic-pituitary-ovarian axis. Several hormones such as gonadotropin-releasing hormone (GnRH), FSH (follicle-stimulating hormone), LH (luteinizing hormone), estrogen, and progesterone play fundamental roles in the ovulation process. Both FSH and LH are the main treatment for women with ovulation disorders. Depending on the reasons for infertility, several different types of treatment are available for infertile women. Fertility drugs as an important part of treatment work like the natural hormones to treat infertility. Several fertility drugs can regulate ovulation and the release of an egg from the ovary in women with polycystic ovary syndrome (PCOS) or undergoing in vitro fertilization (IVF) treatment. This mini-review is about the FDA-approved prescription drugs that induce ovulation in women with ovulatory problems.
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Affiliation(s)
- Chunlei Sun
- Pediatrics Department, Yidu Central Hospital of Weifang, Weifang, China
| | - Xi Rong
- Pharmacy Department, Yidu Central Hospital of Weifang, Weifang, China
| | - Yongqin Cai
- Gynaecology Department, Yidu Central Hospital of Weifang, Weifang, China
| | - Song Qiu
- Imaging Department of Brain Hospital, Weifang Peoples Hospital, Weifang, China
| | - Maryam Farzaneh
- Physiology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Egbe TO, Nana-Njamen T, Elong F, Tchounzou R, Simo AG, Nzeuga GP, Njamen Nana C, Manka’a E, Tchente Nguefack C, Halle-Ekane GE. Risk factors of tubal infertility in a tertiary hospital in a low-resource setting: a case-control study. FERTILITY RESEARCH AND PRACTICE 2020; 6:3. [PMID: 32161654 PMCID: PMC7059396 DOI: 10.1186/s40738-020-00073-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 02/21/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Infertility is the inability to sustain a pregnancy in a woman with regular (2-3 times per week) unprotected sexual intercourse for a period of 1 year. This is a major public health problem that remains under-recognised in Cameroon and most countries in sub-Saharan Africa. This study aimed at identifying the risk factors associated with tubal infertility in a tertiary hospital in Douala, Cameroon. METHODS We conducted a case-control study at the Obstetrics, Gynaecology and Radiology Departments of the Douala Referral Hospital from October 1, 2016, to July 30, 2017. We recruited 77 women with tubal infertility diagnosed using hysterosalpingography and 154 unmatched pregnant women served as controls. Data on socio-demographic, reproductive and sexual health, and radiologic assessments were collected using a pretested questionnaire. The data were analysed using the Statistical Package for the Social Sciences (SPSS) software version 24.0. Logistic regression models were fitted to identify demographic, reproductive health factors, surgical, medical and toxicological factors associated with tubal infertility. The adjusted odds ratios (AOR) and their 95% confidence interval were interpreted. Statistical significance set at p < 0.05. RESULTS Sixty-one per cent of respondents had secondary infertility. Following multivariate logistic regression analysis, respondents who were housewives (AOR 10.7; 95% CI: 1.68-8.41, p = 0.012), self-employed (AOR 17.1; 95% CI: 2.52-115.8, p = 0.004), with a history of Chlamydia trachomatis infection (AOR 17.1; 95% CI: 3.4-85.5, p = 0.001), with Mycoplasma infection (AOR 5.1; 95% CI: 1.19-22.02, p = 0.03), with ovarian cyst (AOR 20.5; 95% CI: 2.5-168.7, p = 0.005), with uterine fibroid (AOR 62.4; 95% CI: 4.8-803.2, p = 0.002), have undergone pelvic surgery (AOR 2.3; 95% CI: 1.0-5.5, p = 0.05), have undergone other surgeries (AOR 49.8; 95% CI: 6.2-400, p = 0.000), diabetic patients (AOR 10.5; 95% CI 1.0-113.4, p = 0.05) and those with chronic pelvic pain (AOR 7.3; 95% CI: 3.2-17.1, p = 0.000) were significantly associated with tubal infertility while the young aged from 15 to 25 (AOR 0.07; 95% CI: 0.01-0.67, 0.021), those in monogamous marriages (AOR 0.05; 95% CI: 0.003-1.02, p = 0.05), as well as those with a history of barrier contraceptive methods (condom) (AOR 0.17; 95% CI: 0.03-1.1, p = 0.06) were less likely to have tubal infertility. CONCLUSION The following factors were independently associated with tubal infertility: being a housewife, self-employed, history of Chlamydia trachomatis, Mycoplasma infection, and uterine fibroid. Furthermore, a history of pelvic surgery and other surgeries, diabetes mellitus, and chronic pelvic pain were also associated with tubal infertility. Young age, persons in monogamous marriages and users of barrier methods of contraception (condom) were less likely to have tubal infertility. Identification of these factors will be a target of intervention to avoid tubal infertility.
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Affiliation(s)
- Thomas Obinchemti Egbe
- Department of Obstetrics and Gynecology, Douala Referral Hospital, Douala, Cameroon
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Theophile Nana-Njamen
- Department of Obstetrics and Gynecology, Douala Referral Hospital, Douala, Cameroon
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Felix Elong
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | | | | | | | - Cedric Njamen Nana
- Department of Obstetrics and Gynecology, Douala Referral Hospital, Douala, Cameroon
| | | | - Charlotte Tchente Nguefack
- Department of Obstetrics and Gynecology, Douala Referral Hospital, Douala, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Gregory Edie Halle-Ekane
- Department of Obstetrics and Gynecology, Douala Referral Hospital, Douala, Cameroon
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
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Kim C, Younes N, Temprosa M, Edelstein S, Goldberg RB, Araneta MG, Wallia A, Brown A, Darwin C, Ibebuogu U, Pi-Sunyer X, Knowler WC. Infertility, Gravidity, and Risk Of Diabetes among High-Risk Women in the Diabetes Prevention Program Outcomes Study. J Clin Endocrinol Metab 2020; 105:5709621. [PMID: 31955207 PMCID: PMC7007766 DOI: 10.1210/clinem/dgaa013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 01/16/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The extent to which infertility and pregnancy independently increase risk of diabetes and subclinical atherosclerosis is not known. RESEARCH DESIGN AND METHODS We conducted a secondary analysis of Diabetes Prevention Program (DPP) and the DPP Outcomes Study over a 15-year period. We included women who answered questions about gravidity and infertility at baseline (n = 2085). Infertility was defined as > 1 year of unsuccessful attempts to conceive; thus, women could have histories of infertility as well as pregnancy. Risk of diabetes associated with gravidity and infertility was calculated using Cox proportional hazards models adjusting for age, race/ethnicity, treatment arm, body mass index, and pregnancy during the study. Among women who underwent assessment of coronary artery calcification (CAC) (n = 1337), odds of CAC were calculated using logistic regression models with similar covariates. RESULTS Among premenopausal women (n = 1075), women with histories of pregnancy and infertility (n = 147; hazard ratio [HR] 1.80; 95% confidence interval [CI] 1.30, 2.49) and women with histories of pregnancy without infertility (n = 736; HR 1.49; 95% CI 1.15, 1.93) had greater diabetes risk than nulligravid women without infertility (n = 173). Premenopausal nulligravid women with histories of infertility had a non-significant elevation in risk, although the number of these women was small (n = 19; HR 1.63; 95% CI 0.88, 3.03). Associations were not observed among postmenopausal women (n = 1010). No associations were observed between infertility or pregnancy with CAC. CONCLUSIONS Pregnancy, particularly combined with a history of infertility, confers increased risk of diabetes but not CAC among glucose-intolerant premenopausal women.
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Affiliation(s)
- Catherine Kim
- Departments of Medicine, Obstetrics & Gynecology, and Epidemiology, University of Michigan, Ann Arbor, Michigan
- Correspondence and Reprint Requests: Catherine Kim, MD, MPH, c/o the Diabetes Prevention Program Outcomes Study Coordinating Center, George Washington University Biostatistics Center, 6110 Executive Blvd. Suite 750, Rockville, Maryland 20852. E-mail:
| | - Naji Younes
- Biostatistics Center, George Washington University, Rockville, Maryland
| | - Marinella Temprosa
- Biostatistics Center, George Washington University, Rockville, Maryland
- Department of Epidemiology & Biostatistics, George Washington University, Washington, DC
| | - Sharon Edelstein
- Biostatistics Center, George Washington University, Rockville, Maryland
- Department of Epidemiology & Biostatistics, George Washington University, Washington, DC
| | | | - Maria G Araneta
- Department of Family and Preventive Medicine, University of California, San Diego, California
| | - Amisha Wallia
- Department of Medicine, Northwestern University, Chicago, Illinois
| | - Angela Brown
- Department of Medicine, Washington University, St. Louis, Missouri
| | - Christine Darwin
- Department of Medicine, University of California, Los Angeles, California
| | - Uzoma Ibebuogu
- Department of Medicine, University of Tennessee, Memphis, Tennessee
| | - Xavier Pi-Sunyer
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York City, New York
| | - William C Knowler
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Phoenix, Arizona
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Bungum AB, Glazer CH, Arendt LH, Schmidt L, Pinborg A, Bonde JP, Tøttenborg SS. Risk of hospitalization for early onset of cardiovascular disease among infertile women: a register-based cohort study. Hum Reprod 2019; 34:2274-2281. [DOI: 10.1093/humrep/dez154] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/30/2019] [Indexed: 12/23/2022] Open
Abstract
AbstractSTUDY QUESTIONIs female infertility predictive of a woman’s future risk of early cardiovascular disease (CVD)?SUMMARY ANSWERFemale infertility does not seem to be predictive of early CVD during a mean follow-up of 9 years.WHAT IS KNOWN ALREADYAssociations between infertility and comorbidity have been found in several studies, but data on the association between female infertility and risk of CVD are scarce and inconclusive.STUDY DESIGN, SIZE, DURATIONIn this nationwide cohort study, we included 87 221 women registered in the Danish National IVF register, undergoing medically assisted reproduction (MAR) between 1st of January 1994 and 31st of December 2015. The cohort was followed for incident hospitalization due to CVD in the Danish National Patient Register from enrollment to 31 December 2015. Women with a history of CVD prior to enrollment were excluded. Cox proportional hazard models with age as the underlying time scale were used to estimate hazard ratios (HR) with 95% CI of CVD among women with an infertility diagnosis, compared to women without an infertility diagnosis. All analyses were adjusted for educational attainment.PARTICIPANTS/MATERIALS, SETTING, METHODSFemale infertility and the reason for infertility was diagnosed and registered in the IVF register by specialists in Danish public and private fertility clinics since 1st of January 1994. In our cohort, 53 806 women (61.7%) were diagnosed with female factor infertility, while 33 415 (38.3%) did not have a female factor infertility diagnosis and made up the reference group.MAIN RESULTS AND THE ROLE OF CHANCEA total of 686 (1.3%) infertile women were hospitalized for CVD compared to 250 (0.7%) among women without an infertility diagnosis during a mean follow-up time of 9 years. We found no increased risk of early CVD in our analyses (adjusted HR 0.98, 95% CI: 0.85;1.14). Likewise, analyses stratified by specific infertility diagnosis, showed no risk difference.LIMITATIONS, REASONS FOR CAUTIONWe were unable to adjust for confounding parameters such as body mass index, cigarette smoking or alcohol consumption. These results may not be generalizable to infertile women who do not seek out fertility treatment, or infertile women with other lifestyle characteristics than Danish women.WIDER IMPLICATIONS OF THE FINDINGSDiagnosing female infertility or the time of MAR does not seem to be a window of opportunity where early screening for cardiovascular disease risk factors can have a prophylactic potential.STUDY FUNDING/COMPETING INTEREST(S)This study is part of the ReproUnion collaborative study, co-financed by the European Union, Interreg V ÖKS. None of the authors declare any conflict of interest.
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Affiliation(s)
- Ane Berger Bungum
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, 2400 Copenhagen NV, Denmark
| | - Clara Helene Glazer
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, 2400 Copenhagen NV, Denmark
| | - Linn Håkonsen Arendt
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Lone Schmidt
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Denmark
| | - Anja Pinborg
- Fertility Department, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, 2400 Copenhagen NV, Denmark
| | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, 2400 Copenhagen NV, Denmark
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Lv C, Chen C, Chen Q, Zhai H, Zhao L, Guo Y, Wang N. Multiple pregnancies and the risk of diabetes mellitus in postmenopausal women. Menopause 2019; 26:1010-1015. [PMID: 31453963 DOI: 10.1097/gme.0000000000001349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE We aimed to investigate whether the number of pregnancies during childbearing age was associated with diabetes in postmenopausal women with no history of gestational diabetes. METHODS Our data source was the continuous National Health and Nutrition Examination Survey 1999 to 2014. We selected 9,138 postmenopausal women over 40 years old who did not have a history of gestational diabetes during pregnancy. Logistic regression analyses were applied for the association of the number of pregnancies with diabetes. RESULTS We found women with ≥4 pregnancies had significantly greater fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), 2-hour plasma glucose, and the Homeostatic Model Assessment of Insulin Resistance than those with two to three pregnancies (all P < 0.01). These women also had a significantly higher prevalence of diabetes (28.4% vs 20.7%; P < 0.001). Using the two to three pregnancies group as the reference, we observed a positive association of log-FPG and log-HbA1c with 4 or more pregnancies after adjustment for sociodemographic, lifestyle, and reproductive factors, and body mass index (both P < 0.05). Compared to women with two to three pregnancies, the odds ratios for diabetes were 1.31 (95% confidence interval [CI] 1.01-1.71) for women who never got pregnant and 1.28 (95% CI 1.10-1.48) for those with at least 4 pregnancies after multivariate adjustment. CONCLUSIONS At least 4 pregnancies through childbearing age may be a potential risk factor for diabetes in postmenopausal women without a history of gestational diabetes.
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Affiliation(s)
- Chengjie Lv
- Department of Neonatal Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Qi Chen
- Department of Endocrinology and Metabolism, Shanghai Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hualing Zhai
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Li Zhao
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yuyu Guo
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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Monseur BC, Morris JR, Hipp HS, Berghella V. Hypertensive disorders of pregnancy and infertility treatment: a population-based survey among United States women. J Assist Reprod Genet 2019; 36:1449-1456. [PMID: 31134412 DOI: 10.1007/s10815-019-01490-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/16/2019] [Indexed: 01/16/2023] Open
Abstract
PURPOSE To explore associations between infertility treatment and hypertensive disorders of pregnancy. METHODS We collated multi-year as well as multi-state data from a national representative survey examining the association between self-reported infertility treatment (i.e., medication, intrauterine insemination, or assisted reproductive technology) and hypertensive disorders of pregnancy (i.e., high blood pressure, pregnancy-induced hypertension (PIH), preeclampsia, and toxemia). Data were analyzed using logistic regression. A total of 21,884 women in the United States (U.S.), from the Centers for Disease Control and Prevention's (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS) survey (2009-2015), participated in the study. RESULTS In our analysis, 12.91% women reported a history of infertility treatment and 15.19% reported a history of hypertensive disorder of pregnancy. Compared with women who had never had infertility treatment, women who reported infertility treatment had 1.18 (adjusted OR, 95% confidence interval (CI) 1.05, 1.33) higher odds of reporting hypertensive disorder of pregnancy. Neither types of infertility treatment nor proximity of treatment to pregnancy were independently associated with hypertensive disorder of pregnancy. CONCLUSIONS Our results suggest that among U.S. women, the treatment of infertility may be associated with hypertension disorder of pregnancy regardless of type of treatment.
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Affiliation(s)
- Brent C Monseur
- Department of Obstetrics & Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, 833 Chestnut Street, Suite 301, Philadelphia, PA, 19107, USA.
| | - Jerrine R Morris
- Department of Gynecology and Obstetrics, Emory University School of Medicine, 550 Peachtree Street, Suite 1800, Atlanta, GA, 30308, USA
| | - Heather S Hipp
- Division of Reproductive Endocrinology and Infertility, Emory University School of Medicine, 550 Peachtree Street, Suite 1800, Atlanta, GA, 30308, USA
| | - Vincenzo Berghella
- Division of Maternal Fetal Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, 833 Chestnut Street, Philadelphia, PA, 19107, USA
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Murugappan G, Li S, Lathi RB, Baker VL, Eisenberg ML. Increased risk of incident chronic medical conditions in infertile women: analysis of US claims data. Am J Obstet Gynecol 2019; 220:473.e1-473.e14. [PMID: 30710512 DOI: 10.1016/j.ajog.2019.01.214] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/10/2019] [Accepted: 01/16/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND The risk of common chronic medical conditions among infertile women is not known. OBJECTIVE The objective of the study was to study the association between female infertility and the risk of incident chronic disease. STUDY DESIGN This was a retrospective cohort analysis using the Optum deidentified Clinformatics Datamart from 2003 through 2016. A total of 64,345 infertile women were identified by infertility diagnosis, testing, or treatment and compared with 3,128,345 noninfertile patients seeking routine gynecologic care. Women with a prior diagnosis of the relevant chronic disease or cancer or with either diagnosis within 6 months of the index event were excluded. The main outcome was a diagnosis of incident chronic disease as identified by International Classification of Diseases, ninth revision/International Classification of Diseases, 10th revision codes. Results were adjusted for age, index year, nulliparity, race, smoking, obesity, number of visits per year, and highest level of education. RESULTS Infertile patients were more likely to develop diabetes (adjusted hazard risk, 1.44, confidence interval, 1.38-1.49), renal disease (adjusted hazard risk, 1.22, confidence interval, 1.12-1.32), liver disease (adjusted hazard risk, 1.25, confidence interval, 1.20-1.30), cerebrovascular disease (adjusted hazard risk, 1.26, confidence interval, 1.15-1.38), ischemic heart disease (adjusted hazard risk, 1.16, confidence interval, 1.09-1.24), other heart disease (adjusted hazard risk, 1.16, confidence interval, 1.12-1.20), and drug abuse (adjusted hazard risk, 1.24, confidence interval, 1.15-1.33) compared with noninfertile patients. Infertile patients were significantly less likely to develop alcohol abuse (adjusted hazard risk, 0.86, confidence interval, 0.79-0.95) compared with noninfertile patients. Risk associations were similar after excluding women with polycystic ovarian syndrome and premature ovarian insufficiency. In subgroup analyses of women who underwent pregnancy and childbirth during enrollment, several previously noted risk associations were attenuated compared with the overall cohort. CONCLUSION While the absolute risk of chronic disease is low, infertility is associated with an increased risk of incident chronic disease compared with a group of noninfertile women.
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Craig LB, Peck JD, Janitz AE. The prevalence of infertility in American Indian/Alaska Natives and other racial/ethnic groups: National Survey of Family Growth. Paediatr Perinat Epidemiol 2019; 33:119-125. [PMID: 30706501 PMCID: PMC6438739 DOI: 10.1111/ppe.12538] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/20/2018] [Accepted: 01/02/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The prevalence of infertility in American Indian/Alaska Native (AI/AN) populations is unknown. The objective of our study was to estimate the prevalence of infertility and impaired fecundity in the AI/AN population and other racial and ethnic groups. METHODS We analyzed female respondent data from the pooled National Survey of Family Growth (NSFG) cycles 2002, 2006-2010, and 2011-2013. We used modified Poisson regression with robust error variance accounting for survey weighting to estimate prevalence proportion ratios (PPR) and 95% confidence intervals (CI) for NSFG definitions of infertility and impaired fecundity by race and Hispanic ethnicity. RESULTS The prevalence of infertility and impaired fecundity in the pooled NSFG was 6.4% (95% CI 5.7, 7.0) and 11.0% (95% CI 11.0, 12.2), respectively. Compared to whites, blacks had a 1.45 times greater adjusted prevalence of infertility (95% CI 1.15, 1.83) and AI/ANs had a 1.37 times greater prevalence of infertility (95% CI 0.91, 2.06) compared to whites. We observed a 1.30 times greater prevalence of impaired fecundity among AI/AN (95% CI 1.04, 1.62) compared to whites. We observed no differences in impaired fecundity for black or Asian/Pacific Islander women compared to whites or for Hispanic compared to non-Hispanic women. CONCLUSIONS Inequalities in the burden of reproductive impairments among blacks and AI/AN women warrant further evaluation to identify opportunities for prevention and disparity reduction.
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Affiliation(s)
- LaTasha B Craig
- Section of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, College of Medicine, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Jennifer D Peck
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Amanda E Janitz
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
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Xu XH, Kou LC, Wang HM, Bo CM, Song XC. Genetic polymorphisms of melatonin receptors 1A and 1B may result in disordered lipid metabolism in obese patients with polycystic ovary syndrome. Mol Med Rep 2019; 19:2220-2230. [PMID: 30664204 PMCID: PMC6390034 DOI: 10.3892/mmr.2019.9872] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 11/28/2018] [Indexed: 02/07/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a condition in which a woman's levels of the sex hormones (estrogen and progesterone) are out of balance, leading to the growth of ovarian cysts. PCOS can affect the menstrual cycle, fertility, cardiac function and even appearance of women. Therefore, we aimed to explore the genetic polymorphism of the melatonin receptors 1A and 1B in obese patients with PCOS to identify a new theoretical basis for its treatment. Patients presenting with PCOS (n=359) were enrolled and classified into an obese OB-PCOS group [body mass index (BMI) of PCOS patients ≥25 kg/m2] or a nonobese NOB-PCOS group, and 215 oviduct infertile patients who experienced normal ovulation were used as the control group. All baseline characteristics, endocrine hormone levels, lipid and glucose metabolism, and insulin indices were measured. The genotypes of rs2119882 within the MTNR1A gene and of rs10830963 within the MTNR1B gene were determined by PCR-RFLP; the genotype frequency and the difference in the distribution of allele frequency were compared. For rs2119882, C allele carriers who were not diagnosed with PCOS had an increased risk of developing PCOS, and C allele carriers with PCOS had an increased risk of developing OB-PCOS. For rs10830963, G allele carriers who were not diagnosed with PCOS had an increased risk of developing PCOS. The TT genotype in rs2119882 and the CC genotype in rs10830963 were protective factors for OB-PCOS, and increased levels of LH, testosterone, and estradiol and abnormal menstruation were key risk factors for PCOS. Furthermore, the TT genotype at the rs2119882 site was the key protective factor for OB-PCOS patients. Our study found that MTNR1A rs2119882 and MTNR1B rs10830963 could increase the risk for PCOS and cause glycolipid metabolism disorder in PCOS patients.
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Affiliation(s)
- Xiu-Hua Xu
- Obstetrics and Gynecology Clinic, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
| | - Lian-Cui Kou
- Department of Blood Rheumatism, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
| | - Hai-Mei Wang
- Marketing and Customer Service, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
| | - Chun-Mei Bo
- Obstetrics and Gynecology Clinic, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
| | - Xiao-Cui Song
- Department of Reproductive Medicine, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
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Feldman B, Orbach-Zinger S, Leventer-Roberts M, Hoshen M, Dagan N, Balicer R, Eidelman LA. Maternal age and cardiovascular and metabolic disease outcomes: a retrospective cohort study using data from population-based electronic medical records. J Matern Fetal Neonatal Med 2018; 33:1853-1860. [PMID: 30278799 DOI: 10.1080/14767058.2018.1531844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: To evaluate whether a woman's age at first birth is associated with cardiovascular risk and metabolic health outcomes (cardiometabolic outcomes) by age 45.Methods: This is a retrospective, population-based cohort study that uses electronic health record data from the largest health fund in Israel. Women aged 34-39 at baseline (2004-2006) free of chronic diseases were identified as nulliparous at baseline and were followed up to 10 years (through 2016). The cohort was divided into three groups based on their age at first birth: younger parturients (ages 35-39), older parturients (ages 40-44), and never had children. The percentage of adverse pregnancy events and cardiometabolic outcomes at age 45 were compared across these three groups as well as to women in the general population. Cardiovascular risk and metabolic health outcomes were defined as: Type 2 diabetes, obesity, hypertension, cardiovascular disease, and Framingham risk score.Methods and results: Out of a group of 126,121 women aged 34-39 at baseline, 9979 were nulliparous and free of comorbidities. Over the course of the follow-up, there were 952 younger parturients and 673 older parturients who had their first birth, and 8354 women who remained persistent nulliparous. While older parturients had more adverse pregnancy events, there was no difference in rates of cardiometabolic outcomes between the two parturient groups, and they both had lower rates than the persistent nulliparous and the general population.Conclusions: Parturients free of major chronic diseases who give birth at a later age do not have increased cardiometabolic outcomes in midlife as compared to a general population of women in a large retrospective cohort. Our results may support clinicians when counseling healthy women who are seeking advice regarding delaying their first pregnancy without a tradeoff on health outcomes.
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Affiliation(s)
- Becca Feldman
- Clalit Research Institute and Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
| | - Sharon Orbach-Zinger
- Department of Anesthesia, Rabin Medical Center, Beilinson Hospital, Petach Tikvah, Israel (affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel)
| | - Maya Leventer-Roberts
- Clalit Research Institute and Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel.,Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Moshe Hoshen
- Clalit Research Institute and Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
| | - Noa Dagan
- Clalit Research Institute and Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel.,Department of Computer Science, Ben Gurion University, Be'er Sheva, Israel
| | - Ran Balicer
- Clalit Research Institute and Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel.,Department of Epidemiology, Ben Gurion University, Be'er Sheva, Israel
| | - Leonid A Eidelman
- Department of Anesthesia, Rabin Medical Center, Beilinson Hospital, Petach Tikvah, Israel (affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel)
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Gleason JL, Shenassa ED, Thoma ME. Self-reported infertility, metabolic dysfunction, and cardiovascular events: a cross-sectional analysis among U.S. women. Fertil Steril 2018; 111:138-146. [PMID: 30458992 DOI: 10.1016/j.fertnstert.2018.10.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 09/03/2018] [Accepted: 10/03/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To explore associations between infertility and metabolic syndrome, and cardiovascular events. Infertility is increasingly a public health issue, with emerging links to chronic disease. Existing literature on infertility focuses primarily on known causes, which likely excludes a substantial number of women for whom there is no known cause or formal diagnosis. DESIGN/SETTING We conducted a cross-sectional analysis examining the association between self-reported infertility (i.e., ever experiencing inability to conceive after 12 months of trying to become pregnant) and metabolic syndrome and cardiovascular events (i.e., congestive heart failure, coronary heart disease, heart attack, or stroke). Data were analyzed using multivariate logistic regression. PATIENT(S) A total of 744 U.S. women, 20-59 years of age, from the National Health and Nutrition Examination Survey (2013-2014), participated in the study. Among them, 15.7% reported ever experiencing infertility, 27.6% met the definition of metabolic syndrome, and 2.84% reported ever having a cardiovascular event. INTERVENTION(S) N/A. MAIN OUTCOME MEASURE(S) Metabolic syndrome and cardiovascular events. RESULTS Compared to women who had never experienced infertility, women who reported infertility had a 1.79 (95% confidence interval [CI] 1.04, 3.08) higher odds of reporting symptoms of metabolic syndrome and 1.83 (95% CI 1.15, 2.89) times higher odds of having experienced a cardiovascular event. Furthermore, women with self-reported infertility had a 71% higher odds of reporting a cardiovascular event after controlling for metabolic syndrome (95% CI 1.01, 3.00). CONCLUSIONS Our results suggest that among U.S. women, the experience of infertility at any point in a woman's reproductive window may be associated with later-life cardiovascular health.
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Affiliation(s)
- Jessica L Gleason
- Maternal & Child Health Program, Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland.
| | - Edmond D Shenassa
- Maternal & Child Health Program, Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland; Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island; Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland
| | - Marie E Thoma
- Maternal & Child Health Program, Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland
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WALLACE ME, BAZZANO L, ZHANG C, HARVILLE E. Fasting glucose concentrations and associations with reproductive history over 40 years of follow-up. Gynecol Endocrinol 2018; 34:724-727. [PMID: 29366358 PMCID: PMC6085868 DOI: 10.1080/09513590.2018.1431771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is the onset or first recognition of diabetes that occurs during pregnancy. We aimed to assess for trends in fasting blood glucose levels across the life-course among a cohort of women by reproductive history: nulligravid women, gravid women with and without a history of GDM. Women who had participated in the Bogalusa Heart Study as children were interviewed about their reproductive history, including GDM (n = 358). We compared fasting blood glucose (mg/dL) measured after last pregnancy (or after age 40 among nulligravid women) across reproductive history groups in linear models adjusted for prepregnancy fasting blood glucose, body mass index, race, parity, and age at outcome measure. We fit a log-Poisson model to estimate the associations with prediabetes risk after age 40. After adjustments, mean fasting glucose after age 40 was not different between gravid women without GDM history and nulligravid women. However, women with a history of GDM had mean fasting glucose 27 mg/dL greater than nulligravid women (95% CI = 12.35, 41.64). Heterogeneity by race indicated Black women with a history of GDM had disproportionately elevated mean fasting glucose after age 40. Fasting blood glucose trends over the life-course differ among women by reproductive history and race.
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Affiliation(s)
- Maeve E. WALLACE
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St. Suite 2210, New Orleans, Louisiana 70112. Phone: (504)988-7305.
| | - Lydia BAZZANO
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St. Suite 2000, New Orleans, Louisiana 70112 Phone: (504)988-7323.
| | - Cuilin ZHANG
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710 B Rockledge Drive, Bethesda, MD 20892. Phone: (301-435-6917).
| | - Emily HARVILLE
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St. Suite 2000, New Orleans, Louisiana 70112 Phone: (504)988-7327.
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Schieve LA, Drews-Botsch C, Harris S, Newschaffer C, Daniels J, DiGuiseppi C, Croen LA, Windham GC. Maternal and Paternal Infertility Disorders and Treatments and Autism Spectrum Disorder: Findings from the Study to Explore Early Development. J Autism Dev Disord 2018; 47:3994-4005. [PMID: 28900768 DOI: 10.1007/s10803-017-3283-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Previous studies of associations between ASD and conception using assisted reproductive technology (ART) are inconsistent and few studies have examined associations with other infertility treatments or infertility disorders. We examined associations between ASD and maternal/paternal infertility disorders and numerous maternal treatments among 1538 mother-child pairs in the Study to Explore Early Development, a population-based case-control study. ASD was associated with any female infertility diagnosis and several specific diagnoses: blocked tubes, endometriosis, uterine-factor infertility, and polycystic ovarian syndrome. Stratified analyses suggested associations were limited to/much stronger among second or later births. The findings were not explained by sociodemographic factors such as maternal age or education or multiple or preterm birth. ASD was not associated with ART or non-ART infertility treatments.
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Affiliation(s)
- Laura A Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Mailstop E-86, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA.
| | | | - Shericka Harris
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Mailstop E-86, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Craig Newschaffer
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Julie Daniels
- Gillings Scholl of Global Public Health, The University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Carolyn DiGuiseppi
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | | | - Gayle C Windham
- California Department of Public Health, Richmond, CA, 94804, USA
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Pérez-López FR, Martínez-Domínguez SJ, Viñas A, Pérez-Tambo R, Lafita A, Lajusticia H, Chedraui P. Endometriosis and gestational diabetes mellitus risk: a systematic review and meta-analysis. Gynecol Endocrinol 2018; 34:363-369. [PMID: 29105527 DOI: 10.1080/09513590.2017.1397115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To perform a systematic review and meta-analysis regarding endometriosis and the risk of gestational diabetes mellitus (GDM). METHODS We carried out a search of the following databases: Medline, Embase, Web of Science, Cochrane Library, Scopus, Scielo, Clinicaltrials.gov, the UK Clinical Trials Gateway, and the Australian New Zealand Clinical Trials Registry, from inception through April 28 2017, without language restrictions, in order to evaluate the effect of endometriosis over GDM risk, in women with and without endometriosis. Odds ratios (ORs) and their 95% confidence intervals (CIs) or mean differences (MDs) were calculated as effects. Methodological quality of evidence was assessed with the Newcastle-Ottawa Scale, and heterogeneity among studies with the I2 statistic. Random-effects models were used for meta-analyses, and publication bias was assessed with Egger's test. RESULTS We identified 12 studies (10 cohort and two case control studies) with a total of 48,762 pregnancies, including 3,461 with endometriosis. Endometriosis had no significant effect on GDM risk (OR =1.14; 95% CI: 0.86, 1.51; p = .35, I2 = 56%, Egger's test p = .45). Secondary outcomes (gestational age at delivery, birthweight, and Neonatal Intensive Care Unit admission) were statistically similar in women with and without endometriosis. CONCLUSIONS Better-designed studies are needed to confirm our results.
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Affiliation(s)
- Faustino R Pérez-López
- a Facultad de Medicina , Universidad de Zaragoza & Instituto Aragonés de Ciencias de la Salud (IACS) , Zaragoza , Spain
- b Department of Obstetrics and Gynecology , Lozano-Blesa University Hospital , Zaragoza , Spain
| | - Samuel J Martínez-Domínguez
- a Facultad de Medicina , Universidad de Zaragoza & Instituto Aragonés de Ciencias de la Salud (IACS) , Zaragoza , Spain
| | - Andrea Viñas
- a Facultad de Medicina , Universidad de Zaragoza & Instituto Aragonés de Ciencias de la Salud (IACS) , Zaragoza , Spain
| | - Raquel Pérez-Tambo
- a Facultad de Medicina , Universidad de Zaragoza & Instituto Aragonés de Ciencias de la Salud (IACS) , Zaragoza , Spain
| | - Alberto Lafita
- a Facultad de Medicina , Universidad de Zaragoza & Instituto Aragonés de Ciencias de la Salud (IACS) , Zaragoza , Spain
| | - Héctor Lajusticia
- a Facultad de Medicina , Universidad de Zaragoza & Instituto Aragonés de Ciencias de la Salud (IACS) , Zaragoza , Spain
| | - Peter Chedraui
- c Facultad de Ciencias Médicas , Institute of Biomedicine, Research Area for Women's Health, Universidad Católica de Santiago de Guayaquil , Guayaquil , Ecuador
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Guo P, Zhou Q, Ren L, Chen Y, Hui Y. Higher parity is associated with increased risk of Type 2 diabetes mellitus in women: A linear dose-response meta-analysis of cohort studies. J Diabetes Complications 2017; 31:58-66. [PMID: 28340964 DOI: 10.1016/j.jdiacomp.2016.10.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/13/2016] [Accepted: 10/04/2016] [Indexed: 12/16/2022]
Abstract
AIM The goal of this study is to investigate the association between higher parity and the risk of occurrence of type 2 diabetes mellitus (T2DM) in women and to quantify the potential dose-response relation. METHODS We searched MEDLINE, and EMBASE electronic databases for related cohort studies up to March 10th, 2016. Summary rate ratios (RRs) and 95% confidence intervals (CIs) for T2DM with at least 3 categories of exposure were eligible. A random-effects dose-response analysis procedure was used to study the relations between them. RESULTS After screening a total of 13,647 published studies, only 7 cohort studies (9,394 incident cases and 286,840 female participants) were found to be eligible for this meta-analysis. In the category analysis, the pooled RR for the highest number of parity vs. the lowest one was 1.42 (95% CI: 1.17-1.72, I2=71.5%, Pheterogeneity=0.002, Power=0.99). In the dose-response analysis, a noticeable linear dose-risk relation was found between parity and T2DM (Pfor nonlinearity test=0.942). For every live birth increase in parity, the combined RR was 1.06 (95% CI: 1.02-1.09, I2=84.3%, Pheterogeneity=0.003, Power=0.99). Subgroup and sensitivity analyses yielded similar results. No publication bias was found in the results. CONCLUSION This meta-analysis suggests that higher parity and the risk of T2DM show a linear relationship in women.
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Affiliation(s)
- Peng Guo
- Department of Hepatobiliary Surgery, Renmin Hospital, Hubei University of Medicine, Hubei 442000, China.
| | - Quan Zhou
- Department of Science and Education, The First People's Hospital of Changde City, Hunan, 415003, China
| | - Lei Ren
- Department of Joint Surgery, The Third Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
| | - Yu Chen
- Department of Spinal Surgery, The Third Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
| | - Yue Hui
- Department of Intensive Care Unit, Taihe Hospital, Hubei University of Medicine, Hubei, 442000, China.
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Li P, Shan Z, Zhou L, Xie M, Bao W, Zhang Y, Rong Y, Yang W, Liu L. MECHANISMS IN ENDOCRINOLOGY: Parity and risk of type 2 diabetes: a systematic review and dose-response meta-analysis. Eur J Endocrinol 2016; 175:R231-45. [PMID: 27334332 DOI: 10.1530/eje-16-0321] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 06/21/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Epidemiologic studies regarding the association between parity and risk of type 2 diabetes have yielded inconsistent results. Therefore, we performed a systematic review and dose-response meta-analysis to determine the relation between parity and type 2 diabetes risk. METHODS We searched PubMed and Embase for published epidemiologic studies that assessed the relation between parity and risk of type 2 diabetes up to 31 March 2016. A dose-response random-effects model was used to combine study-specific relative risks (RRs) and 95% confidence intervals (CIs). Potential sources of heterogeneity were explored by meta-regression and subgroup analyses. RESULTS Seven cohort studies, 1 case-control study and 9 cross-sectional studies including 296 923 participants were eligible for inclusion. The combined RR for the highest versus lowest category of parity indicated a 54% increment in type 2 diabetes risk (95% CI: 29-83%). In the cubic spline model, a nonlinear association was found between parity and risk of type 2 diabetes (P = 0.02 for nonlinearity). Compared with nulliparous women, the estimated RR (95% CI) of type 2 diabetes for women with one to seven children was 1.01 (0.96-1.07), 1.08 (1.00-1.16), 1.20 (1.12-1.30), 1.32 (1.22-1.42), 1.37 (1.27-1.48), 1.39 (1.26-1.52) and 1.39 (1.23-1.57) respectively. CONCLUSIONS Higher parity is significantly associated with an increased risk of type 2 diabetes. Further studies are warranted to fully adjust for the potential confounders and explore the causality between parity and type 2 diabetes risk.
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Affiliation(s)
- Peiyun Li
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Zhilei Shan
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Li Zhou
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Manling Xie
- Department of Pathology and Laboratory MedicineEmory University School of Medicine, Atlanta, Georgia, USA
| | - Wei Bao
- Department of EpidemiologyCollege of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Yan Zhang
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Ying Rong
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Wei Yang
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Liegang Liu
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
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Hunt PA, Sathyanarayana S, Fowler PA, Trasande L. Female Reproductive Disorders, Diseases, and Costs of Exposure to Endocrine Disrupting Chemicals in the European Union. J Clin Endocrinol Metab 2016; 101:1562-70. [PMID: 27003299 PMCID: PMC4880176 DOI: 10.1210/jc.2015-2873] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
CONTEXT A growing body of evidence suggests that endocrine-disrupting chemicals (EDCs) contribute to female reproductive disorders. OBJECTIVE To calculate the associated combined health care and economic costs attributable to specific EDC exposures within the European Union (EU). DESIGN An expert panel evaluated evidence for probability of causation using the Intergovernmental Panel on Climate Change weight-of-evidence characterization. Exposure-response relationships and reference levels were evaluated, and biomarker data were organized from carefully identified studies from the peer-reviewed literature to represent European exposure and approximate burden of disease as it occurred in 2010. Cost-of-illness estimation used multiple peer-reviewed sources. SETTING, PATIENTS AND PARTICIPANTS AND INTERVENTION Cost estimation was carried out from a societal perspective, ie, including direct costs (eg, treatment costs) and indirect costs such as productivity loss. RESULTS The most robust EDC-related data for female reproductive disorders exist for 1) diphenyldichloroethene-attributable fibroids and 2) phthalate-attributable endometriosis in Europe. In both cases, the strength of epidemiological evidence was rated as low and the toxicological evidence as moderate, with an assigned probability of causation of 20%–39%. Across the EU, attributable cases were estimated to be 56 700 and 145 000 women, respectively, with total combined economic and health care costs potentially reaching €163 million and €1.25 billion. CONCLUSIONS EDCs (diphenyldichloroethene and phthalates) may contribute substantially to the most common reproductive disorders in women, endometriosis and fibroids, costing nearly €1.5 billion annually. These estimates represent only EDCs for which there were sufficient epidemiologic studies and those with the highest probability of causation. These public health costs should be considered as the EU contemplates regulatory action on EDCs.
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Affiliation(s)
- Patricia A Hunt
- School of Molecular Biosciences (P.A.H.), Washington State University, Pullman, Washington 99164; Center for Child Health, Behavior and Development (S.S.), Seattle Children's Research Institute, Seattle, Washington 98145; Department of Pediatrics (S.S.), University of Washington, Seattle, Washington 98145; Division of Applied Medicine (P.A.F.), Institute of Medical Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland, United Kingdom; New York University (NYU) School of Medicine (L.T.), New York, New York 10016; NYU Wagner School of Public Service (L.T.), New York, New York 10012; and Education and Human Development (L.T.), Department of Nutrition, Food and Public Health, NYU Steinhardt School of Culture New York, New York, New York 10013; NYU College of Global Public Health (L.T.), New York University, New York, New York 10003
| | - Sheela Sathyanarayana
- School of Molecular Biosciences (P.A.H.), Washington State University, Pullman, Washington 99164; Center for Child Health, Behavior and Development (S.S.), Seattle Children's Research Institute, Seattle, Washington 98145; Department of Pediatrics (S.S.), University of Washington, Seattle, Washington 98145; Division of Applied Medicine (P.A.F.), Institute of Medical Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland, United Kingdom; New York University (NYU) School of Medicine (L.T.), New York, New York 10016; NYU Wagner School of Public Service (L.T.), New York, New York 10012; and Education and Human Development (L.T.), Department of Nutrition, Food and Public Health, NYU Steinhardt School of Culture New York, New York, New York 10013; NYU College of Global Public Health (L.T.), New York University, New York, New York 10003
| | - Paul A Fowler
- School of Molecular Biosciences (P.A.H.), Washington State University, Pullman, Washington 99164; Center for Child Health, Behavior and Development (S.S.), Seattle Children's Research Institute, Seattle, Washington 98145; Department of Pediatrics (S.S.), University of Washington, Seattle, Washington 98145; Division of Applied Medicine (P.A.F.), Institute of Medical Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland, United Kingdom; New York University (NYU) School of Medicine (L.T.), New York, New York 10016; NYU Wagner School of Public Service (L.T.), New York, New York 10012; and Education and Human Development (L.T.), Department of Nutrition, Food and Public Health, NYU Steinhardt School of Culture New York, New York, New York 10013; NYU College of Global Public Health (L.T.), New York University, New York, New York 10003
| | - Leonardo Trasande
- School of Molecular Biosciences (P.A.H.), Washington State University, Pullman, Washington 99164; Center for Child Health, Behavior and Development (S.S.), Seattle Children's Research Institute, Seattle, Washington 98145; Department of Pediatrics (S.S.), University of Washington, Seattle, Washington 98145; Division of Applied Medicine (P.A.F.), Institute of Medical Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland, United Kingdom; New York University (NYU) School of Medicine (L.T.), New York, New York 10016; NYU Wagner School of Public Service (L.T.), New York, New York 10012; and Education and Human Development (L.T.), Department of Nutrition, Food and Public Health, NYU Steinhardt School of Culture New York, New York, New York 10013; NYU College of Global Public Health (L.T.), New York University, New York, New York 10003
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Infertility, fertility treatment, and risk of hypertension. Fertil Steril 2015; 104:391-7. [PMID: 26049054 DOI: 10.1016/j.fertnstert.2015.04.043] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 04/07/2015] [Accepted: 04/24/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the association between infertility and fertility treatments on subsequent risk of hypertension. DESIGN Cohort study. SETTING Not applicable. PATIENT(S) A total of 116,430 female nurses, followed from 1993 to June 2011, as part of the Nurses' Health Study II cohort. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Self-reported, physician-diagnosed hypertension. RESULT(S) Compared with women who have never reported infertility, infertile women were at no greater risk of hypertension (multivariable adjusted relative risk (RR) = 1.01, with 95% confidence interval [CI] [0.94-1.07]). Infertility due to tubal disease was associated with a higher risk of hypertension (RR = 1.15 [1.01-1.31]), but no other diagnoses were associated with hypertension risk, compared with women who did not report infertility (ovulatory disorder: RR = 1.03 [0.94-1.13]; cervical: RR = 0.88 [0.70-1.10]; male factor: RR = 1.05 [0.95-1.15]; other reason: RR = 1.02 [0.94-1.11]; reason not found: RR = 1.02 [0.95-1.10]). Infertile women collectively had 5,070 cases of hypertension. No clear pattern between use of fertility treatment and hypertension was found among infertile women (clomiphene citrate: RR = 0.97 [0.90-1.04]; gonadotropin alone: RR = 0.97 [0.87-1.08]; intrauterine insemination: RR = 0.86 [0.71-1.03]; in vitro fertilization: RR = 0.86 [0.73-1.01]). CONCLUSION(S) Among this relatively young cohort of women, no apparent increase occurred in hypertension risk among infertile women, or among women who had undergone fertility treatment previously.
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Ehrlich S. Effect of fertility and infertility on longevity. Fertil Steril 2015; 103:1129-35. [DOI: 10.1016/j.fertnstert.2015.03.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 03/23/2015] [Accepted: 03/23/2015] [Indexed: 10/23/2022]
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