Environmental contaminant levels and fecundability among non-smoking couples

Polychlorinated biphenyl serum concentrations, lifestyle and time-to-pregnancy

BACKGROUND

Consumption of fish contaminated with polychlorinated biphenyls (PCBs) and prenatal PCB serum concentrations have been associated with a longer time-to-pregnancy (TTP). However, the relationship between preconception serum PCBs concentrations and TTP has not been previously studied.

METHODS

Eighty-three women (contributing 442 menstrual cycles) planning pregnancies completed daily diaries regarding menstruation, intercourse, home pregnancy test results, and reported use of alcohol and cigarettes. TTP denoted the number of observed menstrual cycles required for pregnancy. Preconception blood specimens underwent toxicologic analysis for 76 PCB congeners via gas chromatography with electron capture; serum lipids were quantified with enzymatic methods. A priori, PCB congeners were summed into a total and three groupings-estrogenic, anti-estrogenic and other-and entered into discrete analogs of Cox models with time-varying covariates to estimate fecundability odds ratios (FOR) and corresponding 95% confidence intervals (CIs).

RESULTS

Estrogenic and anti-estrogenic PCB concentrations (ng/g serum) conferred reduced FORs in fully adjusted models (0.32; 95% CI 0.03, 3.90 and 0.01: 95% CI < 0.00, 1.99, respectively). Reduced FORs (0.96) were observed for alcohol consumption standardized to a 28-day menstrual cycle in the same adjusted model (FOR = 0.96; 95% CI 0.93, 1.00).

CONCLUSIONS

These data suggest that environmental exposures including those amenable to change, such as alcohol consumption, may impact female fecundity. The findings are sensitive to model specification and PCB groupings, underscoring the need to further assess the impact of chemical mixtures on sensitive reproductive outcomes, such as TTP, especially in the context of lifestyle factors which are amenable to change, thereby improving reproductive health.

Exposure to a mixture of polychlorinated biphenyls and polychlorinated dibenzofurans resulted in a prolonged time to pregnancy in women

BACKGROUND

Polychlorinated biphenyls (PCBs), dibenzofurans (PCDFs), and dibenzodioxins (PCDDs) may affect the female reproductive system in animals and humans. In 1978-1979, a mass poisoning occurred in central Taiwan due to PCB/PCDF-contaminated cooking oil; this incident was called Yucheng ("oil disease" in Chinese).

OBJECTIVE

The purpose of our study was to determine whether PCB/PCDF exposure affected fertility in exposed women.

METHODS

After the event, we followed the exposed individuals and a reference group who were sex-, age-, and community-matched. In 2003, we obtained fertility histories from Yucheng and reference women by telephone interview. We used Kaplan-Meier survival curves and multivariable Cox regression to compare time to pregnancy (TTP) between Yucheng and reference women, and we performed multiple logistic regression to determine whether PCB/PCDF exposure caused infertility.

RESULTS

In total, 412 women responded, with a median TTP of 4 months in Yucheng women and 3 months in reference women (p = 0.019). After adjusting for confounders by Cox regression, we found a fecundability ratio of 0.90 [95% confidence interval (CI), 0.80-1.00] for Yucheng women. Among the 408 women who had non-contraceptive sexual activity for > 12 months, 19.7% of Yucheng women and 9.7% of reference women did not become pregnant (i.e., they were infertile). After we adjusted for confounders by logistic regression, the infertility odds ratio was 2.34 (95% CI, 1.23-4.59) for Yucheng women compared with the reference group.

CONCLUSIONS

We found prolonged TTP and reduced fertility among women previously exposed to PCBs/PCDFs. Because of the limited sample size and the relatively small decrease in the fertility rate, these effects require cautious interpretation and further investigation for confirmation.

Paternal work stress and prolonged time to pregnancy

OBJECTIVE

The aim of this study was to explore an association between psychosocial stress at work in married men and their spouses' prolonged time to pregnancy (TTP).

METHODS

All married male workers of a large Korean petrochemical enterprise and their wives fulfilling the selection criteria were included. Main selection criteria were lack of use of contraceptives and experienced pregnancy in recent past. Data were available from 322 couples. Psychosocial stress at work was measured by the effort-reward imbalance questionnaire. Prolonged TTP was measured by the "TTP questionnaire".

RESULTS

After adjustment for confounding effects of demographic and life-style characteristics and benzene exposure, delayed TTP, defined by frequency of first-cycle pregnancy, was associated with one standard deviation (SD) increase of the effort-reward ratio in the chronically stressed group of married men (OR = 0.47; 95% CI = 0.22-0.99) in logistic regression analysis. A similar, but somewhat weaker effect, was found for the overall group (OR = 0.67; 95% CI = 0.47-0.94).

CONCLUSIONS

Paternal stress at work, as measured by effort-reward imbalance, seemed to be associated with a decreased number of conceptions in the first menstrual cycle.