Incorporating heterogeneous intercourse records into time to pregnancy models

Abstract

Information on the timing of intercourse relative to ovulation can be incorporated into time to pregnancy models to improve the power to detect covariate effects, to estimate the day-specific conception probabilities, and to distinguish between biological and behavioral effects on fecundability, and therefore the probability of conception in a menstrual cycle. In this paper, Bayesian methods are proposed for joint modeling of intercourse behavior and biologic fecundability. The model accommodates a sterile subpopulation of couples, general covariate effects, and heterogeneity among fecund couples in menstrual cycle viability and in frequency of unprotected intercourse. Methods are described for incorporating cycles with varying amounts of intercourse information into a single analysis. A Markov chain Monte Carlo algorithm is outlined for estimation of the posterior distributions of the unknowns. Themethods are applied to data from a North Carolina study of couples attempting pregnancy.