ArticleEnvironmental research2023
Association between chemical mixtures and female fertility in women undergoing assisted reproduction in Sweden and Estonia.
Article in Environmental research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed, 64 citations in OpenAlex.
- A PFAS mixture at environmental relevant concentration induces DNA damage and compromises the in vitro maturation of mouse oocytes.Archives of toxicology · 2026Article
- Exposure to Legacy and Novel Per- and Polyfluoroalkyl Substances and Diminished Ovarian Reserve: Evidence from Blood-Follicle Transfer and Mixture Risk Assessment in Reproductive-Aged Women.Environment & health (Washington, D.C.) · 2026Article
- Integrated computational and in vitro analysis reveals the toxic mechanisms of PFAS in female diminished ovarian reserve.Scientific reports · 2026Article
- Quantification of per- and polyfluoroalkyl substances in plasma and follicular fluid of patients undergoing in vitro fertilization in Iowa: A pilot study.F&S reports · 2026Article
- Perfluorooctane sulfonate (PFOS) in follicular fluid and human granulosa cell dysfunction: a physiologically based toxicokinetic model translation of long-term low-levelHuman reproduction open · 2026Article
- PFAS exposure and reproductive dysfunction: implications for outcomes in assisted reproductive technologies.Frontiers in endocrinology · 2026Review
- Exposure to per- and poly-fluoroalkyl substances and associations with embryo quality and adverse pregnancy outcomes: a prospective cohort study.Frontiers in public health · 2026Article
- Endocrine-disrupting chemicals and female reproductive health: a growing concern.Nature reviews. Endocrinology · 2025Review
- Integrated chemical exposome-metabolome profiling of follicular fluid and associations with fertility outcomes during assisted reproduction.Environment international · 2025Article
- Effects of phthalate exposure on human ovarian extracellular matrix composition: insights from a 3D spheroid model.Environmental research · 2025Article
- Epidemiologically relevant phthalate mixture and mono(2-ethyl-5-hydroxyhexyl) phthalate exposure alter cell energy metabolism in primary mouse granulosa cells.Reproductive toxicology (Elmsford, N.Y.) · 2025Article
- Bayesian benchmark dose modeling analysis and derivation of points of departure for female reproductive toxicity following exposure to di(2-ethylhexyl) phthalate (DEHP) - effects on reproductive hormones, folliculogenesis and estrous cyclicity.Toxicological sciences : an official journal of the Society of Toxicology · 2025Article
- Oral exposure to di(2-ethylhexyl) phthalate alters the expression of GATA6, OCT4, and CDX2 in blastocysts and decreases the rate of implantation in a mouse model.Toxicological sciences : an official journal of the Society of Toxicology · 2025Article
- Di (2-ethylhexyl) Phthalate decrease pregnancy rate via disrupting the microbe-gut-hypothalamic-pituitary-ovarian axis in mice.NPJ biofilms and microbiomes · 2025Article
- Distribution of perfluorooctanoic acid in exposed female postpubertal pigs in thermal neutral or heat-stressed conditions.Toxicological sciences : an official journal of the Society of Toxicology · 2025Article
- Distribution of Environmental Phenols into Follicular Fluid and Urine of Women Attending Infertility Clinic.Journal of xenobiotics · 2025Article
- Association between endocrine disrupting chemicals and female infertility: a study based on NHANES database.Frontiers in public health · 2025Article
- Exposure to Environmental Chemicals and Infertility Among US Reproductive-Aged Women.International journal of environmental research and public health · 2024Article
- Environmental Stress-Induced Alterations in Embryo Developmental Morphokinetics.Journal of xenobiotics · 2024Review
- Environmental factors affecting female fertility.Endocrine · 2024Review
Corrections and comments
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Authors and funding
17 authors at 7 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWomen of reproductive age are exposed to ubiquitous chemicals such as phthalates, parabens, and per- and polyfluoroalkyl substances (PFAS), which have potential endocrine disrupting properties and might affect fertility. Our objective was to investigate associations between potential endocrine-disrupting chemicals (EDCs) and female fertility in two cohorts of women attending fertility clinics.
methodsIn a total population of 333 women in Sweden and Estonia, we studied the associations between chemicals and female fertility, evaluating ovarian sensitivity index (OSI) as an indicator of ovarian response, as well as clinical pregnancy and live birth from fresh and frozen embryo transfers. We measured 59 chemicals in follicular fluid samples and detected 3 phthalate metabolites, di-2-ethylhexyl phthalate (DEHP) metabolites, 1 paraben, and 6 PFAS in >90% of the women. Associations were evaluated using multivariable-adjusted linear or logistic regression, categorizing EDCs into quartiles of their distributions, as well as with Bayesian Kernel Machine Regression.
resultsWe observed statistically significant lower OSI at higher concentrations of the sum of DEHP metabolites in the Swedish cohort (Q4 vs Q1, β = -0.21, 95% CI: -0.38, -0.05) and methylparaben in the Estonian cohort (Q3 vs Q1, β = -0.22, 95% CI: -0.44, -0.01). Signals of potential associations were also observed at higher concentrations of PFUnDA in both the combined population (Q2 vs. Q1, β = -0.16, 95% CI -0.31, -0.02) and the Estonian population (Q2 vs. Q1, β = -0.27, 95% CI -0.45, -0.08), and for PFOA in the Estonian population (Q4 vs. Q1, β = -0.31, 95% CI -0.61, -0.01). Associations of chemicals with clinical pregnancy and live birth presented wide confidence intervals.
conclusionsWithin a large chemical mixture, we observed significant inverse associations levels of DEHP metabolites and methylparaben, and possibly PFUnDA and PFOA, with OSI, suggesting that these chemicals may contribute to altered ovarian function and infertility in women.
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