PMID- 33147335 OWN - NLM STAT- MEDLINE DCOM- 20220301 LR - 20240313 IS - 1460-2369 (Electronic) IS - 1355-4786 (Print) IS - 1355-4786 (Linking) VI - 27 IP - 2 DP - 2021 Feb 19 TI - Persistent organic pollutants and couple fecundability: a systematic review. PG - 339-366 LID - 10.1093/humupd/dmaa037 [doi] AB - BACKGROUND: Despite increasing regulation, exposure to persistent organic pollutants (POPs) remains a serious public health concern due to their accumulation in the environment and ability to biomagnify up the food chain. POPs are associated with endocrine-disrupting effects including adverse reproductive outcomes that could affect fecundability, i.e. the capacity to conceive a pregnancy, quantified as time to pregnancy (TTP). OBJECTIVE AND RATIONALE: Results of epidemiologic studies that examine the impact of various chemical classes of POPs on TTP have not been synthesised. We undertook a systematic review to summarise the strength of evidence for associations of four common groups of POPs with couple fecundability and to identify gaps and limitations in the literature in order to inform policy decisions and future research. SEARCH METHODS: We performed an electronic search of literature published between 1 January 2007 and 6 August 2019 in MEDLINE, EMBASE.com, Global Health, DART/TOXLINE and POPLINE. We included empirical research papers that examined human exposure to organochlorine (OC) pesticides, brominated flame retardants, polychlorinated organic compounds and/or per- and polyfluoroalkyl substances (PFAS) and considered TTP or fecundability as an outcome. Standardised forms for screening, data extraction and study quality were developed using DistillerSR software, and all reviews were completed in duplicate. We used the Newcastle-Ottawa Scale to assess risk of bias and devised additional quality metrics based on specific methodological features of fecundability studies. OUTCOMES: The search returned 4573 articles, and 28 papers from 19 different studies met inclusion criteria. Among them, four studies measured TTP prospectively, three had data on participants' prenatal exposure, three examined associations in both male and female partners and one focused exclusively on males. Analyses varied widely in terms of exposure characterisation, precluding a meta-analytic approach. Evidence was strongest for adverse associations of female exposure to polychlorinated biphenyls with TTP, with some additional support for associations of female exposure to polybrominated diphenyl ethers and PFAS with longer TTP. Our review provided little or no support for associations between female exposure to OC pesticides or male exposure to any of the POP groups and TTP. WIDER IMPLICATIONS: Evidence suggests that female exposure to at least some POPs may reduce fecundability. Although many of these chemicals are no longer in production, they are still detectable in human biosamples because of their persistence in the environment. Replacement chemicals that are being introduced as older ones are restricted may have similar reproductive consequences. Future studies should examine these newer POPs, assess interactions between POPs and other chemical and non-chemical exposures, investigate how POPs are distributed in and metabolised by the human body and focus on populations that may be disproportionately exposed. CI - (c) The Author(s) 2020. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please email: journals.permissions@oup.com. FAU - Kahn, Linda G AU - Kahn LG AD - Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016 USA. FAU - Harley, Kim G AU - Harley KG AD - Center for Environmental Research and Children's Health, University of California Berkeley, Berkley, CA 94720, USA. FAU - Siegel, Eva L AU - Siegel EL AD - Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. FAU - Zhu, Yeyi AU - Zhu Y AD - Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA. FAU - Factor-Litvak, Pam AU - Factor-Litvak P AD - Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. FAU - Porucznik, Christina A AU - Porucznik CA AD - Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA. FAU - Klein-Fedyshin, Michele AU - Klein-Fedyshin M AD - Health Sciences Library System, University of Pittsburgh, Pittsburgh, PA 15213, USA. FAU - Hipwell, Alison E AU - Hipwell AE AD - Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA. CN - program collaborators for Environmental Influences on Child Health Outcomes Program LA - eng GR - UH3 OD023289/OD/NIH HHS/United States GR - UH3 OD023249/OD/NIH HHS/United States GR - UG3 OD023244/OD/NIH HHS/United States GR - R01 ES008977/ES/NIEHS NIH HHS/United States GR - K01 DK120807/DK/NIDDK NIH HHS/United States GR - K99 ES030403/ES/NIEHS NIH HHS/United States GR - UH3 OD023244/OD/NIH HHS/United States GR - UG3 OD023249/OD/NIH HHS/United States GR - P30 ES009089/ES/NIEHS NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Systematic Review PL - England TA - Hum Reprod Update JT - Human reproduction update JID - 9507614 RN - 0 (Environmental Pollutants) RN - 0 (Halogenated Diphenyl Ethers) RN - 0 (Pesticides) RN - DFC2HB4I0K (Polychlorinated Biphenyls) SB - IM MH - *Environmental Pollutants/toxicity MH - Female MH - Halogenated Diphenyl Ethers MH - Humans MH - Male MH - Persistent Organic Pollutants MH - *Pesticides/toxicity MH - *Polychlorinated Biphenyls/toxicity MH - Pregnancy MH - Time-to-Pregnancy PMC - PMC7903116 OTO - NOTNLM OT - brominated flame retardants OT - couple fecundability OT - endocrine-disrupting chemicals OT - environmental effects OT - organochlorine pesticides OT - perfluoroalkyl substances OT - persistent organic pollutants OT - polychlorinated biphenyls OT - systematic review OT - time to pregnancy EDAT- 2020/11/05 06:00 MHDA- 2022/03/03 06:00 PMCR- 2021/11/04 CRDT- 2020/11/04 17:12 PHST- 2020/03/31 00:00 [received] PHST- 2020/07/22 00:00 [revised] PHST- 2020/11/05 06:00 [pubmed] PHST- 2022/03/03 06:00 [medline] PHST- 2020/11/04 17:12 [entrez] PHST- 2021/11/04 00:00 [pmc-release] AID - 5956109 [pii] AID - dmaa037 [pii] AID - 10.1093/humupd/dmaa037 [doi] PST - ppublish SO - Hum Reprod Update. 2021 Feb 19;27(2):339-366. doi: 10.1093/humupd/dmaa037.