Couples attempting to conceive have approximately a 1 in 7 chance of being infertile at one year. Unfortunately, no validated markers exist to predict future infertility for couples initiating or delaying the process of reproduction. Despite limited supporting evidence, markers of ovarian aging are being measured at doctor's offices and in commercial home kits as a method of assessing women's fertility. Our long term goal is to examine the ability of markers of ovarian aging to predict infertility in the general population. The objective of this small, exploratory study is to determine the extent to which markers of ovarian aging associate with fecundability (probability of conception per cycle) in a reproductive age population of unknown fertility potential. Findings from this study will be used to select the number, timing, and choice of markers for predictive testing in a future, larger cohort. The proposed study will enroll 100 women from the community, who desire to conceive, and obtain baseline measures of ovarian aging: early follicular phase serum follicle stimulating hormone, inhibin B, and anti-mullerian hormone. Participants will be actively followed throughout their attempts to conceive over the following six months. During that time, women will collect urine during the early follicular phase of each cycle for FSH measurement, conduct up to two home pregnancy tests per cycle for standardized pregnancy determination, and complete a daily diary for up to three menstrual cycles for collection of detailed exposure data. These methods will allow us to address our primary research aims: (1) generate preliminary estimates of the association between fecundability and markers of ovarian aging and (2) determine the cycle-to-cycle variation in an individual's markers of ovarian aging. The primary tools for the proposed study including a web-based diary system, computer-assisted interviews, data management and quality control systems, and experienced staff are in place, assuring feasibility. A simple, validated measure of reproductive potential would be of significant benefit to women, who are considering initiating or delaying childbearing. Given that unproven home urinary kits are already being marketed, a prospective study to determine their ability to predict fecundability and fertility in the general population is essential.

Public Health Relevance

Couples attempting to conceive have approximately a 1 in 7 chance of being infertile at one year, resulting in significant distress and anxiety. A simple, validated measure of reproductive potential would be of major benefit to women, who are considering initiating or delaying childbearing. Given that unproven home urinary """"""""fertility test"""""""" kits are already being marketed, a prospective study to determine their ability to predict fecundability and fertility in the general population is imperative.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21HD060229-02
Application #
7843448
Study Section
Infectious Diseases, Reproductive Health, Asthma and Pulmonary Conditions Study Section (IRAP)
Program Officer
Taymans, Susan
Project Start
2009-05-15
Project End
2012-04-30
Budget Start
2010-05-01
Budget End
2012-04-30
Support Year
2
Fiscal Year
2010
Total Cost
$184,737
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Obstetrics & Gynecology
Type
Schools of Medicine
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Steiner, Anne Z; Pritchard, David; Stanczyk, Frank Z et al. (2017) Association Between Biomarkers of Ovarian Reserve and Infertility Among Older Women of Reproductive Age. JAMA 318:1367-1376
Crawford, Natalie M; Pritchard, David A; Herring, Amy H et al. (2017) Prospective evaluation of luteal phase length and natural fertility. Fertil Steril 107:749-755
Crawford, Natalie M; Fenton, Suzanne E; Strynar, Mark et al. (2017) Effects of perfluorinated chemicals on thyroid function, markers of ovarian reserve, and natural fertility. Reprod Toxicol 69:53-59
Crawford, Natalie M; Pritchard, David A; Herring, Amy H et al. (2016) Prospective evaluation of the impact of intermenstrual bleeding on natural fertility. Fertil Steril 105:1294-1300
Casilla-Lennon, Marianne M; Meltzer-Brody, Samantha; Steiner, Anne Z (2016) The effect of antidepressants on fertility. Am J Obstet Gynecol 215:314.e1-5
Steiner, Anne Z; Jukic, Anne Marie Z (2016) Impact of female age and nulligravidity on fecundity in an older reproductive age cohort. Fertil Steril 105:1584-1588.e1
Mesen, Tolga B; Mersereau, Jennifer E; Kane, Jennifer B et al. (2015) Optimal timing for elective egg freezing. Fertil Steril 103:1551-6.e1-4
Steiner, Anne Z; Pritchard, David A; Young, Steven L et al. (2014) Peri-implantation intercourse lowers fecundability. Fertil Steril 102:178-82
Su, H I; Flatt, S W; Natarajan, L et al. (2013) Impact of breast cancer on anti-mullerian hormone levels in young women. Breast Cancer Res Treat 137:571-7
Evans-Hoeker, Emily; Pritchard, David A; Long, D Leann et al. (2013) Cervical mucus monitoring prevalence and associated fecundability in women trying to conceive. Fertil Steril 100:1033-1038.e1

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