PMID- 33945905 OWN - NLM STAT- MEDLINE DCOM- 20210811 LR - 20210811 IS - 1873-6750 (Electronic) IS - 0160-4120 (Linking) VI - 155 DP - 2021 Oct TI - Persistent organic pollutants and the size of ovarian reserve in reproductive-aged women. PG - 106589 LID - S0160-4120(21)00214-2 [pii] LID - 10.1016/j.envint.2021.106589 [doi] AB - Industrial chemicals such as persistent organic pollutants (POPs) have been associated with reduced fertility in women, including longer time-to-pregnancy (TTP), higher odds for infertility, and earlier reproductive senescence. Fertility is highly dependent on the ovarian reserve, which is composed of a prenatally determined stock of non-growing follicles. The quantity and quality of the follicles decline with age, thereby eventually leading to menopause. In the clinical setting, assessing ovarian reserve directly through the histological analysis of follicular density in ovaries is not practical. Therefore, surrogate markers of ovarian reserve, such as serum anti-Mullerian hormone (AMH) are typically used. Here, we studied associations between chemical exposure and ovarian reserve in a cohort of pregnant women undergoing elective caesarean section (n = 145) in Stockholm, Sweden. Full data (histological, clinical, serum) were available for 50 women. We estimated the size of the reserve both directly by determining the density of follicles in ovarian cortical tissue samples, and indirectly by measuring AMH in associated serum samples. Concentrations of 9 organochlorine pesticides (OCPs), 10 polychlorinated biphenyls (PCBs), 3 polybrominated diphenylethers (PBDEs) and 9 perfluoroalkyl substances (PFAS) were determined in serum, and clinical data were retrieved from electronic medical records. Healthy follicle densities (median 0, range 0-193 follicles/mm(3)) and AMH levels (median 2.33 ng/mL, range 0.1-14.8 ng/mL) varied substantially. AMH correlated with the density of growing follicles. Twenty-three chemicals detected in more than half of the samples were included in the analyses. None of the chemicals, alone or as a mixture, correlated with AMH, growing or atretic follicles. However, HCB, transnonachlor, PCBs 74 and 99 were associated with decreased non-growing follicle densities. HCB and transnonachlor were also negatively associated with healthy follicle density. Further, mixture of lipophilic POPs (PBDE 99, p,p'-DDE, and PCB 187) was associated with lower non-growing follicle densities. In addition, exposure to HCB, p,p'-DDE, and mixture of OCPs were significantly associated with higher odds of infertility. The results suggest that exposure to chemicals may reduce the size of ovarian reserve in humans, and strongly encourage to study mechanisms behind POP-associated infertility in women in more detail. CI - Copyright (c) 2021 The Authors. Published by Elsevier Ltd.. All rights reserved. FAU - Bjorvang, Richelle D AU - Bjorvang RD AD - Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden. Electronic address: richelle.duque.bjorvang@ki.se. FAU - Hassan, Jasmin AU - Hassan J AD - Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden. Electronic address: jasmin.hassan@ki.se. FAU - Stefopoulou, Maria AU - Stefopoulou M AD - Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden. Electronic address: maria.stefopoulou@sll.se. FAU - Gemzell-Danielsson, Kristina AU - Gemzell-Danielsson K AD - Department of Women's and Children's Health, Karolinska Institutet and Karolinska University Hospital Solna, 171 76 Stockholm, Sweden. Electronic address: kristina.gemzell@ki.se. FAU - Pedrelli, Matteo AU - Pedrelli M AD - Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, 141 52 Stockholm, Sweden. Electronic address: matteo.pedrelli@ki.se. FAU - Kiviranta, Hannu AU - Kiviranta H AD - Department of Health Security, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland. Electronic address: hannu.kiviranta@thl.fi. FAU - Rantakokko, Panu AU - Rantakokko P AD - Department of Health Security, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland. Electronic address: panu.rantakokko@thl.fi. FAU - Ruokojarvi, Paivi AU - Ruokojarvi P AD - Department of Health Security, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland. Electronic address: paivi.ruokojarvi@thl.fi. FAU - Lindh, Christian H AU - Lindh CH AD - Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 223 61 Lund, Sweden. Electronic address: christian.lindh@med.lu.se. FAU - Acharya, Ganesh AU - Acharya G AD - Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden. Electronic address: ganesh.acharya@ki.se. FAU - Damdimopoulou, Pauliina AU - Damdimopoulou P AD - Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden. Electronic address: pauliina.damdimopoulou@ki.se. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210501 PL - Netherlands TA - Environ Int JT - Environment international JID - 7807270 RN - 80497-65-0 (Anti-Mullerian Hormone) SB - IM MH - Adult MH - Anti-Mullerian Hormone MH - Cesarean Section MH - Female MH - Humans MH - *Ovarian Reserve MH - *Persistent Organic Pollutants MH - Pregnancy MH - Time-to-Pregnancy OTO - NOTNLM OT - Anti-Mullerian hormone OT - Female fertility OT - Ovarian reserve OT - Ovary OT - Persistent organic pollutants EDAT- 2021/05/05 06:00 MHDA- 2021/08/12 06:00 CRDT- 2021/05/04 20:13 PHST- 2021/02/07 00:00 [received] PHST- 2021/04/07 00:00 [revised] PHST- 2021/04/16 00:00 [accepted] PHST- 2021/05/05 06:00 [pubmed] PHST- 2021/08/12 06:00 [medline] PHST- 2021/05/04 20:13 [entrez] AID - S0160-4120(21)00214-2 [pii] AID - 10.1016/j.envint.2021.106589 [doi] PST - ppublish SO - Environ Int. 2021 Oct;155:106589. doi: 10.1016/j.envint.2021.106589. Epub 2021 May 1.