Female Reproductive Health and Exposure to Phthalates and Bisphenol A: A Cross Sectional Study

Overview

Journal Toxics

Date 2021 Nov 25

PMID 34822691

Citations 11

Authors

Lidia Caporossi

Paola Vigano

Enrico Paci

Silvia Capanna

Alessandra Alteri

Giovanni Campo

Daniela Pigini

Mariangela De Rosa

Giovanna Tranfo

Bruno Papaleo

Affiliations

Soon will be listed here.

Abstract

The xenoestrogenicity of some plasticisers (phthalates and bisphenol A) is documented in the literature and may pose a risk to female reproductive health. The aim of this study was to assess exposure to six phthalates. This was achieved by measuring their respective metabolites (mono-ethylphthalate (MEP); mono-n-butylphthalate (MnBP); mono-n-ottylphthalate (MnOP); and monobenzylphthalate (MBzP)), as well as the sum of two of the diethyl-hexyl phthalate metabolites-(∑DEHP) and bisphenol A (BPA) in a female population with infertility problems, and by conducting a correlation analysis between infertility factors, work activities, and lifestyle habits, in order to formulate a causal hypothesis. A cross-sectional epidemiological study was carried out and women under 43 years of age were recruited from an assisted reproduction technology (ART) center; the sample of 186 women was given a specific questionnaire and a spot urine sample was collected. Phthalate metabolites and urinary BPA were analyzed by HPLC/MS/MS. The results showed significantly higher mean values for MEP in women with recurrent pregnancy loss (RPL) (820.5 ± 1929.5 µg/g of creatinine) and idiopathic infertility (230.0 ± 794.2 µg/g of creatinine) than in women with other infertility factors (76.9 ± 171.8 µg/g of creatinine). Similarly, for MnOP levels, women with idiopathic infertility (2.95 ± 3.44 µg/g of creatinine) showed significantly higher values than women with the other infertility factors taken together (1.35 ± 2.05 µg/g of creatinine). Women with tubal factors of infertility, RPL, and endocrine dysfunctions show higher values of DEHP ( = 0.032). Considering occupations, women working in commerce showed more than twice as much urinary BPA levels (1.10 ± 0.48 µg/g of creatinine) compared to women working in other industries (0.45 ± 0.35 µg/g of creatinine). The presence of significantly higher values of certain phthalates, DEHP in particular, especially in women with RPL and idiopathic infertility, suggests a possible involvement of these compounds as competing factors in reproductive issues. The study of sources of exposure suggested that the working activity in trade, as a casher in particular, represents a major one for BPA ( = 0.015).

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References

Deng T, Du Y, Wang Y, Teng X, Hua X, Yuan X . The associations of urinary phthalate metabolites with the intermediate and pregnancy outcomes of women receiving IVF/ICSI treatments: A prospective single-center study. Ecotoxicol Environ Saf. 2019; 188:109884. DOI: 10.1016/j.ecoenv.2019.109884. View

Machtinger R, Combelles C, Missmer S, Correia K, Fox J, Racowsky C . The association between severe obesity and characteristics of failed fertilized oocytes. Hum Reprod. 2012; 27(11):3198-207. DOI: 10.1093/humrep/des308. View

Park S, Jeon J, Jeong K, Chung H, Lee H, Sung Y . The Association of Ovarian Reserve with Exposure to Bisphenol A and Phthalate in Reproductive-aged Women. J Korean Med Sci. 2021; 36(2):e1. PMC: 7801152. DOI: 10.3346/jkms.2021.36.e1. View

Minguez-Alarcon L, Messerlian C, Bellavia A, Gaskins A, Chiu Y, Ford J . Urinary concentrations of bisphenol A, parabens and phthalate metabolite mixtures in relation to reproductive success among women undergoing in vitro fertilization. Environ Int. 2019; 126:355-362. PMC: 6469504. DOI: 10.1016/j.envint.2019.02.025. View

Krais A, Andersen C, Eriksson A, Johnsson E, Nielsen J, Pagels J . Excretion of Urinary Metabolites of the Phthalate Esters DEP and DEHP in 16 Volunteers after Inhalation and Dermal Exposure. Int J Environ Res Public Health. 2018; 15(11). PMC: 6266104. DOI: 10.3390/ijerph15112514. View

Frederiksen H, Skakkebaek N, Andersson A . Metabolism of phthalates in humans. Mol Nutr Food Res. 2007; 51(7):899-911. DOI: 10.1002/mnfr.200600243. View

Zong T, Lai L, Hu J, Guo M, Li M, Zhang L . Maternal exposure to di-(2-ethylhexyl) phthalate disrupts placental growth and development in pregnant mice. J Hazard Mater. 2015; 297:25-33. DOI: 10.1016/j.jhazmat.2015.04.065. View

Rebai I, Fernandes J, Azzouz M, Benmohammed K, Bader G, Benmbarek K . Urinary bisphenol levels in plastic industry workers. Environ Res. 2021; 202:111666. DOI: 10.1016/j.envres.2021.111666. View

Bloom M, Kim D, Vom Saal F, Taylor J, Cheng G, Lamb J . Bisphenol A exposure reduces the estradiol response to gonadotropin stimulation during in vitro fertilization. Fertil Steril. 2011; 96(3):672-677.e2. PMC: 3168558. DOI: 10.1016/j.fertnstert.2011.06.063. View

10.

Radwan P, Wielgomas B, Radwan M, Krasinski R, Klimowska A, Kaleta D . Urinary bisphenol A concentrations and in vitro fertilization outcomes among women from a fertility clinic. Reprod Toxicol. 2020; 96:216-220. DOI: 10.1016/j.reprotox.2020.07.009. View

11.

Zhang H, Gao F, Ben Y, Su Y . Association between phthalate exposure and risk of spontaneous pregnancy loss: A systematic review and meta-analysis. Environ Pollut. 2020; 267:115446. DOI: 10.1016/j.envpol.2020.115446. View

12.

Mu D, Gao F, Fan Z, Shen H, Peng H, Hu J . Levels of Phthalate Metabolites in Urine of Pregnant Women and Risk of Clinical Pregnancy Loss. Environ Sci Technol. 2015; 49(17):10651-7. DOI: 10.1021/acs.est.5b02617. View

13.

Ribeiro E, Ladeira C, Viegas S . Occupational Exposure to Bisphenol A (BPA): A Reality That Still Needs to Be Unveiled. Toxics. 2017; 5(3). PMC: 5634705. DOI: 10.3390/toxics5030022. View

14.

Huo X, Chen D, He Y, Zhu W, Zhou W, Zhang J . Bisphenol-A and Female Infertility: A Possible Role of Gene-Environment Interactions. Int J Environ Res Public Health. 2015; 12(9):11101-16. PMC: 4586663. DOI: 10.3390/ijerph120911101. View

15.

Di Napoli I, Tagliaferri S, Sommella E, Salviati E, Porri D, Raspini B . Lifestyle Habits and Exposure to BPA and Phthalates in Women of Childbearing Age from Northern Italy: A Pilot Study. Int J Environ Res Public Health. 2021; 18(18). PMC: 8469822. DOI: 10.3390/ijerph18189710. View

16.

Mok-Lin E, Ehrlich S, Williams P, Petrozza J, Wright D, Calafat A . Urinary bisphenol A concentrations and ovarian response among women undergoing IVF. Int J Androl. 2009; 33(2):385-93. PMC: 3089904. DOI: 10.1111/j.1365-2605.2009.01014.x. View

17.

Bello A, Xue Y, Bello D . Urinary biomonitoring of occupational exposures to Bisphenol A Diglycidyl Ether (BADGE) - based epoxy resins among construction painters in metal structure coating. Environ Int. 2021; 156:106632. DOI: 10.1016/j.envint.2021.106632. View

18.

Ndaw S, Remy A, Jargot D, Robert A . Occupational exposure of cashiers to Bisphenol A via thermal paper: urinary biomonitoring study. Int Arch Occup Environ Health. 2016; 89(6):935-46. PMC: 4927604. DOI: 10.1007/s00420-016-1132-8. View

19.

Begum T, Gerona R, Melamed J, McGough A, Lenhart N, Wong R . Sources of exposure to urinary phthalates among couples undergoing infertility treatment. Int J Hyg Environ Health. 2020; 229:113567. DOI: 10.1016/j.ijheh.2020.113567. View

20.

He J, Chang K, Liu S, Ji J, Liu L, Feng Y . Phthalate levels in urine of pregnant women and their associated missed abortion risk. Reprod Biol. 2021; 21(1):100476. DOI: 10.1016/j.repbio.2020.100476. View