Delayed conception in women with low-urinary iodine concentrations: a population-based prospective cohort study

Is iodine deficiency associated with decreased fecundability? Moderate to severe iodine deficiency is associated with a 46% decrease in fecundability. Iodine deficiency is common in women of childbearing age but its effect on fecundability has not been investigated. The LIFE Study, a population-based prospective cohort study, enrolled 501 women who had discontinued contraception within 2 months to become pregnant between 2005 and 2009. Women reported on risk factors for infertility by interview then kept daily journals of relevant information. Women used fertility monitors to time intercourse relative to ovulation then used home digital pregnancy tests to identify pregnancies on the day of expected menstruation. Urine samples for iodine analysis were collected on enrollment. Samples were in the deficiency range in 44.3% of participants. The group whose iodine-creatinine ratios were below 50 mu g/g (moderate to severe deficiency) had a 46% reduction in fecundity (P = 0.028) compared with the group whose iodine-creatinine ratios were in the adequate range: adjusted fecundability odds ratio of becoming pregnant per cycle, 0.54 (95% confidence interval 0.31-0.94). Iodine concentrations vary within individuals over time, so the data must be interpreted by group as we have done; residual confounding is possible. Significant delays in becoming pregnant occur at iodine concentrations that are common in women in the USA and parts of Europe. Replicating these findings will be important to determine whether improving iodine status could be beneficial in improving fecundability.