title: Menstrual cycle characteristics: associations with fertility and spontaneous abortion.
abstract: BACKGROUND
  Epidemiologists often use menstrual cycle patterns as indicators of endocrine function in environmental and occupational studies, yet few studies have considered whether menstrual cycle characteristics are associated with fertility or pregnancy outcome.
  
  
  METHODS
  We prospectively studied 470 women to determine whether cycle length or bleed length were associated with fertility or spontaneous abortion. Women completed daily diaries with information on menstrual bleeding, intercourse, birth control use, and covariates. For each menstrual cycle, women collected at least 2 urine samples, which were assayed for human chorionic gonadotropin to define early pregnancies. Women were followed for 1 year or until the end of a clinical pregnancy.
  
  
  RESULTS
  Cycles with lengths of 30 to 31 days preceded cycles with the highest fecundity. Shorter cycles were less likely to be followed by conception (fecundity ratio [FR] = 0.6; 95% confidence interval [CI] = 0.4-1.0). Compared with 30- to 31-day cycles, conceptions after shorter and longer cycles were more likely to be spontaneously aborted (for shorter cycles, odds ratio [OR] = 3.0 [95% CI = 0.9-9.6] and for longer cycles, OR = 3.0 [0.9-10.6]). Cycles with 5 days of menstrual bleeding had the highest fecundity. Cycles with up to 4 days of bleeding had lower fecundity (for bleed lengths of 4 days, FR = 0.5 [0.3-0.8] and for bleed lengths less than 4 days, FR = 0.6 [0.3-0.9]). Spontaneous abortion was less likely after bleeds greater than 5 days (OR = 0.4 [0.1-1.1]) when compared with 5-day bleeds.
  
  
  CONCLUSIONS
  Menstrual cycle characteristics appear to be associated with fertility and spontaneous abortion.
authors.affiliation: Department of Epidemiology, Emory University, 1518 Clifton Rd., Atlanta, Georgia 30322, USA. csmall@sph.emory.edu
authors.forename: Chanley M
authors.initials: CM
authors.lastname: Small
authors.forename: Amita K
authors.initials: AK
authors.lastname: Manatunga
authors.forename: Mitchel
authors.initials: M
authors.lastname: Klein
authors.forename: Heather S
authors.initials: HS
authors.lastname: Feigelson
authors.forename: Celia E
authors.initials: CE
authors.lastname: Dominguez
authors.forename: Ruth
authors.initials: R
authors.lastname: McChesney
authors.forename: Michele
authors.initials: M
authors.lastname: Marcus
mesh_terms: D000022:Abortion, Spontaneous; D000328:Adult; D005260:Female; D005298:Fertility; D006801:Humans; D008404:Massachusetts; D008597:Menstrual Cycle; D009515:New Jersey; D009518:New York; D011247:Pregnancy; D011256:Pregnancy Outcome