Plasma glycemic measures and fecundability in a Singapore preconception cohort study

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Authors:

See Ling Loy, Ph.D., Chee Wai Ku, M.R.C.O.G., Ada En Qi Lai, Xin Hui Choo, Angela Hui Min Ho, Yin Bun Cheung, Ph.D., Keith M. Godfrey, Ph.D., Yap-Seng Chong, M.R.C.O.G., Peter D. Gluckman, D.Sc., Lynette Pei-Chi Shek, F.R.C.P.C.H., Kok Hian Tan, F.R.C.O.G., Fabian Kok Peng Yap, F.R.C.P.C.H., Shiao-Yng Chan, F.R.C.O.G., Ph.D., Jerry Kok Yen Chan, F.R.C.O.G., Ph.D.

Abstract:

Objective

To examine the association between plasma glycemia in women attempting to conceive and fecundability, as measured by time to pregnancy.


Design

Prospective preconception population-based study.


Setting

Hospital.


Patient(s)

Asian preconception women, 18–45 years old, attempting conception for ≤12 cycles at study entry.


Intervention(s)

None.


Main Outcome Measure(s)

We ascertained time to pregnancy within a year of glycemic assessment in menstrual cycles. We estimated fecundability ratios (FRs) and 95% confidence intervals using discrete-time proportional hazards models, adjusting for age, ethnicity, education, body mass index, and cycle regularity and accounting for left truncation and right censoring.


Result(s)

We studied a population sample of 766 women from the Singapore Preconception Study of Long-Term Maternal and Child Outcomes prospective cohort. Compared with women with normoglycemia, women with dysglycemia (prediabetes and diabetes, defined by the American Diabetes Association) had a lower FR (0.56). Compared with the respective lowest quintiles, women in the highest quintile of fasting glucose (≥5.1 mmol/L) had an FR of 0.60, while women in the highest 2-hour postload glucose quintile (≥6.9 mmol/L) had an FR of 0.66. Overall, the FRs decreased generally across the range of fasting and 2-hour plasma glucose. Glycated hemoglobin was not associated with fecundability.


Conclusion(s)

Increasing preconception plasma glucose is associated with reduced fecundability, even within the normal range of glucose concentrations.


Clinical Trial Registration Number

NCT03531658.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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