Higher Urinary Lignan Concentrations in Women but Not Men Are Positively Associated with Shorter Time to Pregnancy

Phytoestrogens have been associated with subtle hormonal changes, although effects on fecundity are unknown. Our objective was to evaluate the association between male and female urinary phytoestrogen (isoflavone and lignan) concentrations and time to pregnancy (TIP) in a population-based cohort of 501 couples desiring pregnancy and discontinuing contraception. Couples were followed for 12 moor until pregnancy. Fecundability ORs (FORs) and 95% CIs were estimated after adjusting for age, body mass index, race, site, creatinine, supplement use, and physical activity in relation to female, male, and joint couple concentrations. Models included the phytoestrogen of interest and the sum of the remaining individual phytoestrogens. FORs <1 denote a longer UP and FORs >1 a shorter TIP. Urinary lignan concentrations were higher, on average, among female partners of couples who became pregnant during the study compared with women who did not become pregnant (median enterodiol: 118 vs. 80 nmol/L; P < 0.10; median enterolactone: 990 vs. 412 nmol/L; P < 0.05) and were associated with significantly shorter UP in models based on both individual and couples' concentrations (couples' models: enterodiol FOR, 1.13; 95% Cl: 1.02, 1.26; enterolactone FOR, 1.11; 95% Cl: 1.01, 1.21). Male lignan concentrations were not associated with HP, nor were isoflavone concentrations. Sensitivity analyses showed that associations observed are unlikely to be explained by potential unmeasured confounding by lifestyle or other nutrients. Our results suggest that female urinary lignan concentrations at levels characteristic of the U.S. population are associated with a shorter TIP among couples who are attempting to conceive, highlighting the importance of dietary influences on fecundity.