Mixtures of persistent organic pollutants and ovarian function in women undergoing IVF

Published:September 20, 2022DOI:


      Research question

      Do internal levels of persistent organic pollutants (POP) in serum and follicular fluid affect ovarian function of women attending IVF?


      This cohort study included 136 women undergoing IVF in the assisted reproductive technology (ART) service of University Hospital from Nantes (France). Representative POP were measured using gas and liquid chromatography coupled with tandem mass spectrometry. Polyfluoroalkylated and perfluoroalkylated substances were measured in serum and polychlorinated biphenyls and organochlorinated pesticides in follicular fluid. Statistical associations between POP and ovarian reserve markers (anti-Müllerian Hormone [AMH] and antral follicle count [AFC], and ovarian responsiveness markers (Ovarian Sensitivity Index [OSI] and Follicular Output RaTe [FORT]), were explored in single and multipollutant regression models.


      Twenty-seven out of 53 POP congeners were frequently detected in almost all women attending IVF. Adjusted models did not show statistically significant associations between POP and ovarian reserve markers. Positive associations were found between some POP, i.e. hexachlorobenzene with FORT (β 0.42, 95% CI 0.13 to 0.71, P = 0.005) or PCB52 with Ovarian Sensitivity Index (β 0.22; 95% CI, 0.07 to 0.38, P = 0.005). Negative associations between some polyfluoroalkylated and perfluoroalkylated substances, PCB189 and trans-nonachlor with AFC and AMH were found among current smokers.


      Globally, associations between POP and the markers of ovarian function or responsiveness were lacking. Nonetheless, the stratification analysis suggested that current smoking could be a risk modifier, and extension of the study to a larger population sample size is needed.


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      Tiphaine Lefebvre is a gynaecologist specializing in reproductive medicine. She works at the ART service, University Hospital, Nantes, leading the clinical research programme. She is Assistant Professor at the Faculty of Medicine, University of Nantes, and supervises trainees. Her research interests are female infertility, endocrinology and environmental effect on fertility.
      Key message
      Persistent organic pollutants were found in all samples of serum and follicular fluid of women attempting IVF. Some pesticides were positively linked with follicular output rate. Negative associations between some PFAS, PCB189 and trans-nonachlor and AFC, AMH, or both, were found among current smokers.