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Self-reported history of comorbidities and markers of ovarian reserve among subfertile women

  • Reproductive physiology and disease
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

To investigate whether history of comorbidities is associated with markers of ovarian reserve among subfertile women.

Methods

This observational study includes 645 women seeking fertility care at the Massachusetts General Hospital who enrolled in the Environment and Reproductive Health (EARTH) study (2005–2019). Women completed a comprehensive questionnaire including medical diagnosis of comorbidities. Ovarian reserve markers including antral follicle count (AFC), assessed by transvaginal ultrasound, and circulating serum levels of day 3 FSH and AMH, are assessed by immunoassays. We fit linear regression models to evaluate the association between history of comorbidities and markers of ovarian reserve while adjusting for confounders.

Results

Self-reported history of hypertension, cancer, and neurological disorders was negatively associated with AFC in unadjusted models and in adjusted models for age, smoking, physical activity, comorbidity count, and BMI. Adjusted mean AFC (95% CI) was lower among women with history of hypertension, compared to women with no self-reported history of hypertension (11.5 vs 15.6, p value 0.0001). In contrast, day 3 FSH levels were positively related to history of eating disorders in both unadjusted and adjusted models (10.8 vs. 7.43 IU/L, p value ≤ 0.0001). Self-reported history of other comorbidities was unrelated to AFC, day 3 FSH, and AMH levels.

Conclusions

History of hypertension, cancer, and neurological disorders was negatively associated with AFC, and eating disorders were positively related to day 3 FSH levels. The prevention of common comorbidities among women in reproductive age may help increase women’s fertility given the declining birth rates and increasing use of assisted reproductive technologies in the past years.

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Acknowledgements

The authors gratefully acknowledge all members of the EARTH study team, specifically the Harvard T. H. Chan School of Public Health research staff Myra Keller, Ramace Dadd, and Alex Azevedo, physicians and staff at Massachusetts General Hospital Fertility Center. A special thanks to all of the study participants.

Funding

The project was financed by Grants (R01ES022955, R01ES033651, R01ES009718, and P30ES000002) from the National Institutes of Health.

Author information

Authors and Affiliations

  1. Channing Division of Network Medicine, Harvard Medical School & Brigham and Women’s Hospital, Boston, MA, USA

    Lidia Mínguez-Alarcón & Jorge E. Chavarro

  2. Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA

    Lidia Mínguez-Alarcón, Jennifer B. Ford & Russ Hauser

  3. Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Karissa C. Hammer & Irene Souter

  4. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Paige L. Williams, Russ Hauser & Jorge E. Chavarro

  5. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Paige L. Williams

  6. Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Kathryn M. Rexrode

  7. Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, MA, Boston, USA

    Russ Hauser

  8. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Jorge E. Chavarro

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  1. Lidia Mínguez-Alarcón
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Corresponding author

Correspondence to Lidia Mínguez-Alarcón.

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This study was approved by the applicable institutional review boards and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki.

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Not applicable. Study data was de-identified.

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Mínguez-Alarcón, L., Hammer, K.C., Williams, P.L. et al. Self-reported history of comorbidities and markers of ovarian reserve among subfertile women. J Assist Reprod Genet 39, 2719–2728 (2022). https://doi.org/10.1007/s10815-022-02643-5

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