Epidemiology Branch, DIPHR, NICHD, National Institutes of Health, Bethesda, Maryland.
Biotechnical and Clinical Laboratory Sciences, University at Buffalo, State University of New York, Buffalo, New York.
J Clin Endocrinol Metab. 2018 Dec 1;103(12):4501-4510. doi: 10.1210/jc.2018-00448.
Fatty acids (FAs) are important for reproductive processes, including steroidogenesis, though associations with fecundability, as measured by time to pregnancy (TTP), are unclear.
To investigate the relationship between preconception plasma phospholipid FA (PPFA) levels and time to human chorionic gonadotropin-pregnancy among women with prior pregnancy loss.
DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort of 1228 women attempting pregnancy (aged 18 to 40 years, with one or two prior pregnancy losses) followed for up to six cycles at four US university medical centers during 2006 to 2012. PPFA levels were measured at baseline.
Associations with fecundability overall and by body mass index (BMI) group after adjusting for confounders were estimated using fecundability odds ratios (FORs) and 95% CIs. False discovery rate (FDR) was used to account for multiple comparisons.
Monounsaturated fatty acids (MUFAs) were associated with increased fecundability or shorter TTP [FOR, 1.08 (95% CI, 1.01 to 1.16) per unit increase in percentage of total FAs], whereas polyunsaturated fatty acids (PUFAs) were associated with decreased fecundability or longer TTP [FOR, 0.95 (95% CI, 0.91 to 1.00) per 1% change], though associations only remained significant after FDR adjustment among women with BMI <25 kg/m2. Saturated FA and trans FA were not associated with fecundability. Omega-3 FAs and omega-6 linoleic acid were not associated with fecundability.
We observed associations between preconception MUFA and PUFA levels and fecundability among women with normal BMI, highlighting the importance of FA composition among normal-weight women with prior pregnancy loss.
脂肪酸（FAs）对生殖过程很重要，包括类固醇生成，但与受孕时间（TTP）的关系尚不清楚。
研究有过妊娠丢失史的女性，在受孕前血浆磷脂脂肪酸（PPFA）水平与人绒毛膜促性腺激素妊娠时间之间的关系。
设计、地点和参与者：2006 年至 2012 年期间，在美国 4 所大学医疗中心对 1228 名年龄在 18 至 40 岁之间、有一次或两次妊娠丢失史的有妊娠计划的女性进行了前瞻性队列研究，随访了最多 6 个周期。在基线时测量了 PPFA 水平。
采用受孕可能性比值（FOR）及其 95%置信区间（CI），在调整混杂因素后，评估总体和按体重指数（BMI）分组的受孕可能性与 FA 水平之间的关系。采用假发现率（FDR）来考虑多重比较。
单不饱和脂肪酸（MUFAs）与受孕可能性增加或 TTP 缩短有关[每增加总 FA 的 1%，比值比（FOR）为 1.08（95%CI，1.01 至 1.16）]，而多不饱和脂肪酸（PUFAs）与受孕可能性降低或 TTP 延长有关[FOR，0.95（95%CI，0.91 至 1.00），每 1%的变化]，但只有在 BMI<25kg/m2 的女性中，经过 FDR 调整后，这些关联仍然具有统计学意义。饱和脂肪酸和反式脂肪酸与受孕可能性无关。ω-3 脂肪酸和 ω-6 亚油酸与受孕可能性无关。
我们观察到正常 BMI 女性受孕前 MUFA 和 PUFA 水平与受孕可能性之间存在关联，这突出了正常体重有过妊娠丢失史女性 FA 组成的重要性。
