(344) Evaluating Time to Conception Changes Over Two Decades
Authors: Ripps S , Gurayah A , Weber A , Marquez K , Mouhanna J , Golan R , Miller D , Ramasamy R 
Published: February 2024

Abstract

Introduction
The time to conception is an essential factor that influences reproductive outcomes, and understanding its variance aids in appropriate family planning. Factors such as Body Mass Index (BMI), polycystic ovarian syndrome (PCOS), and maternal age significantly impact time to conception. Our study explores these factors in the light of the perceived increase in conception time over the last decade. Existing data show a decrease in births per woman worldwide over several decades; however, there is a lack evidence to prove if this trend is due to fertility or volition. Our goal was to observe whether or not a true increase in time to conception exists.

Objective
The study aimed to discern whether time to conception has increased over the past decade compared to the previous decade. The secondary aim was to explore the relationship between conception time and several variables, including BMI, PCOS, maternal age, and lifestyle habits.

Methods
We employed Amazon Mechanical Turk (MTurk) to conduct an online survey of 12 questions. The study population consisted of pregnant women from the year 2000 onwards. The survey assessed a range of factors: maternal and paternal age, pregnancy year, physical activity levels, tobacco and alcohol use, BMI, race/ethnicity, certain aspects of medical history, months to conception, and total number of gestations. Univariable logistic regression models were employed to assess the correlation between these factors and conception time.

Results
The results from 852 respondents showed no significant differences in time to conception when comparing individuals who became pregnant post-2012 versus pre-2012. However, several factors significantly influenced conception time. Mothers who exercised more than 150 minutes per week or had endometriosis, history of pelvic inflammatory disease (PID), or PCOS were 1.4, 1.7, 1.7, and 2.4 times more likely, respectively, to have longer times to conception (&gt;= 6 months) (p &lt; 0.05). Additionally, paternal factors such as undergoing chemotherapy, having testicular cancer, or varicocele were associated with 1.7, 1.6, and 3.5 times longer conception times, respectively (p &lt; 0.05).

Conclusions
Although there was no apparent increase in time to conception over the past decade, several factors were significantly associated with extended conception time. These include maternal factors like physical activity, endometriosis, PID, and PCOS, as well as paternal factors like undergoing chemotherapy, having testicular cancer or varicocele. The current guidelines recommend a twelve-month period of attempting conception before pursuing fertility assessment. This study implies that a reevaluation of these guidelines may be warranted. It is plausible that women with one or more of these risk factors should be advised to seek medical attention earlier than twelve months, or even prior to attempting conception. Understanding these relationships provides valuable insights for family planning and infertility treatment, underscoring the importance of comprehensive health and lifestyle evaluation in couples planning to conceive. Future studies should focus on developing targeted interventions to optimize these factors and potentially reduce conception time.

Disclosure
No.