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CME / CE Released: 11/1/2006
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November 1, 2006 — Intake of iron supplements reduced risk for ovulatory infertility in a group of premenopausal women, according to the 8-year follow-up results of a prospective study reported in the November issue of Obstetrics and Gynecology.
"Whether iron intake could influence risk of ovulatory infertility among apparently healthy women without a history of previous infertility is not known," write Jorge E. Chavarro, MD, ScD, from the Harvard School of Public Health in Boston, Massachusetts, and colleagues. "Therefore, we evaluated the association between iron supplement use, total iron intake, and the incidence of ovulatory infertility in a group of women participating in the Nurses' Health Study II [NHS II]."
This prospective cohort study followed up 18,555 married, premenopausal women without a history of infertility who attempted a pregnancy or became pregnant between 1991 and 1999. Mean age at baseline was 32.6 ± 3.6 years. Diet was assessed twice during follow-up and prospectively related to the incidence of infertility caused by ovulatory disorder.
During the 8 years of follow-up, 438 women reported infertility caused by ovulatory disorder. Compared with women who did not use iron supplements, those who did had a significantly lower risk for ovulatory infertility (relative risk [RR], 0.60; 95% confidence interval, 0.39 - 0.92) after adjustment for potential confounders.
Total nonheme iron intake, primarily consumed as multivitamins and iron supplements, was inversely associated with infertility risk. The RR for women in the highest quintile of iron intake compared with those in the lowest quintile was 0.39 - 0.92 (95% confidence interval; P for trend = .005.) In multivariable adjusted analyses, heme iron intake was unrelated to ovulatory infertility.
Study limitations include that it was not a cohort of women known to be planning a pregnancy.
"Consumption of iron supplements and nonheme iron from other sources may decrease the risk of ovulatory infertility," the authors write. "Because these results have not been reported previously it is important that they are reproduced, preferably in prospective studies using diverse measures of iron intake and in randomized trials among healthy and infertile women. Nevertheless, given that iron deficiency is commonly found among women of reproductive age and may be associated with adverse pregnancy and perinatal outcomes, women planning to become pregnant should consider using iron supplements because they may help them prevent iron deficiency and also improve fertility."
The main NHS II grant and a training grant supported this study.
Obstet Gynecol. 2006;108:1145-1152.
