title: Serum concentrations of polychlorinated biphenyls in relation to in vitro fertilization outcomes.
abstract: BACKGROUND
  Human exposure to polychlorinated biphenyls (PCBs) remains widespread. PCBs have been associated with adverse reproductive health outcomes including reduced fecundability and increased risk of pregnancy loss, although the human data remain largely inconclusive.
  
  
  OBJECTIVE
  Our goal was to explore the relationship between serum PCB concentrations and early pregnancy loss among a large cohort of women undergoing in vitro fertilization (IVF) between 1994 and 2003.
  
  
  METHODS
  Concentrations of 57 PCB congeners were measured in serum samples collected during 827 IVF/intracytoplasmic sperm injection cycles from 765 women. Joint statistical models that accommodate multiple outcomes and multiple cycles per woman were used to assess the relationship between serum PCB quartiles and implantation failure, chemical pregnancies (human chorionic gonadotropin level > 5.0 mIU/mL) that did not result in clinical pregnancy, or spontaneous abortion, while also adjusting for confounders.
  
  
  RESULTS
  PCB-153 was the congener present in the highest concentration (median, 46.2 ng/g lipid). Increasing quartiles of PCB-153 and the sum of all measured PCB congeners (ΣPCBs) were associated with significantly elevated dose-dependent odds of failed implantation. Adjusted odds ratios (95% confidence interval) for highest versus lowest quartile were 2.0 (1.2-3.4) for PCB-153 and 1.7 (1.0-2.9) for ΣPCBs. There were suggestive trends for increased odds of implantation failure for PCB-118 and cytochrome P450-inducing congeners (p-values for trend = 0.06). No statistically significant associations between PCBs and chemical pregnancy or spontaneous abortion were found.
  
  
  CONCLUSIONS
  Serum PCB concentrations at levels similar to the U.S. general population were associated with failed implantation among women undergoing IVF. These findings may help explain previous reports of reduced fecundability among women exposed to PCBs.
authors.affiliation: Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109, USA. meekerj@umich.edu
authors.forename: John D
authors.initials: JD
authors.lastname: Meeker
authors.forename: Arnab
authors.initials: A
authors.lastname: Maity
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Missmer
authors.forename: Paige L
authors.initials: PL
authors.lastname: Williams
authors.forename: Shruthi
authors.initials: S
authors.lastname: Mahalingaiah
authors.forename: Shelley
authors.initials: S
authors.lastname: Ehrlich
authors.forename: Katharine F
authors.initials: KF
authors.lastname: Berry
authors.forename: Larisa
authors.initials: L
authors.lastname: Altshul
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Perry
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Cramer
authors.forename: Russ
authors.initials: R
authors.lastname: Hauser
mesh_terms: D000022:Abortion, Spontaneous / Q000139:chemically induced / Q000453:epidemiology; D000328:Adult; D001900:Boston / Q000453:epidemiology; D015331:Cohort Studies; D010064:Embryo Implantation / Q000187:drug effects; D004781:Environmental Exposure; D004785:Environmental Pollutants / Q000097:blood / Q000633:toxicity; D005189:False Positive Reactions; D005260:Female; D005307:Fertilization in Vitro / Q000187:drug effects*; D006801:Humans; D011078:Polychlorinated Biphenyls / Q000097:blood* / Q000633:toxicity*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology
chemical_list: D004785:Environmental Pollutants; D011078:Polychlorinated Biphenyls