Dietary Supplement Intake and Fecundability in a Singapore Preconception Cohort Study

Chee Wai Ku; Chee Onn Ku; Liza Pui Chin Tay; Hui Kun Xing; Yin Bun Cheung; Keith M. Godfrey; Marjorelee T. Colega; Cherlyen Teo; Karen Mei Ling Tan; Yap Seng Chong; Lynette Pei Chi Shek; Kok Hian Tan; Shiao Yng Chan; Shan Xuan Lim; Mary Foong Fong Chong; Fabian Yap; Jerry Kok Yen Chan; See Ling Loy

doi:10.3390/nu14235110

Dietary Supplement Intake and Fecundability in a Singapore Preconception Cohort Study

Chee Wai Ku
, Chee Onn Ku
, Liza Pui Chin Tay
, Hui Kun Xing
, Yin Bun Cheung
, Keith M. Godfrey
, Marjorelee T. Colega
, Cherlyen Teo
, Karen Mei Ling Tan
, Yap Seng Chong
, Lynette Pei Chi Shek
, Kok Hian Tan
, Shiao Yng Chan
, Shan Xuan Lim
, Mary Foong Fong Chong
, Fabian Yap
, Jerry Kok Yen Chan^*
, See Ling Loy

^*Corresponding author for this work

Research output: Contribution to journal › Article › Scientific › peer-review

9 Citations (Scopus)

16 Downloads (Pure)

Abstract

Subfertility is a global problem affecting millions worldwide, with declining total fertility rates. Preconception dietary supplementation may improve fecundability, but the magnitude of impact remains unclear. This prospective cohort study aimed to examine the association of preconception micronutrient supplements with fecundability, measured by time to pregnancy (TTP). The study was conducted at KK Women’s and Children’s Hospital, Singapore, between February 2015 and October 2017, on 908 women aged 18-45 years old, who were trying to conceive and were enrolled in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO). Baseline sociodemographic characteristics and supplement intake were collected through face-to-face interviews. The fecundability ratio (FR) was estimated using discrete-time proportional hazard modelling. Adjusting for potentially confounding variables, folic acid (FA) (FR 1.26, 95% confidence interval 1.03–1.56) and iodine (1.28, 1.00–1.65) supplement users had higher fecundability compared to non-users. Conversely, evening primrose oil supplement users had lower fecundability (0.56, 0.31–0.99) than non-users. In this study, preconception FA and iodine supplementation were associated with shortened TTP, while evening primrose oil use was associated with longer TTP. Nonetheless, the association between supplement use and the magnitude of fecundability changes will need to be further confirmed with well-designed randomised controlled trials.

Original language	English
Article number	5110
Journal	Nutrients
Volume	14
Issue number	23
DOIs	https://doi.org/10.3390/nu14235110
Publication status	Published - Dec 2022
Publication type	A1 Journal article-refereed

Funding

This work is supported by the Singapore National Research Foundation under its TCR Flagship Programme and administered by the Singapore Ministry of Health’s NMRC, Singapore—NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Singapore Institute for Clinical Sciences, A*STAR, Singapore has provided additional funding support for the project. KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515-10042) and NIHR Southampton Biomedical Research Centre (IS-BRC-1215-20004)), the European Union (Erasmus+ Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP) and the British Heart Foundation (RG/15/17/3174, SP/F/21/150013). For the purpose of Open Access, the author has applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising from this submission. SYC is supported by a Clinician Scientist Award from the Singapore NMRC (NMRC/CSA-INV/0010/2016; MOH-000455-01). CWK and JKYC received salary support from the National Medical Research Council, Ministry of Health, Singapore (NMRC/MOH-000596-00 and NMRC/CSA-SI-008-2016, respectively). The funders played no role in study design, data collection and analysis, decision to publish, or manuscript preparation. KMG, YSC and FY received reimbursement for speaking at conferences sponsored by companies selling nutritional products. KMG, YSC and SYC are part of an academic consortium that received research funding from Abbott Nutrition, Nestle and Danone. All other authors declare no competing interests.

Keywords

evening primrose oil
fertility
folic acid
preconception
supplements
time to pregnancy

Publication forum classification

Publication forum level 1

ASJC Scopus subject areas

Food Science
Nutrition and Dietetics

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10.3390/nu14235110Licence: CC BY

nutrients-14-05110Final published version, 674 KBLicence: CC BY

https://urn.fi/URN:NBN:fi:tuni-202212209365Licence: CC BY

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Ku, C. W., Ku, C. O., Tay, L. P. C., Xing, H. K., Cheung, Y. B., Godfrey, K. M., Colega, M. T., Teo, C., Tan, K. M. L., Chong, Y. S., Shek, L. P. C., Tan, K. H., Chan, S. Y., Lim, S. X., Chong, M. F. F., Yap, F., Chan, J. K. Y., & Loy, S. L. (2022). Dietary Supplement Intake and Fecundability in a Singapore Preconception Cohort Study. Nutrients, 14(23), Article 5110. https://doi.org/10.3390/nu14235110

@article{5025451f3f4540f1a24411d7358a26d3,

title = "Dietary Supplement Intake and Fecundability in a Singapore Preconception Cohort Study",

abstract = "Subfertility is a global problem affecting millions worldwide, with declining total fertility rates. Preconception dietary supplementation may improve fecundability, but the magnitude of impact remains unclear. This prospective cohort study aimed to examine the association of preconception micronutrient supplements with fecundability, measured by time to pregnancy (TTP). The study was conducted at KK Women{\textquoteright}s and Children{\textquoteright}s Hospital, Singapore, between February 2015 and October 2017, on 908 women aged 18-45 years old, who were trying to conceive and were enrolled in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO). Baseline sociodemographic characteristics and supplement intake were collected through face-to-face interviews. The fecundability ratio (FR) was estimated using discrete-time proportional hazard modelling. Adjusting for potentially confounding variables, folic acid (FA) (FR 1.26, 95\% confidence interval 1.03–1.56) and iodine (1.28, 1.00–1.65) supplement users had higher fecundability compared to non-users. Conversely, evening primrose oil supplement users had lower fecundability (0.56, 0.31–0.99) than non-users. In this study, preconception FA and iodine supplementation were associated with shortened TTP, while evening primrose oil use was associated with longer TTP. Nonetheless, the association between supplement use and the magnitude of fecundability changes will need to be further confirmed with well-designed randomised controlled trials.",

keywords = "evening primrose oil, fertility, folic acid, preconception, supplements, time to pregnancy",

author = "Ku, \{Chee Wai\} and Ku, \{Chee Onn\} and Tay, \{Liza Pui Chin\} and Xing, \{Hui Kun\} and Cheung, \{Yin Bun\} and Godfrey, \{Keith M.\} and Colega, \{Marjorelee T.\} and Cherlyen Teo and Tan, \{Karen Mei Ling\} and Chong, \{Yap Seng\} and Shek, \{Lynette Pei Chi\} and Tan, \{Kok Hian\} and Chan, \{Shiao Yng\} and Lim, \{Shan Xuan\} and Chong, \{Mary Foong Fong\} and Fabian Yap and Chan, \{Jerry Kok Yen\} and Loy, \{See Ling\}",

note = "Funding Information: This work is supported by the Singapore National Research Foundation under its TCR Flagship Programme and administered by the Singapore Ministry of Health{\textquoteright}s NMRC, Singapore—NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Singapore Institute for Clinical Sciences, A*STAR, Singapore has provided additional funding support for the project. KMG is supported by the UK Medical Research Council (MC\_UU\_12011/4), the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515-10042) and NIHR Southampton Biomedical Research Centre (IS-BRC-1215-20004)), the European Union (Erasmus+ Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP) and the British Heart Foundation (RG/15/17/3174, SP/F/21/150013). For the purpose of Open Access, the author has applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising from this submission. SYC is supported by a Clinician Scientist Award from the Singapore NMRC (NMRC/CSA-INV/0010/2016; MOH-000455-01). CWK and JKYC received salary support from the National Medical Research Council, Ministry of Health, Singapore (NMRC/MOH-000596-00 and NMRC/CSA-SI-008-2016, respectively). The funders played no role in study design, data collection and analysis, decision to publish, or manuscript preparation. Funding Information: KMG, YSC and FY received reimbursement for speaking at conferences sponsored by companies selling nutritional products. KMG, YSC and SYC are part of an academic consortium that received research funding from Abbott Nutrition, Nestle and Danone. All other authors declare no competing interests. Publisher Copyright: {\textcopyright} 2022 by the authors.",

year = "2022",

month = dec,

doi = "10.3390/nu14235110",

language = "English",

volume = "14",

journal = "Nutrients",

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T1 - Dietary Supplement Intake and Fecundability in a Singapore Preconception Cohort Study

AU - Ku, Chee Wai

AU - Ku, Chee Onn

AU - Tay, Liza Pui Chin

AU - Xing, Hui Kun

AU - Cheung, Yin Bun

AU - Godfrey, Keith M.

AU - Colega, Marjorelee T.

AU - Teo, Cherlyen

AU - Tan, Karen Mei Ling

AU - Chong, Yap Seng

AU - Shek, Lynette Pei Chi

AU - Tan, Kok Hian

AU - Chan, Shiao Yng

AU - Lim, Shan Xuan

AU - Chong, Mary Foong Fong

AU - Yap, Fabian

AU - Chan, Jerry Kok Yen

AU - Loy, See Ling

N1 - Funding Information: This work is supported by the Singapore National Research Foundation under its TCR Flagship Programme and administered by the Singapore Ministry of Health’s NMRC, Singapore—NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Singapore Institute for Clinical Sciences, A*STAR, Singapore has provided additional funding support for the project. KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515-10042) and NIHR Southampton Biomedical Research Centre (IS-BRC-1215-20004)), the European Union (Erasmus+ Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP) and the British Heart Foundation (RG/15/17/3174, SP/F/21/150013). For the purpose of Open Access, the author has applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising from this submission. SYC is supported by a Clinician Scientist Award from the Singapore NMRC (NMRC/CSA-INV/0010/2016; MOH-000455-01). CWK and JKYC received salary support from the National Medical Research Council, Ministry of Health, Singapore (NMRC/MOH-000596-00 and NMRC/CSA-SI-008-2016, respectively). The funders played no role in study design, data collection and analysis, decision to publish, or manuscript preparation. Funding Information: KMG, YSC and FY received reimbursement for speaking at conferences sponsored by companies selling nutritional products. KMG, YSC and SYC are part of an academic consortium that received research funding from Abbott Nutrition, Nestle and Danone. All other authors declare no competing interests. Publisher Copyright: © 2022 by the authors.

PY - 2022/12

Y1 - 2022/12

N2 - Subfertility is a global problem affecting millions worldwide, with declining total fertility rates. Preconception dietary supplementation may improve fecundability, but the magnitude of impact remains unclear. This prospective cohort study aimed to examine the association of preconception micronutrient supplements with fecundability, measured by time to pregnancy (TTP). The study was conducted at KK Women’s and Children’s Hospital, Singapore, between February 2015 and October 2017, on 908 women aged 18-45 years old, who were trying to conceive and were enrolled in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO). Baseline sociodemographic characteristics and supplement intake were collected through face-to-face interviews. The fecundability ratio (FR) was estimated using discrete-time proportional hazard modelling. Adjusting for potentially confounding variables, folic acid (FA) (FR 1.26, 95% confidence interval 1.03–1.56) and iodine (1.28, 1.00–1.65) supplement users had higher fecundability compared to non-users. Conversely, evening primrose oil supplement users had lower fecundability (0.56, 0.31–0.99) than non-users. In this study, preconception FA and iodine supplementation were associated with shortened TTP, while evening primrose oil use was associated with longer TTP. Nonetheless, the association between supplement use and the magnitude of fecundability changes will need to be further confirmed with well-designed randomised controlled trials.

AB - Subfertility is a global problem affecting millions worldwide, with declining total fertility rates. Preconception dietary supplementation may improve fecundability, but the magnitude of impact remains unclear. This prospective cohort study aimed to examine the association of preconception micronutrient supplements with fecundability, measured by time to pregnancy (TTP). The study was conducted at KK Women’s and Children’s Hospital, Singapore, between February 2015 and October 2017, on 908 women aged 18-45 years old, who were trying to conceive and were enrolled in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO). Baseline sociodemographic characteristics and supplement intake were collected through face-to-face interviews. The fecundability ratio (FR) was estimated using discrete-time proportional hazard modelling. Adjusting for potentially confounding variables, folic acid (FA) (FR 1.26, 95% confidence interval 1.03–1.56) and iodine (1.28, 1.00–1.65) supplement users had higher fecundability compared to non-users. Conversely, evening primrose oil supplement users had lower fecundability (0.56, 0.31–0.99) than non-users. In this study, preconception FA and iodine supplementation were associated with shortened TTP, while evening primrose oil use was associated with longer TTP. Nonetheless, the association between supplement use and the magnitude of fecundability changes will need to be further confirmed with well-designed randomised controlled trials.

KW - evening primrose oil

KW - fertility

KW - folic acid

KW - preconception

KW - supplements

KW - time to pregnancy

U2 - 10.3390/nu14235110

DO - 10.3390/nu14235110

M3 - Article

AN - SCOPUS:85143510096

SN - 2072-6643

VL - 14

JO - Nutrients

JF - Nutrients

IS - 23

M1 - 5110

ER -

Dietary Supplement Intake and Fecundability in a Singapore Preconception Cohort Study

Abstract

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Keywords

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ASJC Scopus subject areas

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