Epidemiology, Environment, & Reproduction

Research Summary

The Fertility and Reproductive Health Group is led by Anne Marie Z. Jukic, Ph.D., who also has a secondary appointment in the Reproductive and Developmental Biology Laboratory. The Fertility and Reproductive Health Group focuses on factors that influence reproductive function (e.g., follicle development and menstrual cycles), conception, implantation, placental development, and pregnancy outcomes. Given the financial and emotional burden of subfertility and pregnancy loss, this research has broad and immediate public health relevance.

Menstrual cycles are an indicator of general health and menstrual cycle disturbances may predict difficulties in conceiving a pregnancy. Moreover, women with menstrual cycle irregularities may be treated with hormonal contraception, and there are currently no alternatives for women who desire non-hormonal options to regulate their cycles. Lower levels vitamin D have been associated with prolonged or irregular menstrual cycles, delayed ovulation, and lower pregnancy rates. Low levels of vitamin D are common in the U.S., especially among African-American and Hispanic women. Jukic recently received a Bench-to-Bedside award to support a clinical trial that further investigates the role of vitamin D in menstrual cycles and menstrual cycle hormones. The inVitD Trial is currently enrolling participants with the primary aim of examining how vitamin D supplementation affects reproductive hormones – the backbone of the reproductive axis. inVitD will also examine novel biological pathways for vitamin D action, including through the collection of menstrual effluent.

In addition to vitamin D, research by this Group includes air pollution, heat, phthalates, and phenols. The Fertility and Reproductive Health Group aims to be responsive to novel and emerging environmental exposures.

All research in the Fertility and Reproductive Health Group focuses on at least one of the following:

  1. Environmental exposure assessment in the context of reproductive endpoints
  2. Rigorous and reproducible analytic methods and design
  3. Examination of potential biological pathways

Data Sources

Time to Conceive
Time to Conceive is prospective time-to-pregnancy cohort of females aged 30-44. Participants enrolled at the beginning of their pregnancy attempt and were followed for conception. This study includes prospective measurement of menstrual cycles, pregnancy loss, and pregnancy outcomes. Blood samples have been measured for vitamin D, C-reactive protein, and ovarian reserve biomarkers. Geospatial exposure assessments are ongoing.

The Apple Women's Health Study
 The Apple Women's Health Study aims to gain a deeper understanding of how certain demographic and lifestyle factors could have an impact on menstrual cycles and gynecologic conditions including infertility, menopause, and polycystic ovary syndrome (PCOS). The study includes cycle tracking data and other data from iPhone and/or Apple Watch (optional) and participants’ survey responses.

The North Carolina Early Pregnancy Study
The North Carolina Early Pregnancy Study (EPS) was conducted during the early 80s (1982-86) by the original PIs: Wilcox, Baird, Weinberg. The EPS enrolled 221 women who discontinued contraception in order to become pregnant. Participants were healthy with no known fertility problems. Women completed daily diaries and collected daily first-morning urine specimens for six months, or through the 8th week past LMP if they conceived. Women who became pregnant were followed to determine their pregnancy outcome. Urine specimens have been analyzed for several biomarkers including phthalates, phenols, estrone-3-glucuronide, pregnanediol-3-glucuronide, and human chorionic gonadotrophin (hCG).

Jukic received a B.S. from the University of Notre Dame, an M.S.P.H. from Emory University, and a Ph.D. in epidemiology from the University of North Carolina at Chapel Hill. She completed a postdoctoral fellowship at NIEHS and was an Assistant Professor at the Yale School of Public Health before joining NIEHS as a Principal Investigator.