Adult air pollution exposure and risk of infertility in the nurses' health study II

BACKGROUND: Exposures to air pollution has been associated with lower conception and fertility rates. However, the impact of pollution on infertility is unknown. OBJECTIVES: To examine the associations of roadway proximity (a measure of traffic exposure) and particulate matter (PM) air pollution and incidence of infertility. METHODS: Proximity to major roadways and ambient exposures to particulate matter less than 10 microns (PM10), between 2.5 and 10 microns (PM2.5-10), and less than 2.5 microns (PM2.5) were determined for all residential addresses for 36,294 members of the prospective Nurses' Health Study II cohort from 1993 to 2003. Infertility was defined by report of attempted conception for ≥12 months without success. Participants were able to report if evaluation was sought and if so, offer multiple clinical indications for infertility. Multivariable adjusted Cox proportional hazard models were used to estimate the relation between each exposure and infertility risk. RESULTS: Over 213,416 person-years, there were 2,508 incident reports of infertility. Results for overall infertility were inconsistent across exposure types. We observed a small increased risk in those living closer to compared to farther from a major road, multivariable adjusted hazard ratio (HR)=1.11(95% confidence interval (CI) = 1.02-1.20). Among those reporting primary infertility, risk was greater with closer distance to road and for all PM size fractions and exposure time windows. The multivariable adjusted HR (95%CI) for women living closer to compared to farther from a major road for primary infertility was 1.37 (1.22-1.52), while for secondary infertility HR=1.07 (0.95-1.21). In addition, the HR for every 10 mcg increase in cumulative PM2.5 among women with primary infertility was 1.61 (1.35-1.92), while it was 1.1 (0.91-1.33) for those with secondary infertility. CONCLUSIONS: This study suggests exposures to traffic and PM may be associated with a small increased risk of infertility, especially primary infertility

Air Pollution Exposures During Adulthood and Risk of Endometriosis in the Nurses’ Health Study II

Background: Particulate matter and proximity to large roadways may promote disease mechanisms, including systemic inflammation, hormonal alteration, and vascular proliferation, that may contribute to the development and severity of endometriosis. Objective: Our goal was to determine the association of air pollution exposures during adulthood, including distance to road, particulate matter < 2.5 μm, between 2.5 and 10 μm, and < 10 μm, (PM2.5, PM10–2.5, PM10), and timing of exposure with risk of endometriosis in the Nurses’ Health Study II. Methods: Proximity to major roadways and outdoor levels of PM2.5, PM10–2.5, and PM10 were determined for all residential addresses from 1993 to 2007. Multivariable-adjusted time-varying Cox proportional hazard models were used to estimate the relation between these air pollution exposures and endometriosis risk. Results: Among 84,060 women, 2,486 incident cases of surgically confirmed endometriosis were identified over 710,230 person-years of follow-up. There was no evidence of an association between endometriosis risk and distance to road or exposure to PM2.5, PM10–2.5, or PM10 averaged over follow-up or during the previous 2- or 4-year period. Conclusions: Traffic and air pollution exposures during adulthood were not associated with incident endometriosis in this cohort of women. Citation: Mahalingaiah S, Hart JE, Laden F, Aschengrau A, Missmer SA. 2014. Air pollution exposures during adulthood and risk of endometriosis in the Nurses’ Health Study II. Environ Health Perspect 122:58–64; http://dx.doi.org/10.1289/ehp.130662

Temporal Variability and Predictors of Urinary Bisphenol A Concentrations in Men and Women

Background: Bisphenol A (BPA) is used to manufacture polymeric materials, such as polycarbonate plastics, and is found in a variety of consumer products. Recent data show widespread BPA exposure among the U.S. population.Objective Our goal in the present study was to determine the temporal variability and predictors of BPA exposure. Methods: We measured urinary concentrations of BPA among male and female patients from the Massachusetts General Hospital Fertility Center. Results: Between 2004 and 2006, 217 urine samples were collected from 82 subjects: 45 women (145 samples) and 37 men (72 samples). Of these, 24 women and men were partners and contributed 42 pairs of samples collected on the same day. Ten women became pregnant during the follow-up period. Among the 217 urine samples, the median BPA concentration was 1.20 μg/L, ranging from below the limit of detection (0.4 μg/L) to 42.6 μg/L. Age, body mass index, and sex were not significant predictors of urinary BPA concentrations. BPA urinary concentrations among pregnant women were 26% higher (–26%, +115%) than those among the same women when not pregnant (p > 0.05). The urinary BPA concentrations of the female and male partner on the same day were correlated (r = 0.36; p = 0.02). The sensitivity of classifying a subject in the highest tertile using a single urine sample was 0.64. Conclusion: We found a nonsignificant increase in urinary BPA concentrations in women while pregnant compared with nonpregnant samples from the same women. Samples collected from partners on the same day were correlated, suggesting shared sources of exposure. Finally, a single urine sample showed moderate sensitivity for predicting a subject’s tertile categorization

Informative predictors of pregnancy after first IVF cycle using eIVF practice highway electronic health records

The aim of this study is to determine the most informative pre- and in-cycle variables for predicting success for a first autologous oocyte in-vitro fertilization (IVF) cycle. This is a retrospective study using 22,413 first autologous oocyte IVF cycles from 2001 to 2018. Models were developed to predict pregnancy following an IVF cycle with a fresh embryo transfer. The importance of each variable was determined by its coefficient in a logistic regression model and the prediction accuracy based on different variable sets was reported. The area under the receiver operating characteristic curve (AUC) on a validation patient cohort was the metric for prediction accuracy. Three factors were found to be of importance when predicting IVF success: age in three groups (38-40, 41-42, and above 42 years old), number of transferred embryos, and number of cryopreserved embryos. For predicting first-cycle IVF pregnancy using all available variables, the predictive model achieved an AUC of 68% + /- 0.01%. A parsimonious predictive model utilizing age (38-40, 41-42, and above 42 years old), number of transferred embryos, and number of cryopreserved embryos achieved an AUC of 65% + /- 0.01%. The proposed models accurately predict a single IVF cycle pregnancy outcome and identify important predictive variables associated with the outcome. These models are limited to predicting pregnancy immediately after the IVF cycle and not live birth. These models do not include indicators of multiple gestation and are not intended for clinical application.IIS-1914792 - National Science Foundation; N00014-19-1-2571 - Office of Naval Research Global; GM135930 - Office of Extramural Research, National Institutes of HealthPublished versio

Serum Concentrations of Polychlorinated Biphenyls in Relation to in Vitro Fertilization Outcomes

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

Association of Hexachlorobenzene (HCB), Dichlorodiphenyltrichloroethane (DDT), and Dichlorodiphenyldichloroethylene (DDE) with in Vitro Fertilization (IVF) Outcomes

Background: Hexachlorobenzene (HCB), dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichloroethylene (DDE) are persistent chlorinated pesticides with endocrine activity that may adversely affect the early stages of human reproduction

Targets to treatmetabolic syndrome in polycystic ovary syndrome

Introduction: Metabolic syndrome is comprised of a combination of the following states: increased insulin resistance, dyslipidemia, cardiovascular disease, and increased abdominal obesity. Women with polycystic ovary syndrome (PCOS) have an increased risk of developing metabolic syndrome over the course of their lives. Metabolic syndrome increases risk of major cardiovascular events, morbidity, quality of life, and overall health care costs. Though metabolic syndrome in women with PCOS is an area of great concern, there is no effective individual medical therapeutic to adequately treat this issue. Areas Covered: This article will review key aspects of metabolic syndrome in PCOS. We will discuss classic and novel therapeutics to address metabolic syndrome in women with PCOS. We will conclude with the importance of developing strategic interventions to increase the compliance to lifestyle and dietary modification, in addition to appreciation of the emerging pharmaceutical therapeutics available. Expert Opinion: Innovation in lifestyle modification, including diet, exercise, with and without dedicated stress reduction techniques is the future in treatment of metabolic syndrome in PCOS. Application of novel interventions, such as group medical care, may improve future adherence to lifestyle modification recommendations, in addition to or in combination with pharmaceutical therapeutics

Exploring the causes of semen quality changes post-bariatric surgery: a focus on endocrine-disrupting chemicals

Rapid weight loss promoted by bariatric surgery (BS) can release accumulated lipophilic endocrine-disrupting chemicals (EDCs), making these chemicals systemically available. Men typically have a higher EDC body burden and lose more weight post-BS than women, which may put male BS patients at high risk for testicular toxicity. In this review, we analyze the impacts of BS on semen parameters with a particular focus on the potential effects of EDCs. After BS, serum EDC concentrations progressively increase; and there is evidence that semen parameters deteriorate after BS. Although elevated serum EDC concentrations are associated with inferior sperm parameters, links between semen parameters and EDCs post-BS have not been studied. Understanding these potential associations requires adequately powered studies, particularly within prospective longitudinal cohorts with long-term follow-up for sperm parameters, nutritional status, sex-hormones levels and serum EDC concentrations. Studying BS patients prospectively provides the important opportunity to evaluate dose-response effects of EDC serum concentrations on sperm quality and function. Research is also needed to identify critical chemical exposure periods post-BS to inform reproductive decisions, including consideration of sperm preservation before surgery

Menstrual Cycle Length and Modern Living: A Review

Purpose of review: The aim of this review is to evaluate biological, life history, environmental, and lifestyle factors and exposures that cause variability in menstrual cycle length (MCL). Recent findings: Recent literature has detailed a number of factors that influence MCL, with particular emphasis placed on novel environmental exposures, such as air pollution and endocrine disrupting chemicals. Summary: MCL varies widely in response to intrinsic and extrinsic inputs and is a useful predictor of reproductive health and fecundability. Video abstract: http://links.lww.com/COE/A2