Paediatric and Perinatal Epidemiology, 38(8), 641-650
The use of fertility indicators to predict ovulation has largely been studied for contraceptive purposes, while less so as fertility-promoting tools.
To investigate the association between fertility indicators and fecundability in Danish women trying to conceive.
Web-based preconception cohort study. We analysed data from 11,328 females aged 18-49 years trying to conceive without fertility treatment for ≤6 menstrual cycles, from the Danish SnartGravid.dk and SnartForældre.dk cohorts (2007-2023). Participants reported the use of fertility indicators (counting days since the last menstrual period, cervical fluid monitoring, urinary ovulation testing, feeling ovulation, using a smartphone fertility app and measuring basal body temperature [BBT]). Time to pregnancy was measured in menstrual cycles ascertained by self-reported pregnancy status. We estimated fecundability ratios (FR) and 95% confidence intervals (CI) using proportional probabilities regression models adjusted for age, socio-economic position, health indicators, reproductive history and gynaecological factors.
Fertility indicators were used by 63.3% of participants at study entry. Counting days was the most common (46.9%), while measuring BBT was the least (3.0%). Other indicators ranged from 17.0% to 23.6%, with 69.7% using more than one indicator. Compared with non-use, use of any fertility indicator was associated with greater fecundability (adjusted FR 1.14, 95% CI 1.08, 1.19). Cervical fluid monitoring showed the strongest association (aFR 1.46, 95% CI 1.03, 2.07), followed by urinary ovulation testing (aFR 1.35, 95% CI 1.16, 1.58) and counting days (aFR 1.18, 95% CI 1.09, 1.29). Feeling ovulation and fertility apps were modestly associated with fecundability, while measuring BBT was not associated. Sensitivity analysis restricting to ≤2 cycles of attempt time and two cycles of follow-up showed an aFR for any indicator use of 1.21 (95% CI 1.13, 1.31).
In this Danish preconception cohort, use of fertility indicators was associated with a higher fecundability, varying by type of indicator.
Pedersen, E. S., Mikkelsen, E. M., Sørensen, H. T., Hatch, E. E., Wise, L. A., Rothman, K. J., Stanford, J. B., & Laursen, A. S. D. (2024). The association between the use of fertility indicators and fecundability in a Danish preconception cohort. *Paediatric and perinatal epidemiology*, *38*(8), 641-650. https://doi.org/10.1111/ppe.13108
Pedersen ES, Mikkelsen EM, Sørensen HT, Hatch EE, Wise LA, Rothman KJ, et al. The association between the use of fertility indicators and fecundability in a Danish preconception cohort. Paediatr Perinat Epidemiol. 2024;38(8):641-650. doi:10.1111/ppe.13108
Pedersen, E. S., et al. "The association between the use of fertility indicators and fecundability in a Danish preconception cohort." *Paediatric and perinatal epidemiology*, vol. 38, no. 8, 2024, pp. 641-650.