title: Fertility in four regions spanning large contrasts in serum levels of widespread persistent organochlorines: a cross-sectional study.
abstract: BACKGROUND
  Persistent organochlorine pollutants (POPs) may interfere with reproductive function but direct evidence in humans is very limited.
  
  
  METHODS
  Fertility was examined in four regions with contrasting blood levels of POPs. Pregnant women and their partners in Warsaw (Poland), Kharkiv (Ukraine) and Greenland were consecutively enrolled during antenatal visits. Swedish fishermen and their spouses were recruited separately and independently of current pregnancy. Lipid adjusted serum concentrations of 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153) and 1,1-dichloro-2,2-bis (p-chlorophenyl)-ethylene (DDE) were available for both partners. Time to pregnancy interviews were obtained among 2269 women and 798 men provided a semen sample.
  
  
  RESULTS
  Inuits had high levels of both POP markers, Swedish fishermen were high in CB-153 but low in DDE, men from Kharkiv were high in DDE and low in CB-153 while men from Warsaw were low in CB-153 and had intermediate DDE levels. Compared to Warsaw couples, fecundability was reduced among couples from Kharkiv [adjusted fecundability ratio (FR) 0.64 (95% CI 0.5-0.8)] and elevated in Swedish fishermen families [FR 1.26 (95% CI 1.0-1.6)]. Adjusted geometric means of sperm counts and morphology did not differ between regions while sperm motility was higher in men living in Warsaw.
  
  
  CONCLUSIONS
  We observed regional differences in time to pregnancy and sperm motility that may be related to regional differences in POP blood levels, but other interpretations are also plausible. In particular, differences in access to safe contraception and in the prevalence of contraceptive failures are most likely to bias comparisons of time to pregnancy.
authors.affiliation: Department of Occupational Medicine, Aarhus University Hospital, Noerrebrogade 44, build, 2C, DK-8000 Aarhus C, Denmark. gutof@as.aaa.dk
authors.forename: Gunnar
authors.initials: G
authors.lastname: Toft
authors.forename: Anna
authors.initials: A
authors.lastname: Axmon
authors.forename: Aleksander
authors.initials: A
authors.lastname: Giwercman
authors.forename: Ane Marie
authors.initials: AM
authors.lastname: Thulstrup
authors.forename: Anna
authors.initials: A
authors.lastname: Rignell-Hydbom
authors.forename: Henning Sloth
authors.initials: HS
authors.lastname: Pedersen
authors.forename: Jan K
authors.initials: JK
authors.lastname: Ludwicki
authors.forename: Valentina
authors.initials: V
authors.lastname: Zvyezday
authors.forename: Andery
authors.initials: A
authors.lastname: Zinchuk
authors.forename: Marcello
authors.initials: M
authors.lastname: Spano
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Manicardi
authors.forename: Eva C
authors.initials: EC
authors.lastname: Bonefeld-Jørgensen
authors.forename: Lars
authors.initials: L
authors.lastname: Hagmar
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Bonde
mesh_terms: D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis*; D004785:Environmental Pollutants / Q000009:adverse effects* / Q000097:blood; D005260:Female; D005298:Fertility / Q000187:drug effects*; D008401:Gas Chromatography-Mass Spectrometry; D006116:Greenland; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000097:blood / Q000633:toxicity*; D008297:Male; D011044:Poland; D011247:Pregnancy; D011295:Prenatal Care; D012661:Semen / Q000187:drug effects*; D013076:Sperm Count; D018454:Spouses; D013548:Sweden; D014455:Ukraine
chemical_list: D015415:Biomarkers; D004785:Environmental Pollutants; D006843:Hydrocarbons, Chlorinated