Background: Evidence from both animal and human studies suggests that exposure to phthalates may be associated with adverse female reproductive outcomes.
Objective: We evaluated the associations between urinary concentrations of phthalate metabolites and outcomes of assisted reproductive technologies (ART).
Methods: This analysis included 256 women enrolled in the Environment and Reproductive Health (EARTH) prospective cohort study (2004–2012) who provided one to two urine samples per cycle before oocyte retrieval. We measured 11 urinary phthalate metabolites [mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono-isobutyl phthalate (MiBP), mono-n-butyl phthalate (MBP), monobenzyl phthalate (MBzP), monoethyl phthalate (MEP), monocarboxyisooctyl phthalate (MCOP), monocarboxyisononyl phthalate (MCNP), and mono(3-carboxypropyl) phthalate (MCPP)]. We used generalized linear mixed models to evaluate the association of urinary phthalate metabolites with in vitro fertilization (IVF) outcomes, accounting for multiple IVF cycles per woman.
Results: In multivariate models, women in the highest as compared with lowest quartile of MEHP, MEHHP, MEOHP, MECPP, ΣDEHP (MEHP + MEHHP + MEOHP + MECPP), and MCNP had lower oocyte yield. Similarly, the number of mature (MII) oocytes retrieved was lower in the highest versus lowest quartile for these same phthalate metabolites. The adjusted differences (95% CI) in proportion of cycles resulting in clinical pregnancy and live birth between women in the fourth versus first quartile of ΣDEHP were –0.19 (–0.29, –0.08) and –0.19 (–0.28, –0.08), respectively, and there was also a lower proportion of cycles resulting in clinical pregnancy and live birth for individual DEHP metabolites.
Conclusions: Urinary concentrations of DEHP metabolites were inversely associated with oocyte yield, clinical pregnancy, and live birth following ART.
1Department of Environmental Health, and 2Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; 3Department of Obstetrics and Gynecology, Harvard Medical School/Massachusetts General Hospital Fertility Center, Boston, Massachusetts, USA; 4Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; 5Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA; 6Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA; 7National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; 8Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
Recommended Citation:
Russ Hauser,1,2,et al. Urinary Phthalate Metabolite Concentrations and Reproductive Outcomes among Women Undergoing in Vitro Fertilization: Results from the EARTH Study[J]. Environmental Health Perspectives,2016-01-01,Volume 124(Issue 6):831