Sub fecundity (difficulty conceiving a pregnancy) is a pressing public health problem. Approximately 6.7 million (11%) U.S. women of reproductive age have impaired fecundity and 1.5 million are infertile. Moreover, women are delaying child-bearing to older ages. It is well-known that risk of sub fecundity and adverse reproductive outcomes increases with age. With more women attempting pregnancy at older ages, it is increasingly important to understand modifiable risk factors for adverse reproductive outcomes in this population. Small studies have reported detrimental effects of low vitamin D levels on reproduction, but large population-based human data are lacking. The objective of this project is to examine the role of vitamin D in human female reproductive function, among women over 30 years of age, with the ultimate goal of evaluating the potential of vitamin D as a modifiable risk factor for sub fecundity. To accomplish this objective we will first investigate predictors of baseline vitamin D and the accuracy of embryonic growth measurement (K99) and apply the results of this investigation to the assessment of vitamin D in reproduction (R00). This research will capitalize on an ongoing R01 study of fecundity, Time to Conceive. Time to Conceive is a prospective, cohort study of women attempting to become pregnant. During each menstrual cycle participants test their urine for ovulation. Women that conceive undergo an early pregnancy ultrasound. This proposal has three specific aims, 1) identify predictors of baseline vitamin D levels in a cohort of late reproductive age women (K99), 2) to identify factors that influence early embryonic growth and assess the bias produced by those factors in currently-used ultrasound dating methods (K99), and 3) to elucidate the role of vitamin D in female reproductive function by quantifying its associations with sub fecundity (as measured by time to pregnancy), anti-Mullerian hormone, follicle stimulating hormone, menstrual cycle length, and embryonic growth (R00). To achieve these aims the circulating metabolite of vitamin D, 25-hydroxyvitamin D (25(OH) D), will be measured in blood spots take early in a woman's attempt to become pregnant and again in blood spots drawn in early pregnancy (7-9 weeks gestation). This project will provide the first comprehensive examination of vitamin D and early reproduction in a healthy population-based study. This proposal fits well with the candidate's long-term research interest of examining the physiologic basis of infertility and identifying modifiable factors (including nutritional factors) that can improve the probability of conception for women. The completion of this project will provide pilot data for a subsequent R01 application when the candidate transitions to an independent academic position. Through this project the candidate will receive training in nutritional epidemiology and nutritional biochemistry.

Public Health Relevance

With more women attempting pregnancy for the first time at older ages, it is increasingly important to understand modifiable risk factors for infertility, miscarriage and growth restriction. Small studies have reported detrimental effects of low vitamin D levels on reproduction, but large population-based human data are lacking. This proposal aims to clarify the effects of vitamin D on fertility and early pregnancy development, in healthy women over age 30.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Transition Award (R00)
Project #
5R00HD079659-03
Application #
9130038
Study Section
Special Emphasis Panel (NSS)
Program Officer
Eisenberg, Esther
Project Start
2015-08-01
Project End
2018-07-31
Budget Start
2016-08-01
Budget End
2017-07-31
Support Year
3
Fiscal Year
2016
Total Cost
Indirect Cost
Name
Yale University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
Larsen, Sandra; Haavaldsen, Camilla; Bjelland, Elisabeth Krefting et al. (2018) Placental weight and birthweight: the relations with number of daily cigarettes and smoking cessation in pregnancy. A population study. Int J Epidemiol 47:1141-1150
Jukic, Anne Marie Z; Wilcox, Allen J; McConnaughey, D Robert et al. (2018) 25-Hydroxyvitamin D and Long Menstrual Cycles in a Prospective Cohort Study. Epidemiology 29:388-396
Eskild, Anne; Monkerud, Lars; Jukic, Anne Marie et al. (2018) Maternal concentrations of human chorionic gonadotropin (hCG) and risk for cerebral palsy (CP) in the child. A case control study. Eur J Obstet Gynecol Reprod Biol 228:203-208
Lyttle Schumacher, Brianna M; Jukic, Anne Marie Z; Steiner, Anne Z (2018) Antimüllerian hormone as a risk factor for miscarriage in naturally conceived pregnancies. Fertil Steril 109:1065-1071.e1
Jukic, Anne Marie Z; Hoofnagle, Andrew N; Lutsey, Pamela L (2018) Measurement of Vitamin D for Epidemiologic and Clinical Research: Shining Light on a Complex Decision. Am J Epidemiol 187:879-890
Jukic, Anne Marie Z; Baird, Donna D; Wilcox, Allen J et al. (2018) 25-Hydroxyvitamin D (25(OH)D) and biomarkers of ovarian reserve. Menopause 25:811-816
Dypvik, Johanne; Larsen, Sandra; Haavaldsen, Camilla et al. (2017) Placental weight in the first pregnancy and risk for preeclampsia in the second pregnancy: A population-based study of 186 859 women. Eur J Obstet Gynecol Reprod Biol 214:184-189
Chin, Helen B; Baird, Donna D; McConnaughey, D Robert et al. (2017) Long-term Recall of Pregnancy-related Events. Epidemiology 28:575-579
Jukic, Anne Marie Z; Upson, Kristen; Harmon, Quaker E et al. (2016) Increasing serum 25-hydroxyvitamin D is associated with reduced odds of long menstrual cycles in a cross-sectional study of African American women. Fertil Steril 106:172-179.e2
Jukic, Anne Marie Z; McConnaughey, D Robert; Weinberg, Clarice R et al. (2016) Long-term Recall of Time to Pregnancy. Epidemiology 27:705-11

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