title: Serum dioxin concentrations and quality of ovarian function in women of Seveso.
abstract: BACKGROUND
  Although 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) has been associated with alterations in ovarian function and hormones in animals, it has not been studied in humans. On 10 July 1976, an explosion exposed residents of Seveso, Italy, to the highest levels of TCDD in a population. Twenty years later, we initiated the Seveso Women's Health Study to study reproductive health.
  
  
  OBJECTIVE
  We related TCDD levels measured in sera collected near the time of explosion and ovarian function (ovarian cysts, ovarian follicles, ovulation rate, serum hormones) at follow-up.
  
  
  METHODS
  We included 363 women who were 20-40 years of age and nonusers of oral contraceptives. We examined the relationship of 1976 serum TCDD levels with ultrasound-detected ovarian follicles among 96 women in the menstrual follicular phase and serum hormone levels (estradiol, progesterone) among 129 women in the menstrual luteal phase at follow-up. Ovulation was defined by serum progesterone levels > 3 ng/mL.
  
  
  RESULTS
  The median serum TCDD level was 77.3 ppt, lipid-adjusted. Serum TCDD was not associated with number or size of ovarian follicles. Of women in the luteal phase, 87 (67%) ovulated. Serum log(10)TCDD was not associated with odds of ovulation [adjusted odds ratio = 0.99; 95% confidence interval (CI), 0.5 to 1.9]. Among those who had ovulated, serum log(10)TCDD was not associated with serum progesterone [adjusted beta (adj-beta ) = -0.70; 95% CI, -2.4 to 1.0] or estradiol (adj-beta = -1.81; 95% CI, -10.4 to 6.8).
  
  
  CONCLUSIONS
  We found no clear evidence that 1976 TCDD exposure was associated with ovarian function 20 years later in women exposed to relatively high levels in Seveso, Italy.
authors: School of Public Health, University of California at Berkeley, Berkeley, California 94720-7360, USA. mwarner@berkeley.edu
authors: Marcella
authors: M
authors: Warner
authors: Brenda
authors: B
authors: Eskenazi
authors: David L
authors: DL
authors: Olive
authors: Steven
authors: S
authors: Samuels
authors: Sunita
authors: S
authors: Quick-Miles
authors: Paolo
authors: P
authors: Vercellini
authors: Pier Mario
authors: PM
authors: Gerthoux
authors: Larry
authors: L
authors: Needham
authors: Donald G
authors: DG
authors: Patterson
authors: Paolo
authors: P
authors: Mocarelli
mesh_terms: D000328:Adult; D004781:Environmental Exposure; D004785:Environmental Pollutants / Q000097:blood* / Q000633:toxicity; D004958:Estradiol / Q000097:blood; D005107:Explosions; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000453:epidemiology; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000187:drug effects; D010053:Ovary / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000502:physiology; D010060:Ovulation / Q000187:drug effects; D000072317:Polychlorinated Dibenzodioxins / Q000097:blood* / Q000633:toxicity; D011374:Progesterone / Q000097:blood; D014463:Ultrasonography
chemical_list: D004785:Environmental Pollutants; D000072317:Polychlorinated Dibenzodioxins; D011374:Progesterone; D004958:Estradiol