P-462 The current status of female reproductive health and preconception behaviour in the UK: cross-sectional data from over 135,145 Hertility users
Authors: O'Neill H , Vasavan T , Rodrigues Vaz S , Lawrie L , Getreu N , Timpson A 
Published: June 2023

Abstract

Study question
We sought to characterise the reproductive health of a large cohort of UK-based women to assess the lifestyle of those who were trying to conceive

Summary answer
The vast majority were experiencing one or more symptoms and a substantial number of women who were trying to conceive were leading an unfavourable lifestyle.

What is known already
Data regarding the prevalence of female reproductive health conditions within the UK is outdated, heterogeneous and often collected from cohorts unrepresentative of the current background population. Recent evidence suggests 31% of UK-based women experience at least one severe reproductive health symptom annually (Public Health England, 2018), however this data was also collected from a small population.
Furthermore, although guidance regarding the optimisation of fertility in those trying to conceive (TTC) is available, the uptake of lifestyle changes to preconception behaviour regarding smoking, recreational drug use, alcohol consumption, body weight and physical activity is unknown.

Study design, size, duration
A cross-sectional study was conducted on 135,145 women who were &gt;18 years old and completed a health assessment for Hertility, an at-home women’s health testing service available in the UK, between September 2020 and January 2023.

Participants/materials, setting, methods
Data was collected from women who completed a free virtual health assessment (VHA) on Hertility’s website consisting of up to 24 questions assessing the user’s demographics, lifestyle and medical history. The number of questions presented to the user differed depending on their archetype and only the most recent VHA data was analysed from registered users who completed it multiple times. Counts, means and percentages of completed VHAs were calculated using R software.

Main results and the role of chance
Of 135,145 users, the most common pre-existing reproductive health conditions reported were polycystic ovary syndrome (12.0%, n = 16,181), endometriosis (4.0%, n = 5,393), fibroids or uterine polyps (3.0%, n = 4,092), pelvic inflammatory disease (1.8%, n = 2,387) and premature ovarian insufficiency (0.2%, n = 311). The majority of all users (80.5%, n = 108,833) reported currently experiencing one or more symptoms indicative of an underlying reproductive or thyroid health condition, most commonly: fatigue (48.5%, n = 65,593), irritability (35.1%, n = 47,426), acne (30.4%, n = 41,071), feeling cold often (30.4%, n = 41,071) and irregular periods (26.7%, n = 36,108).
Of the 26.2% (n = 35,352) who reported they were actively TTC, 45.6% (n = 12,920) were consuming alcohol on a weekly basis, 28.1% (n = 9,667) were regular or occasional smokers and 8.4% (n = 2,876) were regular or occasional recreational drug users. Additionally, 3.9% (n = 1,351) and 38.9% (n = 13,541) had a body mass index (BMI) of &lt; 18.5 or &gt; 30 kg/m2 respectively and 12.1% (n = 4279) were not physically active.

Limitations, reasons for caution
As all data was self-reported, there is a risk of recall bias and false reporting. As the users who completed the VHA were seeking a reproductive healthcare service, there is likely a bias in the selection criteria of study participants. Additionally, users were given limited answer options to select from.

Wider implications of the findings
UK-based women are receiving inadequate symptom management and preconception counselling, evidenced by the majority of users experiencing one or more active symptoms of a reproductive or thyroid health condition and a substantial number TTC who have BMIs and/or lifestyle behaviour(s) associated with decreased conception and live birth rates.

Trial registration number
not applicable