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Ebdrup NH, Schullehner J, Knudsen UB, Liew Z, Thomsen AML, Lyngsø J, Bay B, Arendt LH, Clemmensen PJ, Sigsgaard T, Hansen B, Ramlau-Hansen CH. Drinking water nitrate and risk of pregnancy loss: a nationwide cohort study. Environ Health 2022; 21:87. [PMID: 36114546 PMCID: PMC9479399 DOI: 10.1186/s12940-022-00897-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 09/01/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Nitrate contamination is seen in drinking water worldwide. Nitrate may pass the placental barrier. Despite suggestive evidence of fetal harm, the potential association between nitrate exposure from drinking water and pregnancy loss remains to be studied. We aimed to investigate if nitrate in drinking water was associated with the risk of pregnancy loss. METHODS We conducted a nationwide cohort study of 100,410 pregnancies (enrolled around gestational week 11) in the Danish National Birth Cohort (DNBC) during 1996-2002. Spontaneous pregnancy losses before gestational week 22 were ascertained from the Danish National Patient Registry and DNBC pregnancy interviews. Using the national drinking water quality-monitoring database Jupiter, we estimated the individual and time-specific nitrate exposure by linking geocoded maternal residential addresses with water supply areas. The nitrate exposure was analyzed in spline models using a log-transformed continuous level or classified into five categories. We used Cox proportional hazards models to estimate associations between nitrate and pregnancy loss and used gestational age (days) as the time scale, adjusting for demographic, health, and lifestyle variables. RESULTS No consistent associations were found when investigating the exposure as a categorical variable and null findings were also found in trimester specific analyses. In the spline model using the continuous exposure variable, a modestly increased hazard of pregnancy loss was observed for the first trimester at nitrate exposures between 1 and 10 mg/L, with the highest. adjusted hazard ratio at 5 mg/L of nitrate of 1.16 (95% CI: 1.01, 1.34). This trend was attenuated in the higher exposure ranges. CONCLUSION No association was seen between drinking water nitrate and the risk of pregnancy loss when investigating the exposure as a categorical variable. When we modelled the exposure as a continuous variable, a dose-dependent association was found between drinking water nitrate exposure in the first trimester and the risk of pregnancy loss. Very early pregnancy losses were not considered in this study, and whether survival bias influenced the results should be further explored.
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Affiliation(s)
- Ninna Hinchely Ebdrup
- Department of Obstetrics and Gynecology, Horsens Fertility Clinic, Horsens, Denmark.
- Department of Public Health, Aarhus University, Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Jörg Schullehner
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Geological Survey of Denmark and Greenland, Aarhus, Denmark
| | - Ulla Breth Knudsen
- Department of Obstetrics and Gynecology, Horsens Fertility Clinic, Horsens, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Anne Marie Ladehoff Thomsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM - Public Health & Health Services Research, Central Denmark Region, Aarhus, Denmark
| | - Julie Lyngsø
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Bjørn Bay
- Department of Obstetrics and Gynecology, Horsens Fertility Clinic, Horsens, Denmark
- Maigaard Fertility Clinic, Aarhus, Denmark
| | - Linn Håkonsen Arendt
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Torben Sigsgaard
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-Based Research Aarhus University, Aarhus, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus, Denmark
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Ebdrup NH, Riis AH, Ramlau-Hansen CH, Bay B, Lyngsø J, Rytter D, Jørgensen MJ, Knudsen UB. Healthcare Use in the Five Years Before a First Infertility Diagnosis: A Danish Register-Based Case–Control Study in the CROSS-TRACKS Cohort. Clin Epidemiol 2022; 14:677-688. [PMID: 35586868 PMCID: PMC9109896 DOI: 10.2147/clep.s360292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose Infertility may affect somatic and mental health later in life. Nevertheless, health status before diagnosed infertility is sparsely studied in women. We aimed to describe healthcare use in primary and secondary care before a first infertility diagnosis and compare use between cases and controls. Materials and Methods The case–control study was based on register data and used incidence density sampling. From the CROSS-TRACKS Cohort, we included women residing in the Horsens area in Denmark in 2012–2018 (n = 54,175). Eligible women were aged 18–40 years, nulliparous, and living in heterosexual relationships. Cases were women with a first infertility diagnosis in the Danish National Patient Registry (index date). Five controls were matched on age, birth year, and calendar time. Through linkage to Danish national health registries, we identified general practitioner (GP) attendance, paraclinical examinations, hospital contacts, diagnoses, and redeemed prescriptions. Healthcare use from one year to five years before index date was compared with conditional logistic regression. Results We identified 711 cases and 3555 controls. At one year before index date, cases consulted their GP (odds ratio (OR) = 5.2, 95% confidence interval (CI): 3.2, 8.3) and visited hospital (OR = 1.2, 95% CI: 1.0, 1.4) and redeemed prescriptions (OR = 2.3 95% CI: 1.9, 2.7) more often compared to controls. Cases more often had blood and hemoglobin tests performed, redeemed more drugs related to genitourinary and hormonal diseases, and were more often diagnosed with endocrine and genitourinary diseases in the year before a first infertility diagnosis compared to controls. Cases and controls had comparable healthcare use from five years to one year before a first infertility diagnosis. Conclusion Cases and controls had similar healthcare use from five years to one year before a first infertility diagnosis. However, cases had a higher healthcare use in the year preceding a first infertility diagnosis compared to controls.
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Affiliation(s)
- Ninna Hinchely Ebdrup
- Department of Obstetrics and Gynecology, Fertility Clinic, Horsens Regional Hospital, Horsens, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Correspondence: Ninna Hinchely Ebdrup, Department of Obstetrics and Gynecology, Fertility Clinic, Horsens Regional Hospital, Sundvej 30, Horsens, 8700, Denmark, Tel +45 28 47 21 11, Email
| | - Anders Hammerich Riis
- Department of Research, Regional Hospital Horsens, Horsens, Denmark
- Enversion A/S, Aarhus, Denmark
| | | | - Bjørn Bay
- Department of Obstetrics and Gynecology, Fertility Clinic, Horsens Regional Hospital, Horsens, Denmark
- Maigaard Fertility Clinic, Aarhus, Denmark
| | - Julie Lyngsø
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Dorte Rytter
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Ulla Breth Knudsen
- Department of Obstetrics and Gynecology, Fertility Clinic, Horsens Regional Hospital, Horsens, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Ebdrup NH, Knudsen UB, Schullehner J, Arendt LH, Liew Z, Lyngsø J, Bay B, Clemmensen PJ, Sigsgaard T, Hansen B, Ramlau-Hansen CH. Nitrate in Drinking Water and Time to Pregnancy or Medically Assisted Reproduction in Women and Men: A Nationwide Cohort Study in the Danish National Birth Cohort. Clin Epidemiol 2022; 14:475-487. [PMID: 35444467 PMCID: PMC9014114 DOI: 10.2147/clep.s354926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/24/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose No studies have investigated if drinking water nitrate affects human fecundity. Experimental studies point at detrimental effects on fetal development and on female and male reproduction. This cohort study aimed to explore if female and male preconception and long-term exposure to nitrate in drinking water was associated with fecundability measured as time to pregnancy (TTP) or use of medically assisted reproduction (MAR) treatment. Methods The study population consisted of pregnant women recruited in their first trimester in 1996–2002 to the Danish National Birth Cohort. Preconception drinking-water nitrate exposure was estimated for the pregnant women (89,109 pregnancies), and long-term drinking water nitrate exposure was estimated from adolescence to conception for the pregnant women (77,474 pregnancies) and their male partners (62,000 pregnancies) by linkage to the national drinking water quality-monitoring database Jupiter. Difference in risk of TTP >12 months or use of MAR treatment between five exposure categories and log-transformed continuous models of preconception and long-term nitrate in drinking water were estimated. Binominal regression models for risk ratios (RR) were adjusted for age, occupation, education, population density, and lifestyle factors. Results Nitrate in drinking water (median preconception exposure: 1.9 mg/L; median long-term exposure: 3.3 mg/L) was not associated with TTP >12 months or use of MAR treatment, neither in the categorical nor in the continuous models. Conclusion We found no association between preconception or long-term exposure to drinking water nitrate and fecundability.
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Affiliation(s)
- Ninna Hinchely Ebdrup
- Department of Obstetrics and Gynecology, Horsens Regional Hospital, Horsens, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Correspondence: Ninna Hinchely Ebdrup, Department of Obstetrics and Gynecology, Horsens Regional Hospital, Regionshospitalet Horsens, Sundvej 30, Horsens, 8700, Denmark, Tel +4528472111, Email
| | - Ulla Breth Knudsen
- Department of Obstetrics and Gynecology, Horsens Regional Hospital, Horsens, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jörg Schullehner
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Geological Survey of Denmark and Greenland, Aarhus, Denmark
| | - Linn Håkonsen Arendt
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Julie Lyngsø
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Bjørn Bay
- Department of Obstetrics and Gynecology, Horsens Regional Hospital, Horsens, Denmark
- Maigaard Fertility Clinic, Aarhus, Denmark
| | | | - Torben Sigsgaard
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus, Denmark
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Lyngsø J, Kesmodel US, Bay B, Ingerslev HJ, Pisinger CH, Ramlau-Hansen CH. Female cigarette smoking and successful fertility treatment: A Danish cohort study. Acta Obstet Gynecol Scand 2020; 100:58-66. [PMID: 32865819 DOI: 10.1111/aogs.13979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/07/2020] [Accepted: 08/18/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Despite smoking being a well-established risk factor for adverse pregnancy and neonatal outcomes, a substantial proportion of women of reproductive age smoke. Previously, meta-analyses have indicated a significantly negative impact of female smoking on outcomes of assisted reproduction, yet most of the included studies have several, essential methodological limitations. We aimed to investigate whether female cigarette smoking may affect the chance of achieving a clinical pregnancy and live birth among women and couples receiving medically assisted reproduction treatment. MATERIAL AND METHODS A cohort study with longitudinally and repeatedly collected exposure information from 1 January 2010 to 31 August 2015, including data on 1708 women and potential partners initiating either intrauterine insemination, in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) or frozen embryo transfer treatment cycles at the public Fertility Clinic, Aarhus University Hospital, Denmark. Smoking was assessed from self-reported questionnaires completed before treatment. Outcomes were a clinical pregnancy and a live birth. Information on these was obtained from the Danish national health registries, allowing complete follow-up. To evaluate associations between female occasional/daily cigarette smoking and successful medically assisted reproduction treatments, a modified Poisson regression with robust standard errors was used. RESULTS Female occasional/daily cigarette smoking was not associated with the chance of achieving a clinical pregnancy or a live birth in all intrauterine insemination or IVF/ICSI treatment cycles. When compared with nonsmokers, the adjusted relative risk for obtaining a live birth for those reporting smoking was 1.22 (0.70-2.12) among women initiating 1456 intrauterine insemination treatment cycles. Among women initiating 2788 IVF/ICSI treatment cycles, those reporting occasional/daily smoking had a relative risk for obtaining a live birth of 1.15 (0.82-1.60) when compared with nonsmokers. CONCLUSIONS Occasionally/daily cigarette smoking women had similar chance of achieving a clinical pregnancy or a live birth as the nonsmokers when receiving medically assisted reproduction treatments. However, tobacco use before and during pregnancy remains a major cause of reduced fertility as well as maternal, fetal, and infant morbidity and mortality, and should strongly be discouraged.
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Affiliation(s)
- Julie Lyngsø
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.,Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Bjørn Bay
- The Fertility Clinic, Regional Hospital Horsens, Horsens, Denmark
| | - Hans J Ingerslev
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.,Fertility Unit, Aalborg University Hospital, Aalborg, Denmark
| | | | - Cecilia H Ramlau-Hansen
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
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Lyngsø J, Ramlau-Hansen CH, Bay B, Ingerslev HJ, Strandberg-Larsen K, Kesmodel US. Low-to-moderate alcohol consumption and success in fertility treatment: a Danish cohort study. Hum Reprod 2019; 34:1334-1344. [DOI: 10.1093/humrep/dez050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/20/2019] [Accepted: 03/27/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
STUDY QUESTION
Does female weekly alcohol intake and binge drinking impact the chance of a successful fertility treatment?
SUMMARY ANSWER
Low-to-moderate weekly alcohol drinking and binge drinking were not associated with the chance of achieving a clinical pregnancy or a live birth among women and couples undergoing medically assisted reproduction (MAR) treatments.
WHAT IS KNOWN ALREADY
Alcohol consumption is common among women of reproductive age, even though health authorities advise women trying to conceive to abstain from drinking. A growing number of couples struggle with infertility, but it is unknown whether low-to-moderate levels of alcohol consumption and alcohol binge drinking impair success in fertility treatment.
STUDY DESIGN, SIZE, DURATION
Cohort study with prospectively collected exposure information including 1708 women and potential partners undergoing fertility treatment at the public fertility clinic, Aarhus University Hospital, 1 January 2010 to 31 August 2015. In total, data on 1511 intrauterine insemination (IUI) cycles, 2870 in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles and 1355 frozen embryo transfer cycles.
PARTTICIPANTS/MATERIALS, SETTING, METHODS
Exposure to weekly average alcohol intake was assessed from questionnaires completed by participants before the start of treatment. Outcome measures are the achievement of a clinical pregnancy and live birth in consecutive treatment cycles in the Danish national health registries, enabling complete follow-up. A modified Poisson regression with robust standard errors was used to evaluate associations between a weekly average alcohol intake and MAR outcomes, adjusting for female age, body mass index, cigarette smoking, coffee consumption, chronic diseases, level of education, and cycle number. When evaluating the association between binge drinking in the month prior to baseline and MAR outcomes the analyses were further adjusted for average weekly alcohol consumption.
MAIN RESULTS AND THE ROLE OF CHANCE
Low-to-moderate average weekly alcohol intake was not statistically significantly associated with the chance of achieving a clinical pregnancy or a live birth following IUI or IVF/ICSI treatment cycles. Compared to women abstaining from alcohol, the adjusted relative risks for achieving a live birth among those reporting 1–2, 3–7, and >7 drinks per week were 1.00 (95% CI 0.66; 1.53), 1.20 (0.76; 1.91), and 1.48 (0.56; 3.93), respectively, among women initiating IUI treatments. Among those initiating IVF/ICSI treatments, the chance for achieving a live birth among those reporting 1–2, 3–7, and >7 drinks per week were 1.00 (0.83; 1.21), 0.95 (0.75; 1.20), and 0.89 (0.53; 1.51), respectively. The chance of achieving a live birth in the first IUI or IVF/ICSI treatment cycle was unrelated to the number of binge drinking episodes in the month preceding baseline.
LIMITATIONS, REASONS FOR CAUTION
The risk of non-differential exposure misclassification, confounding, or chance cannot be ruled out. In addition, due to the low number of women reporting an intake of >7 drinks/week, the potential effect of high alcohol consumption should be interpreted with caution.
WIDER IMPLICATIONS OF THE FINDINGS
Although it remains unsettled if and how alcohol affects female reproduction, our results indicate that is not necessary to abstain from alcohol when striving for a successful outcome following fertility treatment.
STUDY FUNDING/COMPETING INTEREST(S)
J.L. is supported by a fully financed Ph.D. scholarship from Aarhus University and has received funds from the A.P. Møller foundation. The funding sources had no involvement in the conduct of the article. Dr Kesmodel reports personal fees from MSD and Ferring Pharmaceuticals outside the submitted work. All other authors have no conflicts of interest to declare and all have completed the ICMJE disclosure form.
TRIAL REGISTRATION NUMBER
Not relevant.
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Affiliation(s)
- J Lyngsø
- Department of Public Health, Research Unit for Epidemiology, Bartholins Allé 2, Aarhus University, Aarhus, Denmark
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, Denmark
| | - C H Ramlau-Hansen
- Department of Public Health, Research Unit for Epidemiology, Bartholins Allé 2, Aarhus University, Aarhus, Denmark
| | - B Bay
- The Fertility Clinic, Regional Hospital Horsens, Sundvej 30, Horsens, Denmark
| | - H J Ingerslev
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, Denmark
- Fertility unit, Aalborg University Hospital, Søndre Skovvej 3, Aalborg, Denmark
| | - K Strandberg-Larsen
- Department of Public Health, Section for Epidemiology, University of Copenhagen, Gothersgade 160, Copenhagen K, Denmark
| | - U S Kesmodel
- Department of Obstetrics and Gynaecology, Herlev and Gentofte Hospital, Herlev Ringvej 75, Herlev, Denmark
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Lyngsø J, Kesmodel US, Bay B, Ingerslev HJ, Nybo Andersen AM, Ramlau-Hansen CH. Impact of female daily coffee consumption on successful fertility treatment: a Danish cohort study. Fertil Steril 2019; 112:120-129.e2. [PMID: 31043232 DOI: 10.1016/j.fertnstert.2019.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/18/2019] [Accepted: 03/08/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To investigate whether female coffee consumption affects the chance of achieving a clinical pregnancy and a live birth among women and couples receiving medically assisted reproduction (MAR) treatment. DESIGN Cohort study with prospectively collected exposure data. SETTING Public fertility clinic. PATIENT(S) A total of 1,708 women and potential partners undergoing fertility treatment, contributing with 1,511 intrauterine insemination (IUI) cycles, 2,870 in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles, and 1,355 frozen embryo transfer cycles. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Clinical pregnancy and live birth in consecutive treatment cycles in the Danish national health registries, enabling complete follow-up, and estimation of the cumulative chance of live birth for three consecutive treatment cycles. RESULT(S) Among women receiving IVF or ICSI treatment, coffee consumption did not seem to affect the chance of achieving a clinical pregnancy and a live birth. Women treated with IUI who had a daily coffee consumption of 1-5 cups were more likely to achieve a clinical pregnancy (adjusted relative risk 1.49; 95% confidence interval, 1.05-2.11) and live birth (adjusted relative risk 1.53; 95% confidence interval, 1.06-2.21) compared with the reference group of coffee abstainers. CONCLUSION(S) Women consuming 1-5 cups versus none had a 1.5-fold higher probability of achieving a pregnancy or a live birth when receiving IUI. No associations were found, however, between women's daily coffee consumption and achieving a pregnancy or a live birth from IVF/ICSI.
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Affiliation(s)
- Julie Lyngsø
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark; Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark.
| | | | - Bjørn Bay
- The Fertility Clinic, Regional Hospital Horsens, Horsens, Denmark
| | - Hans Jakob Ingerslev
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark; Fertility Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Anne-Marie Nybo Andersen
- Department of Public Health, Section for Epidemiology, University of Copenhagen, Copenhagen, Denmark
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Bay B, Lyngsø J, Hohwü L, Kesmodel US. Childhood growth of singletons conceived following in vitro fertilisation or intracytoplasmic sperm injection: a systematic review and meta-analysis. BJOG 2018; 126:158-166. [PMID: 30168249 DOI: 10.1111/1471-0528.15456] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Assisted reproductive techniques are associated with an increased risk of adverse pregnancy outcomes, including low birthweight and intrauterine growth restriction. Yet, the long-term follow-up on the growth of these children is limited. OBJECTIVE To systematically review the literature on post-neonatal height and weight among children conceived following in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment, compared with that of children born after spontaneous conception. SEARCH STRATEGY A systematic computerised literature search using the online databases PubMed, Embase, and Scopus. SELECTION CRITERIA Cohort or case-control studies with an exposed group of singletons conceived following IVF or ICSI along with a control group of spontaneously conceived singletons. DATA COLLECTION AND ANALYSIS Studies were reviewed by at least two authors. Meta-analyses were conducted using Cochrane Review Manager. The quality of the studies was assessed with the Newcastle-Ottawa Scale. MAIN RESULTS Twenty studies were included, with 13 of these eligible for meta-analyses. The meta-analyses compared 3972 children born after IVF/ICSI with 11 012 spontaneously conceived children and revealed no statistically significant difference in child weight [mean difference (MD) in weight of -160 g; 95% confidence interval (95% CI) -360, 3]. When stratifying by age of child at follow-up, we found a significant lower weight in children aged 0-4 years conceived following IVF/ICSI treatment (MD -180 g; 95% CI -320, -4), but this was no longer significant in children from 5 years of age (MD -160 g; 95% CI -580, 260). The pooled analysis revealed no statistically significant difference in childhood height. CONCLUSIONS In vitro fertilisation/ICSI was not associated with long-term weight and height. TWEETABLE ABSTRACT Children born following IVF/ICSI do not have impaired long-term weight or height compared with spontaneously conceived children.
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Affiliation(s)
- B Bay
- The Fertility Clinic, Regional Hospital Horsens, Horsens, Denmark.,Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - J Lyngsø
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - L Hohwü
- Department of Health Science and Technology, Public Health and Epidemiology Group, Aalborg University, Aalborg, Denmark
| | - U S Kesmodel
- Department of Obstetrics and Gynaecology, Herlev and Gentofte Hospital, Herlev, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Lyngsø J, Ramlau-Hansen CH, Bay B, Ingerslev HJ, Hulman A, Kesmodel US. Association between coffee or caffeine consumption and fecundity and fertility: a systematic review and dose-response meta-analysis. Clin Epidemiol 2017; 9:699-719. [PMID: 29276412 PMCID: PMC5733907 DOI: 10.2147/clep.s146496] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The aim was to investigate whether coffee or caffeine consumption is associated with reproductive endpoints among women with natural fertility (ie, time to pregnancy [TTP] and spontaneous abortion [SAB]) and among women in fertility treatment (ie, clinical pregnancy rate or live birth rate). Design This study was a systematic review and dose-response meta-analysis including data from case-control and cohort studies. Methods An extensive literature search was conducted in MEDLINE and Embase, with no time and language restrictions. Also, reference lists were searched manually. Two independent reviewers assessed the manuscript quality using the Newcastle-Ottawa Scale (NOS). A two-stage dose-response meta-analysis was applied to assess a potential association between coffee/caffeine consumption and the outcomes: TTP, SAB, clinical pregnancy, and live birth. Heterogeneity between studies was assessed using Cochrane Q-test and I2 statistics. Publication bias was assessed using Egger's regression test. Results The pooled results showed that coffee/caffeine consumption is associated with a significantly increased risk of SAB for 300 mg caffeine/day (relative risk [RR]: 1.37, 95% confidence interval [95% CI]: 1.19; 1.57) and for 600 mg caffeine/day (RR: 2.32, 95% CI: 1.62; 3.31). No association was found between coffee/caffeine consumption and outcomes of fertility treatment (based on two studies). No clear association was found between exposure to coffee/caffeine and natural fertility as measured by fecundability odds ratio (based on three studies) or waiting TTP (based on two studies). Conclusion Results from this meta-analysis support the growing evidence of an association between coffee/caffeine intake and the risk of SAB. However, viewing the reproductive capacity in a broader perspective, there seems to be little, if any, association between coffee/caffeine consumption and fecundity. In general, results from this study are supportive of a precautionary principle advised by health organizations such as European Food Safety Authority (EFSA) and World Health Organization (WHO), although the advised limit of a maximum of two to three cups of coffee/200-300 mg caffeine per day may be too high.
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Affiliation(s)
- Julie Lyngsø
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus
| | | | - Bjørn Bay
- The Fertility Clinic, Regional Horsens Hospital, Horsens
| | | | - Adam Hulman
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus.,Danish Diabetes Academy, Odense
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Lyngsø J, Kainsbak J, Østergård M. [Uterine artery pseudoaneurysm is a rare delayed complication after caesarean section]. Ugeskr Laeger 2017; 179:V11160785. [PMID: 28397667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Uterine artery pseudoaneurysm is a rare complication after caesarean section and may be the cause of acute and potentially life-threatening secondary post-partum haemorrhage. In this case report, we present the clinical presentation and management of a case of uterine artery pseudoaneurysm manifesting as delayed post-partum bleeding after caesarean section. The case report emphasizes the importance of performing Doppler-flow when diagnosing the existence of a uterine artery pseudoaneurysm ultrasonically.
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Lyngsø J, Pedersen JB, Rask P, Kunda R, Bjerregaard NC. [Concurrent achalasia and severe obesity]. Ugeskr Laeger 2016; 178:V07140416. [PMID: 27188993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Achalasia is a rare oesophageal motility disorder which classically is not associated with obesity. We present the case of a 50-year-old woman who underwent gastric bypass and afterwards was diagnosed with achalasia. Following, she was treated successfully with peroral endoscopic myotomy (POEM). A thorough medical history revealed that symptoms of achalasia had been present for 25 years and were the cause of inappropriate eating habits and consequently morbid obesity. This case story illustrates the importance of being aware of simultaneous occurrence of achalasia and morbid obesity. Furthermore, it demonstrates that POEM is safe and effective for symptomatic relief of achalasia after previous gastric bypass.
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Majeed HG, Lyngsø J, Bor P. [The diagnostic value of human chorionic gonadotrophin ratio compared to single measurements of S-human chorionic gonadotrophin on the outcome of pregnancy of unknown location]. Ugeskr Laeger 2014; 176:V09120520. [PMID: 25316357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Pregnancy of unknown location is defined by a positive pregnancy test, without visualizing of the intrauterine or extrauterine pregnancy by transvaginal sonography. We present the advantages of using human chorionic gonadotrophin (hCG) ratio instead of single measurements of S-hCG for predicting the outcomes of pregnancies of unknown location.
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Affiliation(s)
| | - Julie Lyngsø
- Health, Aarhus Universitet, Nordre Ringgade 1, 8000 Aarhus C.
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Lyngsø J, Toft G, Høyer B, Guldbrandsen K, Olsen J, Ramlau-Hansen C. Moderate alcohol intake and menstrual cycle characteristics. Hum Reprod 2013; 29:351-8. [DOI: 10.1093/humrep/det417] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Lyngsø J, Ramlau-Hansen C, Høyer B, Støvring H, Bonde J, Jönsson B, Lindh C, Pedersen H, Ludwicki J, Zviezdai V, Toft G. Menstrual cycle characteristics in fertile women from Greenland, Poland and Ukraine exposed to perfluorinated chemicals: a cross-sectional study. Hum Reprod 2013; 29:359-67. [DOI: 10.1093/humrep/det390] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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