Skåra Karoline H, Lee Yunsung, Jugessur Astanand, Gjessing Håkon K, Aviv Abraham, Brumpton Ben, Næss Øyvind, Hernáez Álvaro, Hanevik Hans Ivar, Magnus Per, Magnus Maria C
Centre for Fertility and Health, Norwegian Institute of Public Health, Skøyen, PO Box 222, 0213, Oslo, Norway.
Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
BMC Med. 2024 Dec 18;22(1):580. doi: 10.1186/s12916-024-03795-0.
Telomere length (TL) has been reported to be associated with conditions such as endometriosis and polycystic ovary syndrome, with some studies finding associations with shorter TL and others with longer TL. In men, studies mostly report associations between shorter TL and sperm quality. To our knowledge, no studies have thus far investigated associations between TL and fecundability or the use of assisted reproductive technologies (ART).
This study is based on the Norwegian Mother, Father, and Child Cohort (MoBa) Study and uses data from the Medical Birth Registry of Norway (MBRN). We included women (24,645 with genotype data and 1054 with TL measurements) and men (18,339 with genotype data and 965 with TL measurements) participating between 1998 and 2008. We investigated associations between leukocyte TL (LTL) and fecundability (defined as the probability to conceive within a given menstrual cycle), infertility (defined has having spent 12 months or more trying to conceive without success), and ART use. We also repeated the analyses using instrumental variables for LTL consisting of genetic risk scores for LTL and genetically predicted LTL.
Approximately 11% of couples had experienced infertility and 4% had used ART. LTL was not associated with fecundability in women (fecundability ratio [FR], 0.98; 95% confidence interval [CI], 0.92-1.04) or men (FR, 0.99; CI, 0.93-1.06), nor with infertility in women (odds ratio [OR], 1.03; CI, 0.85-1.24) or men (OR, 1.05; CI, 0.87-1.28). We observed an increased likelihood of using ART with increasing LTL in men (OR, 1.22; CI, 1.03-1.46), but not in women (OR, 1.10; CI, 0.92-1.31). No significant associations were observed using the instrumental variables for LTL.
We found no indication that LTL is a suitable biomarker for assessing fecundability, infertility, or ART use. Additional studies are required to replicate the association observed between LTL and ART use in men.
据报道，端粒长度（TL）与子宫内膜异位症和多囊卵巢综合征等疾病有关，一些研究发现其与较短的TL有关，而另一些研究则发现与较长的TL有关。在男性中，研究大多报告较短的TL与精子质量之间存在关联。据我们所知，迄今为止尚无研究调查TL与生育力或辅助生殖技术（ART）使用之间的关联。
本研究基于挪威母亲、父亲和儿童队列（MoBa）研究，并使用挪威医疗出生登记处（MBRN）的数据。我们纳入了1998年至2008年间参与研究的女性（24645名有基因型数据，1054名有TL测量值）和男性（18339名有基因型数据，965名有TL测量值）。我们调查了白细胞端粒长度（LTL）与生育力（定义为在给定月经周期内受孕的概率）、不孕症（定义为尝试受孕12个月或更长时间未成功）和ART使用之间的关联。我们还使用由LTL的遗传风险评分和基因预测的LTL组成的LTL工具变量重复了分析。
约11%的夫妇经历过不孕症，4%使用过ART。LTL与女性的生育力（生育力比率[FR]，0.98；95%置信区间[CI]，0.92 - 1.04）或男性的生育力（FR，0.99；CI，0.93 - 1.06）均无关联，与女性的不孕症（优势比[OR]，1.03；CI，0.85 - 1.24）或男性的不孕症（OR，1.05；CI，0.87 - 1.28）也无关联。我们观察到男性中随着LTL增加使用ART的可能性增加（OR，1.22；CI，1.03 - 1.46），但女性中未观察到这种情况（OR，1.10；CI，0.92 - 1.31）。使用LTL的工具变量未观察到显著关联。
我们没有发现LTL是评估生育力、不孕症或ART使用的合适生物标志物的迹象。需要进一步的研究来重复在男性中观察到的LTL与ART使用之间的关联。
