Where you live can affect your ability to conceive, study finds

People who live in socioeconomically deprived neighborhoods are about 20% less likely to conceive in any given menstrual cycle compared with people living in neighborhoods with more resources, a recent Oregon State University study found.

The study measured “fecundability,” which is the monthly probability of getting pregnant, among couples attempting conception without the use of fertility treatments.

Researchers compared neighborhoods based on their “area deprivation index” score, a measure of the socioeconomic resources in a neighborhood. They found that even among a relatively affluent, highly educated study population, people living in more deprived neighborhoods had lower fecundability rates than people living in higher-opportunity neighborhoods.

“The world of fertility research is beginning to examine factors associated with the built environment. There are dozens of studies looking at how your neighborhood environment is associated with adverse birth outcomes, but the pre-conception period is heavily under-studied from a structural standpoint,” said lead author Mary Willis, a postdoctoral scholar in OSU’s College of Public Health and Human Sciences. “Turns out, before you’re even conceived, there may be things affecting your health.”

Public health research in the last decade has highlighted the importance of social determinants of health and the idea that ZIP code is the greatest predictor for overall life expectancy, based on factors like income, health care access, employment rates, education level and access to safe water.

“But the concept that your neighborhood affects your fertility hasn’t been studied in depth,” Willis said. “In addition, the world of infertility research is largely focused on individual factors, so when I came into this study as an environmental epidemiologist, I was thinking we should look at it as a structural problem.”

The study leveraged data from an ongoing study by Boston University, the Pregnancy Study Online (PRESTO). Researchers analyzed a cohort of 6,356 individuals ranging from 21 to 45 years old, attempting to conceive without the use of fertility treatment, in data compiled from 2013 through 2019.

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