title: Associations between paternal urinary phthalate metabolite concentrations and reproductive outcomes among couples seeking fertility treatment.
abstract: BACKGROUND
  Limited evidence suggests that male exposure to ubiquitous environmental phthalates may result in poor reproductive outcomes among female partners.
  
  
  METHODS
  This analysis included male-female couples undergoing in vitro fertilization (IVF) and/or intrauterine insemination (IUI). We evaluated associations between the geometric mean of paternal specific gravity-adjusted urinary phthalate concentrations prior to the female partners' cycle and fertilization, embryo quality, implantation, and live birth using generalized linear mixed models.
  
  
  RESULTS
  Two-hundred eighteen couples underwent 211 IVF and 195 IUI cycles. Trends were observed between paternal urinary mono-3-carboxypropyl phthalate (MCPP; P=0.01) and mono(carboxyoctyl) phthalate (MCOP; P=0.01) and decreased odds of implantation. MCPP and MCOP were also associated with decreased odds of live birth following IVF (P=0.01 and P=0.04, respectively), and monobutyl phthalate above the first quartile was significantly associated with decreased odds of live birth following IUI (P=0.04). However, most urinary phthalate metabolites were not associated with these reproductive outcomes.
  
  
  CONCLUSIONS
  Selected phthalates were associated with decreased odds of implantation and live birth.
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Dodge
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: P L
authors.initials: PL
authors.lastname: Williams
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Williams
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Missmer
authors.affiliation: Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: I
authors.initials: I
authors.lastname: Souter
authors.affiliation: National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Calafat
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: rhauser@hsph.harvard.edu.
authors.forename: R
authors.initials: R
authors.lastname: Hauser
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000652:urine; D010064:Embryo Implantation; D005220:Fathers; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro / Q000009:adverse effects; D006801:Humans; D007246:Infertility / Q000503:physiopathology / Q000628:therapy* / Q000652:urine; D007315:Insemination, Artificial / Q000009:adverse effects; D016014:Linear Models; D050498:Live Birth; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010795:Phthalic Acids / Q000652:urine*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010795:Phthalic Acids; C032279:phthalic acid
keywords: Assisted reproduction; Fertility; Male reproduction; Phthalates