Relationship of urinary phthalate concentrations to female infertility diagnosis

Abstract

Endocrine disrupting compounds (EDC’s) are known to mimick or antagonize steroid hormone actions in animals. We sought to examine relationships between human female infertility diagnoses and urinary concentrations of 16 EDC’s. Cohort study of 94 women undergoing IVF at an academic medical center participating in the Sperm Epigenetics and Development Study (SEEDS). Urine was collected from women before egg retrieval. Urinary concentrations of phthalate EDC’s were measured by liquid chromatography, and urine specific gravity was measured by a handheld refractometer. Infertility diagnosis as reported to SART was collected. We performed logistic regression for each of 5 diagnoses (PCOS, anovulation, diminished ovarian reserve, unexplained infertility, and endometriosis) with 16 phthalate metabolites, and calculated odds ratios of a particular diagnosis versus.the others for 1 unit change in metabolite values, which were log transformed and corrected for specific gravity and BMI. With each unit increase in log exposure to monobenzyl phthalate (MBzP), there was a corresponding 1.79x increased risk for anovulation (p=0.04). With each unit increase in log exposure to mono-3-hydroxybutly phthalate (MHBP), there was a 2.32x increased risk for anovulation (p=0.06). Each unit increase in log exposure to monocarboxy-isononly phthalate (MCNP) resulted in a 1.87x increase in unexplained infertility (p=0.05). There was a trend toward increased unit log exposure to mono-n-butyl phthalate (MBP) in women with PCOS (1.80x, p=0.12) or with anovulation (1.93x, p = 0.15) compared to other diagnoses. With each unit increase in log exposure to mono-hydroxyiosbutyl phthalate (MHiBP), there was a 0.24x decreased risk for endometriosis (p=0.01). With each unit increase in log exposure to monocarbxylisooctyl phthalate (MCOP), there was a 0.67x decrease in odds for diminished ovarian reserve (p=0.11). Women with the diagnoses of anovulation or PCOS, endometriosis, unexplained infertility, and diminished ovarian reserve differ from each other in their environmental contaminant profile. Further studies are needed to confirm these findings and to determine if specific metabolites contribute to or reduce the development of female infertility.