title: Distress and reduced fertility: a follow-up study of first-pregnancy planners.
abstract: OBJECTIVE
  To assess the effect of psychological distress on time to first pregnancy.
  
  
  METHODS
  A follow-up study of time to pregnancy with prospective data on distress, with controlling for potential confounding variables.
  
  
  METHODS
  Two university hospitals.
  
  
  METHODS
  Danish couples (n = 430) who were planning their first pregnancy and had no previous reproductive experience were followed for six menstrual cycles. Psychological distress was measured in each menstrual cycle by the General Health Questionnaire.
  
  
  METHODS
  None.
  
  
  METHODS
  A clinically recognized pregnancy or a biochemical pregnancy detected in urine samples from each period of vaginal bleeding.
  
  
  RESULTS
  For cycles with the highest distress score (General Health Questionnaire score >80th percentile), the probability of conception per cycle was 12.8%, compared with 16.5% in other cycles (adjusted odds ratio [OR] 0.6; 95% confidence interval [CI] 0.4-1.0). The effect of distress was found almost exclusively among women with long menstrual cycles (OR 0.1; 95% CI 0.01-0.4 and OR 0.9; 95% CI 0.5-1.4 for women with cycles of > or =35 and <35 days, respectively). An increased incidence of early embryonal loss was also found among highly distressed women with long cycles, but was based on a small number of observations.
  
  
  CONCLUSIONS
  Psychological distress may be a risk factor for reduced fertility in women with long menstrual cycles.
authors.affiliation: Department of Occupational Medicine, Aarhus University Hospital, Denmark. akh.gp22s.akamkpp1@aaa.dk
authors.forename: N H
authors.initials: NH
authors.lastname: Hjollund
authors.forename: T K
authors.initials: TK
authors.lastname: Jensen
authors.forename: J P
authors.initials: JP
authors.lastname: Bonde
authors.forename: T B
authors.initials: TB
authors.lastname: Henriksen
authors.forename: A M
authors.initials: AM
authors.lastname: Andersson
authors.forename: H A
authors.initials: HA
authors.lastname: Kolstad
authors.forename: E
authors.initials: E
authors.lastname: Ernst
authors.forename: A
authors.initials: A
authors.lastname: Giwercman
authors.forename: N E
authors.initials: NE
authors.lastname: Skakkebaek
authors.forename: J
authors.initials: J
authors.lastname: Olsen
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D001721:Birth Intervals; D006063:Chorionic Gonadotropin / Q000097:blood; D015331:Cohort Studies; D005191:Family Characteristics; D005260:Female; D005298:Fertility / Q000502:physiology*; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008597:Menstrual Cycle / Q000502:physiology / Q000523:psychology; D016017:Odds Ratio; D011247:Pregnancy / Q000523:psychology*; D011446:Prospective Studies; D013315:Stress, Psychological / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*
chemical_list: D006063:Chorionic Gonadotropin