Paternal preconception urinary concentrations of bisphenol A and F in relation to in vitro fertilization outcomes: A prospective cohort study.

Bisphenol F (BPF), a substitute for the widely recognized environmental endocrine-disrupting chemical bisphenol A (BPA), is increasingly utilized in consumer products. Despite the well-established association of BPA with adverse reproductive outcomes, the association with BPF exposure on in vitro fertilization (IVF) outcomes remains largely unknown, particularly regarding paternal exposure, given that male factors already account for approximately 40 % of global infertility. We aimed to evaluate the associations between exposure to BPA and BPF and IVF outcomes among men undergoing assisted reproductive technology (ART) treatment. The study enrolled 128 men undergoing ART treatment from a prospective cohort study in Shenyang, China, between September 2020 and February 2021. Urinary levels of bisphenols using mass spectrometry. Compared to the lowest quartile, men with urinary BPA concentrations in the highest quartile had 0.10 lower adjusted fertilization rate (95 % CI: 0.18, -0.02). Men with urinary BPA concentrations in the highest quartile had a lower probability of live birth compared to those with concentrations in the lowest quartile (adjusted RR = 0.27, 95 % CI: 0.09, -0.86). The quantile g-computation (QGC) model revealed that per quantile increase in the bisphenol mixture was inversely associated with fertilization rate (adjusted β = -0.04, 95 % CI: 0.07, -0.01) and probability of live birth (adjusted RR = 0.54, 95 % CI: 0.34, 0.85). Male co-exposure to BPA and BPF was inversely associated with IVF outcomes, including reduced fertilization rate and the probability of a live birth. Public health initiatives should prioritize reducing bisphenol exposure in men to mitigate infertility risks, not merely focusing on women.