Urinary phthalate metabolite concentrations in relation to history of infertility and use of assisted reproductive technology.
OBJECTIVE
To examine urinary phthalate metabolite concentrations in pregnant women with planned pregnancies in relation to history of infertility and use of assisted reproductive technology (ART).


METHODS
Phthalate metabolite concentrations were measured in first-trimester urine samples collected from women participating in a prospective pregnancy cohort study.


METHODS
Prenatal clinics.


METHODS
A total of 750 women, of whom 86 had a history of infertility. Forty-one women used ART to conceive.


METHODS
None.


METHODS
Primary outcomes were concentrations of four metabolites of diethylhexyl phthalate (DEHP) and their molar sum (∑DEHP). Multivariable analyses compared phthalate metabolite levels in [1] women reporting a history of infertility vs. those who did not (comparison group); and [2] those who used ART to conceive the index pregnancy vs. women with a history of infertility who did not use ART.


RESULTS
Among women with a history of infertility, ∑DEHP was significantly lower in women who conceived after ART compared with those who did not (geometric mean ratio: 0.83; 95% confidence interval 0.71-0.98). Similar significant associations were observed for all of the individual DEHP metabolites. There were no differences in DEHP metabolite concentrations between women with a history of infertility and the comparison group.


CONCLUSIONS
Women who used ART to conceive had lower first-trimester phthalate metabolite concentrations than women with a history of infertility who did not use ART. Further research is needed to explore whether those pursuing fertility treatments take precautions to avoid exposure to environmental toxins, to improve treatment outcomes.
Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York. Electronic address: Snigdha_Alur@URMC.rochester.edu.
Snigdha
S
Alur
Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York.
Hongyue
H
Wang
Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York.
Kathy
K
Hoeger
Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Shanna H
SH
Swan
Department of Pediatrics, University of Washington, Seattle, Washington; Seattle Children's Research Institute, Seattle, Washington.
Sheela
S
Sathyanarayana
Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
Bruce J
BJ
Redmon
Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
Ruby
R
Nguyen
Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York.
Emily S
ES
Barrett
D000328:Adult; D015415:Biomarkers / Q000652:urine; D001711:Biotransformation; D004051:Diethylhexyl Phthalate / Q000009:adverse effects / Q000652:urine*; D052244:Endocrine Disruptors / Q000009:adverse effects / Q000652:urine*; D004781:Environmental Exposure; D004785:Environmental Pollutants / Q000009:adverse effects / Q000652:urine*; D005260:Female; D005298:Fertility; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000652:urine; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States; D016482:Urinalysis
D015415:Biomarkers; D052244:Endocrine Disruptors; D004785:Environmental Pollutants; D004051:Diethylhexyl Phthalate
ART; Phthalate; endocrine-disrupting chemicals (EDCs); infertility