Couples exposure to phthalates and its influence on in vitro fertilization outcomes
Couples exposure to phthalates and its influence on in vitro fertilization outcomes
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DOI：
10.1016/j.chemosphere.2019.03.146
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发表时间：
2019-07-01
期刊：
影响因子：
8.8
通讯作者：
Al-Hassan, Saad
中科院分区：
文献类型：
--
作者：
Al-Saleh, Iman;Coskun, Serdar;Al-Hassan, Saad
This prospective study examined the associations between the levels of eight urinary phthalate metabolites in 599 couples and in vitro fertilization (IVF) outcomes. We used log-binomial multivariate regression to estimate relative risks (RR) for the association between phthalate concentration and IVF binary outcomes (fertilization rate >50%, biochemical pregnancy, clinical pregnancy and live birth) for each woman after adjusting the model for the concentration in a male partner and each relevant confounders. RR was expressed per unit increase in log-transformed urinary metabolite concentration. The percentage of bis-2-ethylhexyl phthalate (DEHP) metabolites excreted as mono-2-ethylhexyl phthalate (MEHP) was calculated as %MEHP. Urinary MEHP in women was associated with an increased risk of biochemical pregnancy (RR =1.35; p = 0.04), failed clinical pregnancy (RR =1.56; p = 0.006) and live birth (RR =1.54; p = 0.011). An increase in monoethyl phthalate was associated with a high risk of failed clinical pregnancy (RR= 1.25; p = 0.03) and live birth (RR =1.35; p = 0.006). An increase in %MEHP was associated with an increase in the risk of biochemical pregnancy (RR= 1.55; p = 0.05), failed clinical pregnancy (RR= 1.73; p = 0.02) and live birth (RR =1.65; p = 0.046). Our results demonstrated that exposure to some phthalates may adversely affect IVF outcomes, particularly when couples' exposure was jointly modeled, emphasizing the importance of a couple-based approach in assessing fertility outcomes. The associations between IVF outcomes and DEHP metabolites were stronger in women whose %MEHP was >75th percentile which may be due to their less efficient metabolism and excretion of DEHP and/or MEHP. (C) 2019 Elsevier Ltd. All rights reserved.
