Menstrual cycle characteristics and fecundability in a North American preconception cohort
Wesselink, AK., Wise, LA., Hatch, EE., Rothman, K., Mikkelsen, EM., Stanford, JB., McKinnon, CJ., & Mahalingaiah, S. (2016). Menstrual cycle characteristics and fecundability in a North American preconception cohort. Annals of Epidemiology, 26(7), 482-487.e1. Advance online publication. https://doi.org/10.1016/j.annepidem.2016.05.006
PURPOSE: The aim of this study was to evaluate the association between menstrual cycle characteristics in early life and adulthood and fecundability.
METHODS: Pregnancy Study Online (PRESTO) is an Internet-based preconception cohort study of pregnancy planners from the United States and Canada. During the preconception period, we enrolled 2189 female pregnancy planners aged 21-45 years who had been attempting conception for ≤6 cycles. Women self-reported menstrual cycle characteristics via an online baseline questionnaire, and pregnancy status was ascertained through bimonthly follow-up questionnaires. Proportional probabilities models were used to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs), adjusting for potential confounders.
RESULTS: Compared with usual menstrual cycle lengths of 27-29 days, cycle lengths of <25 (FR = 0.81, 95% CI: 0.54-1.22) and 25-26 days (FR = 0.92, 95% CI: 0.75-1.14) were associated with reduced fecundability. Compared with women who reached menarche at the age of 12-13 years, those who reached menarche at <12 years had reduced fecundability (FR = 0.87, 95% CI: 0.76-0.99). Women whose cycles never regularized after menarche (FR = 0.93, 95% CI: 0.81-1.06) had slightly reduced fecundability compared with women whose cycles regularized within 2 years of menarche. Bleed length and heaviness of bleeding were not appreciably associated with fecundability.
CONCLUSIONS: Menstrual cycle characteristics, specifically cycle length and age at menarche, may act as markers of fertility potential among pregnancy planners.