Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
Department of Clinical Sciences, Division of Reproduction, The Centre for Reproductive Biology in Uppsala, Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden.
Environ Res. 2022 May 15;208:112626. doi: 10.1016/j.envres.2021.112626. Epub 2021 Dec 29.
Persistent organic pollutants (POPs) are industrial chemicals resistant to degradation and have been shown to have adverse effects on reproductive health in wildlife and humans. Although regulations have reduced their levels, they are still ubiquitously present and pose a global concern. Here, we studied a cohort of 185 women aged 21-43 years with a median of 2 years of infertility who were seeking assisted reproductive technology (ART) treatment at the Carl von Linné Clinic in Uppsala, Sweden. We analyzed the levels of 9 organochlorine pesticides (OCPs), 10 polychlorinated biphenyls (PCBs), 3 polybrominated diphenyl ethers (PBDEs), and 8 perfluoroalkyl substances (PFASs) in the blood and follicular fluid (FF) samples collected during ovum pick-up. Impact of age on chemical transfer from blood to FF was analyzed. Associations of chemicals, both individually and as a mixture, to 10 ART endpoints were investigated using linear, logistic, and weighted quantile sum regression, adjusted for age, body mass index, parity, fatty fish intake and cause of infertility. Out of the 30 chemicals, 20 were detected in more than half of the blood samples and 15 in FF. Chemical transfer from blood to FF increased with age. Chemical groups in blood crossed the blood-follicle barrier at different rates: OCPs > PCBs > PFASs. Hexachlorobenzene, an OCP, was associated with lower anti-Müllerian hormone, clinical pregnancy, and live birth. PCBs and PFASs were associated with higher antral follicle count and ovarian response as measured by ovarian sensitivity index, but also with lower embryo quality. As a mixture, similar findings were seen for the sum of PCBs and PFASs. Our results suggest that age plays a role in the chemical transfer from blood to FF and that exposure to POPs significantly associates with ART outcomes. We strongly encourage further studies to elucidate the underlying mechanisms of reproductive effects of POPs in humans.
持久性有机污染物 (POPs) 是抗降解的工业化学品，已被证明对野生动物和人类的生殖健康有不良影响。尽管法规已经降低了它们的水平，但它们仍然普遍存在，是一个全球性的关注问题。在这里，我们研究了一组 185 名年龄在 21-43 岁之间的女性，她们中位数不孕时间为 2 年，正在瑞典乌普萨拉的卡尔冯林奈诊所接受辅助生殖技术 (ART) 治疗。我们分析了在卵母细胞采集过程中采集的血液和卵泡液 (FF) 样本中 9 种有机氯农药 (OCPs)、10 种多氯联苯 (PCBs)、3 种多溴二苯醚 (PBDEs) 和 8 种全氟烷基物质 (PFASs) 的水平。分析了年龄对化学物质从血液向 FF 转移的影响。使用线性、逻辑和加权分位数总和回归，调整年龄、体重指数、产次、食用高脂肪鱼类和不孕原因，研究了化学物质个体和混合物与 10 个 ART 终点的关联。在 30 种化学物质中，有 20 种在超过一半的血液样本中被检测到，15 种在 FF 中被检测到。随着年龄的增长，血液向 FF 的化学物质转移增加。血液中的化学物质组以不同的速度穿过血-卵泡屏障：OCPs > PCBs > PFASs。六氯苯，一种 OCP，与较低的抗苗勒管激素、临床妊娠和活产有关。PCBs 和 PFASs 与较高的窦卵泡计数和卵巢反应有关，如卵巢敏感性指数所示，但也与较低的胚胎质量有关。作为混合物，PCBs 和 PFASs 的总和也有类似的发现。我们的研究结果表明，年龄在化学物质从血液向 FF 的转移中起作用，POPs 的暴露与 ART 结果显著相关。我们强烈鼓励进一步的研究，以阐明 POPs 对人类生殖影响的潜在机制。
