Night Shift Among Women: Is It Associated With Difficulty Conceiving a First Birth?

Background: Asynchrony in circadian processes alters many physiological systems, including female reproduction. Thus, there are possible reproductive consequences of night shift work for women including menstrual irregularity, endometriosis, and prolonged time to conception. This study examined whether women who worked night shift were more likely than those who did not to require fertility treatment to conceive a first birth, whether they had specific infertility diagnoses, and if such relationships were age-specific. Methods: In a retrospective data linkage study of 128,852 primiparous women, fertility treatment data were linked to the state perinatal registry for South Australia (1986-2002). Potential exposure to night shift work was assessed using a job-exposure matrix. First, the association between night shift work and fertility treatment was assessed among (1) all women, then (2) women in paid employment, using logistic regression. Interactions between age and shift work status were also examined. Secondly, among women who conceived with fertility treatment, we assessed associations between night shift work and type of infertility diagnosis. Potential confounders were considered in all analyses. Results: Among women <= 35 years, night shift workers were more likely to require fertility treatment (all: OR = 1.40, 95% CI 1.19-1.64; in paid employment: OR = 1.27, 95% CI 1.08-1.50). There were no associations among women >35 years. Ethnicity, socioeconomic status and smoking did not affect these results. Among women who underwent fertility treatment, night shift workers were more likely than day workers to have menstrual irregularity (OR = 1.42, 95% CI 1.05-1.91) or endometriosis (OR = 1.34, 95% CI 1.00-1.80). Conclusions: Night shift work may contribute to increased need for fertility treatment in younger women. This increased risk may reflect young women's vulnerability in terms of poor tolerance of night shift work, and/or lack of control and choice about shift schedule.