{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T03:10:06Z","timestamp":1772939406406,"version":"3.50.1"},"posted":{"date-parts":[[2026,3,4]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":40,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Mycoplasma genitalium (MG)<\/jats:italic>\n                    is an emerging sexually transmitted infection (STI) associated with pelvic inflammatory disease and tubal factor infertility. Its relationship with impaired fecundity remains unclear and is rarely examined in the context of co-seropositivity with other STIs.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\n                    We conducted a secondary analysis of the Effects of Aspirin in Gestation and Reproduction (EAGeR) trial, a prospective preconception cohort of women with proven fecundity and prior pregnancy loss.\n                    <jats:italic>MG<\/jats:italic>\n                    serostatus was determined using Western blot\u2013based IgG assays on 1146 stored serum specimens.\n                    <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                    (CT) and other STIs were also measured. Associations between MG seropositivity and measures of impaired fecundity were assessed.\n                  <\/jats:p>\n                  <jats:p>\n                    Pregnancy loss and live birth were modeled using inverse-probability weighted quasi-Poisson and unweighted log-binomial models to calculate relative risks (RR). Fecundability-odds-ratio (FOR) was estimated using a discrete Cox proportional hazards model accounting for left truncation and right censoring. Propensity score (PS) weighted versions of these models assessed risks associated with\n                    <jats:italic>CT<\/jats:italic>\n                    co-seropositivity. Analyses were adjusted for demographic and reproductive history variables.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    Overall, 17.1% (n=210) of participants were\n                    <jats:italic>MG<\/jats:italic>\n                    seropositive, with 27.6% (n=58) co-seropositive with\n                    <jats:italic>CT<\/jats:italic>\n                    . Compared to STI-seronegative women,\n                    <jats:italic>MG<\/jats:italic>\n                    seropositivity was not associated with any outcome, although trends were observed for reduced fecundability (FOR\n                    <jats:sub>adj<\/jats:sub>\n                    : 0.87, 95% CI 0.70-1.08) and live birth (RR\n                    <jats:sub>adj<\/jats:sub>\n                    : 0.94, 95% CI 0.79-1.11). Co-seropositivity with\n                    <jats:italic>CT<\/jats:italic>\n                    was associated with lower likelihood of live birth [Relative Risk (RR)\n                    <jats:sub>PS-weighted<\/jats:sub>\n                    : 0.82, 95% CI: 0.70-0.96]. Sensitivity analyses supported the robustness of these findings.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>\n                    Being co-seropositive for\n                    <jats:italic>MG<\/jats:italic>\n                    and\n                    <jats:italic>CT<\/jats:italic>\n                    preconception may impair fecundity.\n                  <\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.03.03.26347541","type":"posted-content","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T03:45:12Z","timestamp":1772682312000},"source":"Crossref","is-referenced-by-count":0,"title":["Preconception\n                  <i>Mycoplasma genitalium<\/i>\n                  Seropositivity and Risk of Impaired Fecundity"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6747-8821","authenticated-orcid":false,"given":"Yajnaseni","family":"Chakraborti","sequence":"first","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4312-708X","authenticated-orcid":false,"given":"Stefanie N.","family":"Hinkle","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7464-7435","authenticated-orcid":false,"given":"J\u00f8rgen Skov","family":"Jensen","sequence":"additional","affiliation":[{"name":"Research Unit for Reproductive Microbiology, Statens Serum Institut, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5150-1153","authenticated-orcid":false,"given":"Anna Overgaard","family":"Kildemoes","sequence":"additional","affiliation":[{"name":"Research Unit for Reproductive Microbiology, Statens Serum Institut, Copenhagen, Denmark"},{"name":"Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9849-7865","authenticated-orcid":false,"given":"Catherine L.","family":"Haggerty","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 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