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Fecundability in reproductive aged women at risk of sexual dysfunction and associated risk factors: a prospective preconception cohort study
BACKGROUND: Female sexual dysfunction (FSD) is a prevalent problem, affecting up to 41% of reproductive aged women worldwide. However, the association between female sexual function (FSF) and fecundability in women attempting to conceive remains unclear. We aimed 1) to examine the association betwee...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8228958/ https://www.ncbi.nlm.nih.gov/pubmed/34172036 http://dx.doi.org/10.1186/s12884-021-03892-5 |
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author | Loy, See Ling Ku, Chee Wai Cheung, Yin Bun Godfrey, Keith M. Chong, Yap-Seng Shek, Lynette Pei-Chi Tan, Kok Hian Yap, Fabian Kok Peng Bernard, Jonathan Y. Chen, Helen Chan, Shiao-Yng Tan, Tse Yeun Chan, Jerry Kok Yen |
author_facet | Loy, See Ling Ku, Chee Wai Cheung, Yin Bun Godfrey, Keith M. Chong, Yap-Seng Shek, Lynette Pei-Chi Tan, Kok Hian Yap, Fabian Kok Peng Bernard, Jonathan Y. Chen, Helen Chan, Shiao-Yng Tan, Tse Yeun Chan, Jerry Kok Yen |
author_sort | Loy, See Ling |
collection | PubMed |
description | BACKGROUND: Female sexual dysfunction (FSD) is a prevalent problem, affecting up to 41% of reproductive aged women worldwide. However, the association between female sexual function (FSF) and fecundability in women attempting to conceive remains unclear. We aimed 1) to examine the association between FSF in reproductive-aged preconception Asian women and fecundability, as measured by time-to-pregnancy in menstrual cycles, and 2) to examine lifestyle and behavioral factors associated with FSF. METHODS: From the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) prospective cohort, we evaluated FSF using the 6-item Female Sexual Function Index (FSFI-6) and ascertained time-to-pregnancy within a year of baseline assessment. We estimated fecundability ratio (FR) and 95% confidence interval (CI) using the discrete-time proportional hazards model, accounting for left-truncation and right censoring. We used multivariable logistic and linear regression models to identify potential factors related to FSF. RESULTS: Among 513 participants, 58.9% had low FSF as defined by a total FSFI-6 score at or below the median value of 22. Compared to women with high FSF, those with low FSF had a 27% reduction in fecundability (FR 0.73; 95% CI 0.54, 0.99), with adjustment for age, ethnicity, education, parity and body mass index. Overall, the FRs generally reduced with decreasing FSFI-6 scores. Physical activity, obesity, absence of probable depression and anxiety were independently associated with reduced odds of low FSF and increased FSFI-6 scores, after adjusting for sociodemographic characteristics. CONCLUSIONS: Low FSF is associated with a longer time-to-pregnancy. Early evaluation and optimization of FSF through increased physical activity and optimal mental health may help to improve female fecundity. The finding of obese women having improved FSF remains uncertain which warrants further investigations on plausibly mechanisms. In general, the current finding highlights the importance of addressing FSF in preconception care service for general women, which is currently lacking as part of the fertility promotion effort in the country. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-021-03892-5. |
format | Online Article Text |
id | pubmed-8228958 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-82289582021-06-28 Fecundability in reproductive aged women at risk of sexual dysfunction and associated risk factors: a prospective preconception cohort study Loy, See Ling Ku, Chee Wai Cheung, Yin Bun Godfrey, Keith M. Chong, Yap-Seng Shek, Lynette Pei-Chi Tan, Kok Hian Yap, Fabian Kok Peng Bernard, Jonathan Y. Chen, Helen Chan, Shiao-Yng Tan, Tse Yeun Chan, Jerry Kok Yen BMC Pregnancy Childbirth Research BACKGROUND: Female sexual dysfunction (FSD) is a prevalent problem, affecting up to 41% of reproductive aged women worldwide. However, the association between female sexual function (FSF) and fecundability in women attempting to conceive remains unclear. We aimed 1) to examine the association between FSF in reproductive-aged preconception Asian women and fecundability, as measured by time-to-pregnancy in menstrual cycles, and 2) to examine lifestyle and behavioral factors associated with FSF. METHODS: From the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) prospective cohort, we evaluated FSF using the 6-item Female Sexual Function Index (FSFI-6) and ascertained time-to-pregnancy within a year of baseline assessment. We estimated fecundability ratio (FR) and 95% confidence interval (CI) using the discrete-time proportional hazards model, accounting for left-truncation and right censoring. We used multivariable logistic and linear regression models to identify potential factors related to FSF. RESULTS: Among 513 participants, 58.9% had low FSF as defined by a total FSFI-6 score at or below the median value of 22. Compared to women with high FSF, those with low FSF had a 27% reduction in fecundability (FR 0.73; 95% CI 0.54, 0.99), with adjustment for age, ethnicity, education, parity and body mass index. Overall, the FRs generally reduced with decreasing FSFI-6 scores. Physical activity, obesity, absence of probable depression and anxiety were independently associated with reduced odds of low FSF and increased FSFI-6 scores, after adjusting for sociodemographic characteristics. CONCLUSIONS: Low FSF is associated with a longer time-to-pregnancy. Early evaluation and optimization of FSF through increased physical activity and optimal mental health may help to improve female fecundity. The finding of obese women having improved FSF remains uncertain which warrants further investigations on plausibly mechanisms. In general, the current finding highlights the importance of addressing FSF in preconception care service for general women, which is currently lacking as part of the fertility promotion effort in the country. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-021-03892-5. BioMed Central 2021-06-25 /pmc/articles/PMC8228958/ /pubmed/34172036 http://dx.doi.org/10.1186/s12884-021-03892-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Loy, See Ling Ku, Chee Wai Cheung, Yin Bun Godfrey, Keith M. Chong, Yap-Seng Shek, Lynette Pei-Chi Tan, Kok Hian Yap, Fabian Kok Peng Bernard, Jonathan Y. Chen, Helen Chan, Shiao-Yng Tan, Tse Yeun Chan, Jerry Kok Yen Fecundability in reproductive aged women at risk of sexual dysfunction and associated risk factors: a prospective preconception cohort study |
title | Fecundability in reproductive aged women at risk of sexual dysfunction and associated risk factors: a prospective preconception cohort study |
title_full | Fecundability in reproductive aged women at risk of sexual dysfunction and associated risk factors: a prospective preconception cohort study |
title_fullStr | Fecundability in reproductive aged women at risk of sexual dysfunction and associated risk factors: a prospective preconception cohort study |
title_full_unstemmed | Fecundability in reproductive aged women at risk of sexual dysfunction and associated risk factors: a prospective preconception cohort study |
title_short | Fecundability in reproductive aged women at risk of sexual dysfunction and associated risk factors: a prospective preconception cohort study |
title_sort | fecundability in reproductive aged women at risk of sexual dysfunction and associated risk factors: a prospective preconception cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8228958/ https://www.ncbi.nlm.nih.gov/pubmed/34172036 http://dx.doi.org/10.1186/s12884-021-03892-5 |
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