Human Fecundity and Fertility

Germaine M. Buck Louis

Playlist Goals:

To acquaint readers with the field of human fecundity and related fecundity impairments (e.g., infertility and pregnancy loss) from a substantive and methodological perspective.

 To identify important methodological considerations for study design and analysis.

 To emphasize that human fecundity has implications for health and disease across the lifespan. 

 Rationale for Selection of Key Readings:

Fecundity is defined as the biologic capacity of men and women for reproduction irrespective of pregnancy intentions.  Fecundity impairments span a range of male and female outcomes, such as diminished semen quality, conception delay or infertility and pregnancy loss.  Terminology does vary by scientific discipline and geography, but harmonization efforts are being discussed.  There are important conceptual and methodological considerations that impact study, including the inefficiency of human reproduction relative to other species; hidden outcomes such as the absence of a biomarker for conception requiring reliance on a proxy – implantation; a hierarchical data structure; correlated outcomes; past reproductive performance (a strong predictor of future performance), and conditioning on intermediates.  Of late, a growing body of evidence suggests that fecundity is informative for health status across the life course, as conceptualized in the testicular and ovarian dysgenesis syndromes.  As such, fecundity may be the ‘biomarker’ of adult health. 

 These suggested readings include a somewhat historical perspective on human fecundity and related impairments, select methodological considerations, and the implications for health across the lifespan.

 Suggested Readings

(*Selected abbreviated reading)

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