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. 2018 May;29(3):369-378.
doi: 10.1097/EDE.0000000000000812.

Intake of Sugar-sweetened Beverages and Fecundability in a North American Preconception Cohort

Free PMC article

Intake of Sugar-sweetened Beverages and Fecundability in a North American Preconception Cohort

Elizabeth E Hatch et al. Epidemiology. .
Free PMC article


Background: Dietary factors, including sugar-sweetened beverages, may have adverse effects on fertility. Sugar-sweetened beverages were associated with poor semen quality in cross-sectional studies, and female soda intake has been associated with lower fecundability in some studies.

Methods: We evaluated the association of female and male sugar-sweetened beverage intake with fecundability among 3,828 women planning pregnancy and 1,045 of their male partners in a North American prospective cohort study. We followed participants until pregnancy or for up to 12 menstrual cycles. Eligible women were aged 21-45 (male partners ≥21), attempting conception for ≤6 cycles, and not using fertility treatments. Participants completed a comprehensive baseline questionnaire, including questions on sugar-sweetened beverage consumption during the previous 4 weeks. We estimated time-to-pregnancy from follow-up questionnaires completed every 2 months by the female partner. We calculated adjusted fecundability ratios (FR) and 95% confidence intervals (CIs) according to intake of sugar- sweetened beverages using proportional probabilities regression.

Results: Both female and male intakes of sugar-sweetened beverages were associated with reduced fecundability (FR = 0.81; 95% CI = 0.70, 0.94 and 0.78; 95% CI = 0.63, 0.95 for ≥7 sugar-sweetened beverages per week compared with none, for females and males, respectively). Fecundability was further reduced among those who drank ≥7 servings per week of sugar-sweetened sodas (FR = 0.75, 95% CI = 0.59, 0.95 for females and 0.67, 95% CI = 0.51, 0.89 for males).

Conclusions: Sugar-sweetened beverages, particularly sodas and energy drinks, were associated with lower fecundability, but diet soda and fruit juice had little association.

Conflict of interest statement

The authors declare that they have no conflict of interest. The computing code and de-identified data are available by contacting the first or last author.


Figure 1
Figure 1
Association between female (a) and male (b) sugar-sweetened soda intake and fecundability, fitted by restricted cubic splines, PRESTO, 2013–2017. The reference level for the FR is 0 sugar-sweetened sodas/week. The curve for female sugar-sweetened soda intake and fecundability is adjusted for female age, race/ethnicity, education, income, smoking history, BMI, physical activity, caffeine intake, sleep duration, PSS-10 score, intercourse frequency, and doing something to improve chances of conception. The curve for male sugar-sweetened soda intake and fecundability is adjusted for male and female age, male race/ethnicity, male and female BMI, education, income, and smoking. The splines are trimmed at the 99th percentile and have three knots at 2, 5, and 10 sugar-sweetened sodas/week.

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