My research focuses on understanding how nutritional and lifestyle factors affect human reproduction and reproductive milestones throughout the life course, and how these events, in turn, impact other aspects of health. Over the last decade, this broad interest has focused primarily on understanding how nutrition impacts human fertility. More recently, my work has expanded to understand how reproductive events impact health throughout life.
The overarching goal of my infertility research is to identify modifiable lifestyle factors that may improve fertility in humans. Towards achieving this goal, I have developed and adapted a series conducted population-based and hospital-based epidemiologic studies which, together, allow a comprehensive examination of the relationship between nutrition and fertility. My work in population-based cohorts has included the identification of nutritional risk factors for infertility and conditions associated with infertility or decreased fecundity such as endometriosis, spontaneous abortion and ectopic pregnancy, as well studies of how nutrition relates to semen quality and other markers of testicular function in healthy young men. My parallel work among couples undergoing infertility treatment, which has primarily taken place at the Massachusetts General Hospital Fertility Center, has focused on understanding how pre-treatment diet of both the female and the male partner influence their chances of a successful treatment.
My research agenda has expanded to include the study of long-term health consequences exposures and events before and during pregnancy on the health of mother and child alike. This work is currently focused on two fronts. First, I am currently investigating how cesarean delivery influences growth and health trajectories throughout the life-course relative to being born by vaginal delivery. My group’s work is aimed at understanding whether differences in growth and health trajectories can be explained by incomplete accounting for confounders while also investigating potential biologic mediators of these relations including changes to the gut microbiome and changes to the epigenome. Second, we are also investigating how reproductive traits, fertility and pregnancy complications influence women’s health after pregnancy, as they go through the menopausal transition and beyond.
In order to support my substantive research, I have developed research infrastructure platforms that can be used as a multi-purpose platform supporting life course epidemiologic research. One of these platforms is the Nurses’ Health Study 3 (www.nhs3.org), an ongoing, open, web-based prospective cohort study of more than 50,000 young health professional women aimed at evaluating the role of diet, lifestyle, and biological factors on various aspects of women’s health, including fertility and health during pregnancy. In parallel, I have been involved in modifying related cohort studies, in particular the Growing Up Today Study (www.gutsweb.org) and to a lesser extent the Nurses’ Health Study II, to facilitate life course epidemiologic research integrating data across these three cohorts as a single cohesive resource for understanding the life course determinants of chronic diseases manifesting in adult life.