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Title: Plasma glycemic measures and fecundability in a Singapore preconception cohort study
Authors: Loy S.L. 
Ku C.W. 
Lai A.E.Q.
Choo X.H.
Ho A.H.M.
Cheung Y.B. 
Godfrey K.M.
Chong Y.-S. 
Gluckman P.D.
Shek L.P.-C.
Tan K.H. 
Yap F.K.P. 
Chan S.-Y.
Chan J.K.Y. 
Keywords: Diabetes
time to pregnancy
Issue Date: Oct-2020
Publisher: Elsevier Inc.
Citation: Loy S.L., Ku C.W., Lai A.E.Q., Choo X.H., Ho A.H.M., Cheung Y.B., Godfrey K.M., Chong Y.-S., Gluckman P.D., Shek L.P.-C., Tan K.H., Yap F.K.P., Chan S.-Y., Chan J.K.Y. (2020-10). Plasma glycemic measures and fecundability in a Singapore preconception cohort study. Fertility and Sterility 115 (1) : 138 - 147. ScholarBank@NUS Repository.
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. � 2020 American Society for Reproductive Medicine
Source Title: Fertility and Sterility
ISSN: 00150282
DOI: 10.1016/j.fertnstert.2020.07.014
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