Mínguez-Alarcón Lidia, Souter Irene, Williams Paige L, Ford Jennifer B, Hauser Russ, Chavarro Jorge E, Gaskins Audrey J
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Occup Environ Med. 2017 Jun;74(6):426-431. doi: 10.1136/oemed-2016-103953. Epub 2017 Feb 6.
To explore whether work schedules and physically demanding work were associated with markers of ovarian reserve and response.
This analysis included women (n=473 and n=313 for ovarian reserve and ovarian response analysis, respectively) enrolled in a prospective cohort study of couples presenting to an academic fertility centre (2004-2015). Information on occupational factors was collected on a take-home questionnaire, and reproductive outcomes were abstracted from electronic medical records. Generalised linear models and generalised linear mixed models were used to evaluate the associations.
Women who reported lifting or moving heavy objects at work had 1.0 fewer total oocytes (p=0.08), 1.4 fewer mature oocytes (p=0.007) and 0.7 fewer antral follicles (p=0.06) compared with women who reported never lifting or moving heavy objects at work. The inverse association between heavy lifting and oocyte yield was stronger in women >37 years and with a Body Mass Index ≥25 kg/m. Women who worked evening/night/rotating shifts had 2.3 (p<0.001) fewer mature oocytes, on average, compared with women who worked day-only shifts. None of the occupational exposures were associated with day 3 follicle-stimulating hormone or peak oestradiol levels.
Women working non-daytime shifts and those with physically demanding jobs had fewer mature oocytes retrieved after controlled ovarian hyperstimulation. Our results provide insight into possible mechanisms linking these occupational exposures with decreased fecundity.
探讨工作时间表和体力要求高的工作是否与卵巢储备和反应指标相关。
本分析纳入了参加一家学术性生育中心前瞻性队列研究的女性（分别有473名和313名女性用于卵巢储备和卵巢反应分析）（2004 - 2015年）。通过一份带回家填写的问卷收集职业因素信息，并从电子病历中提取生殖结局。使用广义线性模型和广义线性混合模型来评估相关性。
与报告在工作中从未搬运重物的女性相比，报告在工作中搬运重物的女性，其总卵母细胞少1.0个（p = 0.08），成熟卵母细胞少1.4个（p = 0.007），窦卵泡少0.7个（p = 0.06）。在年龄大于37岁且体重指数≥25 kg/m²的女性中，搬运重物与卵母细胞产量之间的负相关更强。与只上日班的女性相比，上晚班/夜班/轮班的女性平均成熟卵母细胞少2.3个（p < 0.001）。没有一种职业暴露与第3天的促卵泡激素或雌二醇峰值水平相关。
非白班工作的女性以及从事体力要求高工作的女性在控制性卵巢过度刺激后获得的成熟卵母细胞较少。我们的结果为将这些职业暴露与生育力下降联系起来的可能机制提供了见解。
