Secondhand tobacco smoke exposure is associated with increased risk of failed implantation and reduced IVF success
Secondhand tobacco smoke exposure is associated with increased risk of failed implantation and reduced IVF success
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DOI：
10.1093/humrep/der226
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发表时间：
2011-09-01
影响因子：
6.1
通讯作者：
Meeker, John D.
中科院分区：
文献类型：
--
作者：
Benedict, Merle D.;Missmer, Stacey A.;Meeker, John D.
背景：不孕症和早期妊娠流产与暴露于二手烟草烟雾（STS）一样普遍。先前的研究表明，暴露于STS与早期妊娠丢失之间存在关系，但研究受到研究规模小和/或暴露估计方法不精确的限制。体外受精允许收集卵泡液（FF），卵泡液是围绕排卵前卵母细胞的液体，在早期生殖研究中，它可能是比尿液或血清更具有生物学相关性的样本介质。方法：在一项前瞻性队列研究的回顾性分析中，我们测量了1994年至2003年间1909名非吸烟女性在3270个IVF治疗周期中收集的FF中的可替宁，以研究STS暴露与植入失败之间的关系。结果：在调整后的模型中，我们发现暴露于STS的女性与未暴露于STS的女性相比，植入失败的风险显著增加[优势比（OR） 1.52；95%置信区间(CI) = 1.20-1.92；风险比(RR) = 1.17；95% ci = 1.10-1.25]。我们还发现，暴露于sts的妇女活产的几率显著降低（OR = 0.75; 95% CI = 0.57-0.99; RR = 0.81; 95% CI = 0.66-0.99）。结论：通过测量FF中的可替宁，估计女性STS暴露与植入失败风险增加和活产几率降低有关。
BACKGROUND: Infertility and early pregnancy loss are prevalent as is exposure to secondhand tobacco smoke (STS). Previous research has suggested a relationship between STS exposure and early pregnancy loss, but studies have been limited by small study sizes and/or imprecise methods for exposure estimation. IVF allows for the collection of follicular fluid (FF), the fluid surrounding the pre-ovulatory oocyte, which may be a more biologically relevant sample media than urine or serum in studies of early reproduction.METHODS: In a retrospective analysis of a prospective cohort study, we measured cotinine in FF collected during 3270 IVF treatment cycles from 1909 non-smoking women between 1994 and 2003 to examine the relationship between STS exposure and implantation failure.RESULTS: In adjusted models, we found a significant increase in the risk of implantation failure among women exposed to STS compared with those unexposed [odds ratio (OR) 1.52; 95% confidence interval (CI) = 1.20-1.92; risk ratio (RR) = 1.17; 95% CI = 1.10-1.25]. We also found a significant decrease in the odds for a live birth among STS-exposed women (OR = 0.75; 95% CI = 0.57-0.99; RR = 0.81; 95% CI = 0.66-0.99).CONCLUSIONS: Female STS exposure, estimated through the measurement of cotinine in FF, is associated with an increased risk of implantation failure and reduced odds of a live birth.