Perfluoroalkyl Acids in Follicular Fluid and Embryo Quality during IVF: A Prospective IVF Cohort in China

卵泡液 胚胎质量 胚胎移植 怀孕 前瞻性队列研究 男科 胚胎 医学 置信区间 妇科 化学 卵母细胞 生理学 体外受精 内科学 生物 遗传学
作者
Xiao-Wen Zeng,Michael S Bloom,Fu Wei,Liling Liu,Jie Qin,Lintao Xue,Shikai Wang,Guolan Huang,Min Teng,Bing He,Xian-Bao Mao,Chu Chu,Shao Lin,Guang-Hui Dong,Weihong Tan
出处
期刊:Environmental Health Perspectives [National Institute of Environmental Health Sciences]
卷期号:131 (2)
标识
DOI:10.1289/ehp10857
摘要

Background: Perfluoroalkyl acids (PFAA) have been measured in ovarian follicular fluid from women using in vitro fertilization (IVF), although associations between follicular fluid PFAA and IVF outcomes have been inconsistent. Objectives: We investigated the association between follicular fluid PFAA and embryo quality in women undergoing IVF. Methods: We prospectively enrolled 729 women undergoing IVF treatment in Guangxi province, China, from July 2018 to December 2018. We measured 32 PFAA, including branched isomers, in follicular fluid using ultra-performance liquid chromatography coupled to tandem mass spectrometry. We applied restricted cubic splines, linear regression, and log-binominal regression models to investigate associations between follicular fluid PFAA and embryo quality, adjusting for confounding variables and investigated oocyte maturity as an intervening variable using causal mediation analysis. We further estimated the overall effect of the PFAA mixture on outcomes using Bayesian kernel machine regression (BKMR). Results: We detected 8 of 32 measured PFAA in >85% of follicular fluid samples. Higher PFAA concentrations were associated with fewer high-quality embryos from IVF. The high-quality embryo rates at the 50th percentile of linear perfluoro-1-octanesulfonate acid (n-PFOS), all branched PFOS isomers (Br-PFOS) and linear perfluoro-n-octanoic acid (n-PFOA) were −6.34% [95% confidence interval (CI): −9.45, −3.32%], −16.78% (95% CI: −21.98, −11.58%) and −8.66% (95% CI: −11.88, −5.43%) lower, respectively, than the high quality embryo rates at the reference 10th percentile of PFAA. Oocyte maturity mediated 11.76% (95% CI: 3.18, 31.80%) and 14.28% (95% CI: 2.95, 31.27%) of the n-PFOS and n-PFOA associations, respectively. The results of the BKMR models showed a negative association between the PFAA mixture and the probability of high-quality embryos, with branched PFOS isomers having posterior inclusion probabilities of 1 and accounting for the majority of the association. Discussion: Exposure to higher PFAA concentrations in follicular fluid was associated with poorer embryo quality during IVF. Branched PFOS isomers may have a stronger effect than linear PFOS isomers. More studies are needed to confirm these findings and to directly estimate the effects on pregnancy and live-birth outcomes. https://doi.org/10.1289/EHP10857
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