Occupational factors and markers of ovarian reserve and response among women at a fertility centre.
To explore whether work schedules and physically demanding work were associated with markers of ovarian reserve and response.



This analysis included women (n=473 and n=313 for ovarian reserve and ovarian response analysis, respectively) enrolled in a prospective cohort study of couples presenting to an academic fertility centre (2004-2015). Information on occupational factors was collected on a take-home questionnaire, and reproductive outcomes were abstracted from electronic medical records. Generalised linear models and generalised linear mixed models were used to evaluate the associations.



Women who reported lifting or moving heavy objects at work had 1.0 fewer total oocytes (p=0.08), 1.4 fewer mature oocytes (p=0.007) and 0.7 fewer antral follicles (p=0.06) compared with women who reported never lifting or moving heavy objects at work. The inverse association between heavy lifting and oocyte yield was stronger in women >37 years and with a Body Mass Index ≥25 kg/m2. Women who worked evening/night/rotating shifts had 2.3 (p<0.001) fewer mature oocytes, on average, compared with women who worked day-only shifts. None of the occupational exposures were associated with day 3 follicle-stimulating hormone or peak oestradiol levels.



Women working non-daytime shifts and those with physically demanding jobs had fewer mature oocytes retrieved after controlled ovarian hyperstimulation. Our results provide insight into possible mechanisms linking these occupational exposures with decreased fecundity.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Lidia
L
Mínguez-Alarcón
Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Irene
I
Souter
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.|Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Paige L
PL
Williams
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Jennifer B
JB
Ford
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.|Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Russ
R
Hauser
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.|Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.|Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Jorge E
JE
Chavarro
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.|Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.|Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Audrey J
AJ
Gaskins
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D015992:Body Mass Index; D005260:Female; D005298:Fertility; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007247:Infertility, Female; D017770:Lifting / Q000009:adverse effects*; D016014:Linear Models; D008404:Massachusetts / Q000453:epidemiology; D008499:Medical Records; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D065851:Ovarian Reserve; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014463:Ultrasonography; D014940:Work Schedule Tolerance / Q000502:physiology*; D016526:Workload; D055815:Young Adult
D005640:Follicle Stimulating Hormone
in vitro fertilization; infertility; ovarian reserve and response; physically demanding work