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Article ; Online: Female dietary patterns and outcomes of in vitro fertilization (IVF): a systematic literature review.

Sanderman, Elizabeth A / Willis, Sydney K / Wise, Lauren A

2022 Volume 21, Issue 1, Page(s) 5

Abstract: Background: Infertility affects up to 15% of couples. In vitro fertilization (IVF) treatment has modest success rates and some factors associated with infertility and poor treatment outcomes are not modifiable. Several studies have assessed the ... ...

Abstract	Background: Infertility affects up to 15% of couples. In vitro fertilization (IVF) treatment has modest success rates and some factors associated with infertility and poor treatment outcomes are not modifiable. Several studies have assessed the association between female dietary patterns, a modifiable factor, and IVF outcomes with conflicting results. We performed a systematic literature review to identify female dietary patterns associated with IVF outcomes, evaluate the body of evidence for potential sources of heterogeneity and methodological challenges, and offer suggestions to minimize heterogeneity and bias in future studies. Methods: We performed systematic literature searches in EMBASE, PubMed, CINAHL, and Cochrane Central Register of Controlled Trials for studies with a publication date up to March 2020. We excluded studies limited to women who were overweight or diagnosed with PCOS. We included studies that evaluated the outcome of pregnancy or live birth. We conducted an initial bias assessment using the SIGN 50 Methodology Checklist 3. Results: We reviewed 3280 titles and/or titles and abstracts. Seven prospective cohort studies investigating nine dietary patterns fit the inclusion criteria. Higher adherence to the Mediterranean diet, a 'profertility' diet, or a Dutch 'preconception' diet was associated with pregnancy or live birth after IVF treatment in at least one study. However, causation cannot be assumed. Studies were potentially hindered by methodological challenges (misclassification of the exposure, left truncation, and lack of comprehensive control for confounding) with an associated risk of bias. Studies of the Mediterranean diet were highly heterogenous in findings, study population, and methods. Remaining dietary patterns have only been examined in single and relatively small studies. Conclusions: Future studies with rigorous and more uniform methodologies are needed to assess the association between female dietary patterns and IVF outcomes. At the clinical level, findings from this review do not support recommending any single dietary pattern for the purpose of improving pregnancy or live birth rates in women undergoing IVF treatment.
MeSH term(s)	Female ; Fertilization in Vitro/methods ; Humans ; Live Birth/epidemiology ; Ovulation Induction/methods ; Pregnancy ; Pregnancy Rate ; Prospective Studies
Language	English
Publishing date	2022-01-18
Publishing country	England
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2091602-4
ISSN	1475-2891 ; 1475-2891
ISSN (online)	1475-2891
ISSN	1475-2891
DOI	10.1186/s12937-021-00757-7
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Female dietary patterns and outcomes of in vitro fertilization (IVF): a systematic literature review

Sanderman, Elizabeth A. / Willis, Sydney K. / Wise, Lauren A.

Nutr J. 2022 Dec., v. 21, no. 1 p.5-5

2022

Abstract: BACKGROUND: Infertility affects up to 15% of couples. In vitro fertilization (IVF) treatment has modest success rates and some factors associated with infertility and poor treatment outcomes are not modifiable. Several studies have assessed the ... ...

Abstract	BACKGROUND: Infertility affects up to 15% of couples. In vitro fertilization (IVF) treatment has modest success rates and some factors associated with infertility and poor treatment outcomes are not modifiable. Several studies have assessed the association between female dietary patterns, a modifiable factor, and IVF outcomes with conflicting results. We performed a systematic literature review to identify female dietary patterns associated with IVF outcomes, evaluate the body of evidence for potential sources of heterogeneity and methodological challenges, and offer suggestions to minimize heterogeneity and bias in future studies. METHODS: We performed systematic literature searches in EMBASE, PubMed, CINAHL, and Cochrane Central Register of Controlled Trials for studies with a publication date up to March 2020. We excluded studies limited to women who were overweight or diagnosed with PCOS. We included studies that evaluated the outcome of pregnancy or live birth. We conducted an initial bias assessment using the SIGN 50 Methodology Checklist 3. RESULTS: We reviewed 3280 titles and/or titles and abstracts. Seven prospective cohort studies investigating nine dietary patterns fit the inclusion criteria. Higher adherence to the Mediterranean diet, a ‘profertility’ diet, or a Dutch ‘preconception’ diet was associated with pregnancy or live birth after IVF treatment in at least one study. However, causation cannot be assumed. Studies were potentially hindered by methodological challenges (misclassification of the exposure, left truncation, and lack of comprehensive control for confounding) with an associated risk of bias. Studies of the Mediterranean diet were highly heterogenous in findings, study population, and methods. Remaining dietary patterns have only been examined in single and relatively small studies. CONCLUSIONS: Future studies with rigorous and more uniform methodologies are needed to assess the association between female dietary patterns and IVF outcomes. At the clinical level, findings from this review do not support recommending any single dietary pattern for the purpose of improving pregnancy or live birth rates in women undergoing IVF treatment.
Keywords	Mediterranean diet ; eating habits ; females ; overweight ; pregnancy ; risk
Language	English
Dates of publication	2022-12
Size	p. 5.
Publishing place	BioMed Central
Document type	Article ; Online
Note	Review
ZDB-ID	2091602-4
ISSN	1475-2891
ISSN	1475-2891
DOI	10.1186/s12937-021-00757-7
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Article ; Online: Sleep and female reproduction.

Willis, Sydney Kaye / Hatch, Elizabeth Elliott / Wise, Lauren Anne

Current opinion in obstetrics & gynecology

2019 Volume 31, Issue 4, Page(s) 222–227

Abstract: Purpose of review: Sleep disturbances are increasing in prevalence in North America. There is growing evidence that poor sleep quality and short sleep duration may adversely affect circadian rhythms, which in turn may affect female reproduction. The ... ...

Abstract	Purpose of review: Sleep disturbances are increasing in prevalence in North America. There is growing evidence that poor sleep quality and short sleep duration may adversely affect circadian rhythms, which in turn may affect female reproduction. The objective of this review is to evaluate recent literature on the association between sleep disturbances and female reproduction. Recent findings: There is accumulating evidence that sleep quality and duration are important for female reproduction, but epidemiologic research is limited. Recent studies provide suggestive evidence that sleep disorders are associated with increased menstrual irregularity, subfertility/infertility, and poor pregnancy and birth outcomes. Mechanisms underlying these associations are likely to be multifactorial and complex. In addition to genetics, circadian disruption may impact reproductive outcomes through dysregulation of the hypothalamic-pituitary-adrenal axis, insulin resistance, oxidative stress, and systemic inflammation. Recommendations for future studies include: use of prospective study designs; assessment of populations not already experiencing reproductive disorders; more detailed and accurate assessments of sleep such as validated self-reported measures or objective sleep measures (e.g. actigraphy); comprehensive assessment of potential confounders and mediators; and elucidation of biologic mechanisms. Summary: There is a growing body of literature showing evidence that sleep disturbances influence female reproduction, although further epidemiologic research is needed.
MeSH term(s)	Abortion, Spontaneous ; Circadian Rhythm ; Female ; Fertility ; Humans ; Hypothalamo-Hypophyseal System ; Infertility, Female/complications ; Male ; Menstrual Cycle ; Menstruation Disturbances/complications ; Pituitary-Adrenal System ; Pregnancy ; Pregnancy Outcome ; Reproduction ; Sleep ; Sleep Wake Disorders/complications
Language	English
Publishing date	2019-05-10
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	1049382-7
ISSN	1473-656X ; 1040-872X
ISSN (online)	1473-656X
ISSN	1040-872X
DOI	10.1097/GCO.0000000000000554
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Article: Identifying barriers to accessing skilled maternal health care in rural Morocco.

Baayd, Jami / Simonsen, Sara E / Stanford, Joseph B / Willis, Sydney K / Frost, Caren J

African journal of reproductive health

2021 Volume 25, Issue 1, Page(s) 20–28

Abstract: Over the past 30 years, the Moroccan government has made enormous strides towards improving maternal health care for Moroccan women, but outcomes for rural women remain much worse than those of their urban counterparts. This study aimed to understand the ...

Abstract	Over the past 30 years, the Moroccan government has made enormous strides towards improving maternal health care for Moroccan women, but outcomes for rural women remain much worse than those of their urban counterparts. This study aimed to understand the experiences of women giving birth in rural Morocco, and to identify the barriers they face when accessing facility-based maternity care. Fifty-five participants were recruited from villages in Morocco's rural south to participate in focus group discussions (FGDs), using appreciative inquiry as the guiding framework. Several themes emerged from the analysis of the focus group data. Women felt well-cared for and safe giving birth both at home and in the large, tertiary care hospitals, but not in the small, primary care hospitals. Women who gave birth at the primary care hospitals reported a shortage of some equipment and supplies and poor treatment at the hands of hospital staff. Locating and paying for transportation was identified as the biggest hurdle in accessing maternity care at any hospital. The findings of this study indicate the need for change within primary care health facilities.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Female ; Focus Groups ; Health Knowledge, Attitudes, Practice ; Health Services Accessibility/statistics & numerical data ; Healthcare Disparities ; Home Childbirth ; Humans ; Maternal Health ; Maternal Health Services/organization & administration ; Maternal Health Services/statistics & numerical data ; Midwifery ; Patient Acceptance of Health Care ; Pregnancy ; Qualitative Research ; Quality of Health Care ; Rural Population
Language	English
Publishing date	2021-06-02
Publishing country	Nigeria
Document type	Journal Article
ZDB-ID	2111906-5
ISSN	1118-4841
ISSN	1118-4841
DOI	10.29063/ajrh2021/v25i1.3
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Article ; Online: Characterization of an

De Vitto, Humberto / Belfon, Kafi K J / Sharma, Nandini / Toay, Sarah / Abendroth, Jan / Dranow, David M / Lukacs, Christine M / Choi, Ryan / Udell, Hannah S / Willis, Sydney / Barrera, George / Beyer, Olive / Li, Teng Da / Hicks, Katherine A / Torelli, Andrew T / French, Jarrod B

Biochemistry

2024

Abstract: Thiamin and its phosphate derivatives are ubiquitous molecules involved as essential cofactors in many cellular processes. ... ...

Abstract	Thiamin and its phosphate derivatives are ubiquitous molecules involved as essential cofactors in many cellular processes. The
Language	English
Publishing date	2024-02-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	1108-3
ISSN	1520-4995 ; 0006-2960
ISSN (online)	1520-4995
ISSN	0006-2960
DOI	10.1021/acs.biochem.3c00640
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Article ; Online: Fecundability in relation to use of mobile computing apps to track the menstrual cycle.

Stanford, Joseph B / Willis, Sydney K / Hatch, Elizabeth E / Rothman, Kenneth J / Wise, Lauren A

Human reproduction (Oxford, England)

2020 Volume 35, Issue 10, Page(s) 2245–2252

Abstract: Study question: To what extent does the use of mobile computing apps to track the menstrual cycle and the fertile window influence fecundability among women trying to conceive?: Summary answer: After adjusting for potential confounders, use of any of ...

Abstract	Study question: To what extent does the use of mobile computing apps to track the menstrual cycle and the fertile window influence fecundability among women trying to conceive? Summary answer: After adjusting for potential confounders, use of any of several different apps was associated with increased fecundability ranging from 12% to 20% per cycle of attempt. What is known already: Many women are using mobile computing apps to track their menstrual cycle and the fertile window, including while trying to conceive. Study design, size, duration: The Pregnancy Study Online (PRESTO) is a North American prospective internet-based cohort of women who are aged 21-45 years, trying to conceive and not using contraception or fertility treatment at baseline. Participants/materials, setting, methods: We restricted the analysis to 8363 women trying to conceive for no more than 6 months at baseline; the women were recruited from June 2013 through May 2019. Women completed questionnaires at baseline and every 2 months for up to 1 year. The main outcome was fecundability, i.e. the per-cycle probability of conception, which we assessed using self-reported data on time to pregnancy (confirmed by positive home pregnancy test) in menstrual cycles. On the baseline and follow-up questionnaires, women reported whether they used mobile computing apps to track their menstrual cycles ('cycle apps') and, if so, which one(s). We estimated fecundability ratios (FRs) for the use of cycle apps, adjusted for female age, race/ethnicity, prior pregnancy, BMI, income, current smoking, education, partner education, caffeine intake, use of hormonal contraceptives as the last method of contraception, hours of sleep per night, cycle regularity, use of prenatal supplements, marital status, intercourse frequency and history of subfertility. We also examined the impact of concurrent use of fertility indicators: basal body temperature, cervical fluid, cervix position and/or urine LH. Main results and the role of chance: Among 8363 women, 6077 (72.7%) were using one or more cycle apps at baseline. A total of 122 separate apps were reported by women. We designated five of these apps before analysis as more likely to be effective (Clue, Fertility Friend, Glow, Kindara, Ovia; hereafter referred to as 'selected apps'). The use of any app at baseline was associated with 20% increased fecundability, with little difference between selected apps versus other apps (selected apps FR (95% CI): 1.20 (1.13, 1.28); all other apps 1.21 (1.13, 1.30)). In time-varying analyses, cycle app use was associated with 12-15% increased fecundability (selected apps FR (95% CI): 1.12 (1.04, 1.21); all other apps 1.15 (1.07, 1.24)). When apps were used at baseline with one or more fertility indicators, there was higher fecundability than without fertility indicators (selected apps with indicators FR (95% CI): 1.23 (1.14, 1.34) versus without indicators 1.17 (1.05, 1.30); other apps with indicators 1.30 (1.19, 1.43) versus without indicators 1.16 (1.06, 1.27)). In time-varying analyses, results were similar when stratified by time trying at study entry (<3 vs. 3-6 cycles) or cycle regularity. For use of the selected apps, we observed higher fecundability among women with a history of subfertility: FR 1.33 (1.05-1.67). Limitations, reasons for caution: Neither regularity nor intensity of app use was ascertained. The prospective time-varying assessment of app use was based on questionnaires completed every 2 months, which would not capture more frequent changes. Intercourse frequency was also reported retrospectively and we do not have data on timing of intercourse relative to the fertile window. Although we controlled for a wide range of covariates, we cannot exclude the possibility of residual confounding (e.g. choosing to use an app in this observational study may be a marker for unmeasured health habits promoting fecundability). Half of the women in the study received a free premium subscription for one of the apps (Fertility Friend), which may have increased the overall prevalence of app use in the time-varying analyses, but would not affect app use at baseline. Most women in the study were college educated, which may limit application of results to other populations. Wider implications of the findings: Use of a cycle app, especially in combination with observation of one or more fertility indicators (basal body temperature, cervical fluid, cervix position and/or urine LH), may increase fecundability (per-cycle pregnancy probability) by about 12-20% for couples trying to conceive. We did not find consistent evidence of improved fecundability resulting from use of one specific app over another. Study funding/competing interest(s): This research was supported by grants, R21HD072326 and R01HD086742, from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, USA. In the last 3 years, Dr L.A.W. has served as a fibroid consultant for AbbVie.com. Dr L.A.W. has also received in-kind donations from Sandstone Diagnostics, Swiss Precision Diagnostics, FertilityFriend.com and Kindara.com for primary data collection and participant incentives in the PRESTO cohort. Dr J.B.S. reports personal fees from Swiss Precision Diagnostics, outside the submitted work. The remaining authors have nothing to declare. Trial registration number: N/A.
MeSH term(s)	Adult ; Child ; Female ; Humans ; Menstrual Cycle ; Middle Aged ; Mobile Applications ; Pregnancy ; Prospective Studies ; Retrospective Studies ; Time-to-Pregnancy ; Young Adult
Language	English
Publishing date	2020-09-10
Publishing country	England
Document type	Journal Article ; Observational Study ; Research Support, N.I.H., Extramural
ZDB-ID	632776-x
ISSN	1460-2350 ; 0268-1161 ; 1477-741X
ISSN (online)	1460-2350
ISSN	0268-1161 ; 1477-741X
DOI	10.1093/humrep/deaa176
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Article ; Online: Peri-implantation intercourse does not lower fecundability.

Stanford, Joseph B / Hansen, Jared L / Willis, Sydney K / Hu, Nan / Thomas, Alun

Human reproduction (Oxford, England)

2020 Volume 35, Issue 9, Page(s) 2107–2112

Abstract: Study question: Does sexual intercourse in the implantation time window (5-9 days after ovulation) reduce fecundability?: Summary answer: After adjustment for intercourse in the fecund window and clustering by couple, there was no association between ...

Abstract	Study question: Does sexual intercourse in the implantation time window (5-9 days after ovulation) reduce fecundability? Summary answer: After adjustment for intercourse in the fecund window and clustering by couple, there was no association between intercourse in the implantation time window and fecundity. What is known already: Previous research has suggested an association between intercourse in the peri-implantation time window (5-9 days after estimated ovulation) and reduced fecundability. Study design, size, duration: We used data from the FERTILI study, a prospective observational study conducted in five European countries, with data collected from 1992 to 1996. Participants/materials, setting, methods: Women who were experienced in fertility awareness tracking kept a daily diary of cervical mucus observations, basal body temperature measurements, coitus and clinically identified pregnancy. We estimated the day of ovulation as cycle length minus 13 days. From 661 women, 2606 cycles had intercourse during the fecund window (from 5 days before to 3 days after the estimated day of ovulation), resulting in 418 pregnancies (conception cycles). An established Bayesian fecundability model was used to estimate the fecundability ratio (FR) of peri-implantation intercourse on fecundability, while adjusting for each partner's age, prior pregnancy, the couple's probability of conception and intercourse pattern(s). We conducted sensitivity analyses estimating ovulation as cycle length minus 12 days, or alternatively, as the peak day of estrogenic cervical mucus. Main results and the role of chance: There was no effect of peri-implantation intercourse on fecundability: adjusted FR for three or more acts of peri-implantation intercourse versus none: 1.00, 95% credible interval: 0.76-1.13. Results were essentially the same with sensitivity analyses. There was an inverse relationship between frequency of intercourse in the fecund window and intercourse in the peri-implantation window. Limitations, reasons for caution: Women with known subfertility were excluded from this study. Many couples in the study were avoiding pregnancy during much of the study, so 61% of otherwise eligible cycles in the database were not at meaningful risk of pregnancy and did not contribute to the analysis. Some couples may not have recorded all intercourse. Wider implications of the findings: We believe the current balance of evidence does not support a recommendation for avoiding intercourse in the peri-implantation period among couples trying to conceive. Study funding/competing interest(s): No external funding. The authors have no potential competing interests. Trial registration number: N/A.
MeSH term(s)	Bayes Theorem ; Coitus ; Embryo Implantation ; Europe ; Female ; Fertility ; Humans ; Pregnancy ; Time-to-Pregnancy
Language	English
Publishing date	2020-07-29
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	632776-x
ISSN	1460-2350 ; 0268-1161 ; 1477-741X
ISSN (online)	1460-2350
ISSN	0268-1161 ; 1477-741X
DOI	10.1093/humrep/deaa156
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Article ; Online: Dietary patterns and fecundability in 2 prospective preconception cohorts.

Willis, Sydney K / Hatch, Elizabeth E / Laursen, Anne Sd / Wesselink, Amelia K / Mikkelsen, Ellen M / Tucker, Katherine L / Rothman, Kenneth J / Mumford, Sunni L / Wise, Lauren A

The American journal of clinical nutrition

2023 Volume 116, Issue 5, Page(s) 1441–1451

Abstract: Background: Diet is increasingly recognized as an important determinant of human fertility, with most research focused on specific nutrients or food groups. However, there has been limited assessment of the effect of dietary patterns on fertility.: ... ...

Abstract	Background: Diet is increasingly recognized as an important determinant of human fertility, with most research focused on specific nutrients or food groups. However, there has been limited assessment of the effect of dietary patterns on fertility. Objectives: We evaluated the association between 4 dietary patterns [the alternative Mediterranean Diet (aMed), the Healthy Eating Index-2010 (HEI-2010), the Danish Dietary Guidelines (DDGI), and the Dietary Inflammatory Index (DII)] and fecundability in 2 preconception cohorts of couples trying to conceive: SF (SnartForaeldre.dk) in Denmark and PRESTO (Pregnancy Study Online) in North America. Methods: Participants completed a baseline questionnaire on sociodemographic, anthropometric, and lifestyle factors and, 10 d later, a validated cohort-specific FFQ. We used data from these respective FFQs to calculate adherence to each dietary pattern. Participants completed bimonthly follow-up questionnaires for ≤12 mo or until pregnancy, whichever came first. We restricted analyses to 3429 SF and 5803 PRESTO participants attempting pregnancy for ≤6 cycles at enrollment. We used proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% CIs, adjusting for potential confounders. Results: Greater DII, indicative of a less anti-inflammatory diet (i.e., poorer diet quality), was associated with reduced fecundability in both SF and PRESTO (DII ≥ -1.5 compared with < -3.3: FR: 0.83; 95% CI: 0.71, 0.97 and FR: 0.82; 95% CI: 0.73, 0.93, respectively). In PRESTO, greater adherence to the aMed or to the HEI-2010 was associated with greater fecundability. In SF, there was no appreciable association between the aMed and fecundability, whereas greater adherence to the DDGI was associated with greater fecundability. Conclusions: In prospective preconception cohort studies from Denmark and North America, higher-quality diets, including diets lower in inflammatory effects, were associated with greater fecundability.
MeSH term(s)	Pregnancy ; Female ; Humans ; Prospective Studies ; Fertility ; North America ; Diet
Language	English
Publishing date	2023-02-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	280048-2
ISSN	1938-3207 ; 0002-9165
ISSN (online)	1938-3207
ISSN	0002-9165
DOI	10.1093/ajcn/nqac213
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Article ; Online: Bystander Prevention for Sexual Violence: #HowIWillChange and Gaps in Twitter Discourse.

Harlow, Alyssa F / Willis, Sydney K / Smith, Meghan L / Rothman, Emily F

Journal of interpersonal violence

2018 Volume 36, Issue 11-12, Page(s) NP5753–NP5771

Abstract: Twitter has rapidly gained popularity as a space for the public to discuss sexual violence (SV) prevention due to a number of high-profile SV cases. This study aimed to examine Twitter discourse on SV prevention through the hashtag #HowIWillChange, which ...

Abstract	Twitter has rapidly gained popularity as a space for the public to discuss sexual violence (SV) prevention due to a number of high-profile SV cases. This study aimed to examine Twitter discourse on SV prevention through the hashtag #HowIWillChange, which encouraged Twitter users to come forward and report plans to engage in bystander prevention. We analyzed 1,493 #HowIWillChange tweets from October 2017 through a directed content analysis approach rooted in an evidence-based framework for the continuum of bystander intervention. We assessed emergent themes around how Twitter users discuss SV to identify gaps and misinformation in public Twitter discourse. Although Twitter users discussed a range of prevention strategies, misinformation was also spread, including perpetuation of the myth that only strangers commit rape, that only male children need lessons on consent, and that SV prevention vilifies men. These results can inform health promotion programs aiming to educate the public on bystander prevention.
MeSH term(s)	Child ; Communication ; Humans ; Male ; Rape ; Sex Offenses ; Sexual Behavior ; Social Media
Language	English
Publishing date	2018-10-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	2028900-5
ISSN	1552-6518 ; 0886-2605
ISSN (online)	1552-6518
ISSN	0886-2605
DOI	10.1177/0886260518808854
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Article: Pesticide residue intake from fruits and vegetables and fecundability in a North American preconception cohort study

Wesselink, Amelia K / Hatch, Elizabeth E / Rothman, Kenneth J / Willis, Sydney K / Orta, Olivia R / Wise, Lauren A

Environment international. 2020 June, v. 139

2020

Abstract: Intake of conventionally-grown fruits and vegetables with higher levels of pesticide residue contamination has been associated with poorer semen quality and lower probability of live birth among couples undergoing fertility treatment. We examined the ... ...

Abstract	Intake of conventionally-grown fruits and vegetables with higher levels of pesticide residue contamination has been associated with poorer semen quality and lower probability of live birth among couples undergoing fertility treatment. We examined the association between dietary intake of pesticide residues and fecundability, the per cycle probability of conception, in a preconception cohort of pregnancy planners. We enrolled women aged 21–45 years who were attempting to conceive without use of fertility treatment into Pregnancy Study Online (PRESTO) from June 2013 through September 2019. Participants completed a baseline questionnaire on demographics, lifestyle factors, and medical and reproductive histories, and bimonthly follow-up questionnaires for up to 12 months or until reported conception. Ten days after baseline, participants completed the National Cancer Institute’s Diet History Questionnaire II, a validated food frequency questionnaire. Using data from the USDA Pesticide Data Program, we classified fruits and vegetables as having high or low pesticide residues using a validated method. We examined the relation between greater intake of high- and low-pesticide residue fruits and vegetables with fecundability using proportional probabilities regression models, adjusted for potential confounders and accounting for consumption of organic produce. We restricted our analysis to 5234 women who had been attempting conception for ≤6 cycles at study entry, and further stratified by pregnancy attempt time at study entry (<3 vs. 3–6 cycles) to evaluate potential for reverse causation. Intakes of high- and low-pesticide residue fruits and vegetables were not appreciably related to fecundability in the full sample, or among women trying to conceive for <3 cycles at study entry. However, among women trying to conceive for 3–6 cycles at study entry, both high- and low-pesticide residue fruit and vegetable intakes were strongly inversely related to fecundability, indicating potential reverse causation bias. These results do not support the hypothesis that intake of pesticide residues from conventionally-grown fruits and vegetables is harmful to fertility, although non-differential exposure misclassification may have attenuated our findings.
Keywords	USDA ; cohort studies ; conception ; demographic statistics ; food frequency questionnaires ; food intake ; fruits ; lifestyle ; organic foods ; pesticide residues ; pesticides ; pregnancy ; probability ; regression analysis ; semen quality ; vegetables ; women
Language	English
Dates of publication	2020-06
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	554791-x
ISSN	1873-6750 ; 0160-4120
ISSN (online)	1873-6750
ISSN	0160-4120
DOI	10.1016/j.envint.2020.105693
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