Couples exposure to phthalates and its influence on in vitro fertilization outcomes. (July 2019)

• Record Type: Journal Article
• Authors: Al-Saleh, Iman; Coskun, Serdar; Al-Doush, Inaam; Abduljabbar, Mai; Al-Rouqi, Reem; Al-Rajudi, Tahreer; Al-Hassan, Saad
• Is Part Of: Chemosphere. Volume 226(2019)
• Page Start: 597
• Page End: 606
• Publication Date: 2019-07
• Subjects: Phthalates -- IVF -- Fertilization rate -- Biochemical pregnancy -- Clinical pregnancy -- Live birth; Pollution -- Periodicals; Pollution -- Physiological effect -- Periodicals; Environmental sciences -- Periodicals; Atmospheric chemistry -- Periodicals; 551.511
• DOI: 10.1016/j.chemosphere.2019.03.146
• Languages: English
• ISSNs: 0045-6535

Abstract

Abstract: 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. Highlights: Phthalates exposure among couples undertaking IVF treatment was prevalent. MEP and MEHP in women were associated with high risk of failed clinical pregnancy and live birth. %MEHP was associated with high risk of biochemical pregnancy, failed clinical pregnancy and live birth. %MEHP > 75th might play a role in modifying the relationship between IVF outcomes and urinary DEHP metabolites in women.