Association of pentachlorophenol in urine and follicular fluid with ovarian reserve and reproductive outcomes among women undergoing in vitro fertilization based on a prospective cohort study.

Pentachlorophenol (PCP), a persistent organic pollutant, has endocrine disrupting properties and there may be a link between its exposure and reproductive outcomes. In this study, we assessed the relationship of PCP exposure levels with ovarian reserve markers and reproductive health outcomes in women (N = 656) undergoing in vitro fertilization (IVF). PCP concentrations were determined in urine (n = 1968; repeated measures) and follicular fluid samples (n = 603). Generalized linear models or generalized estimating equations were used to analyze adjusted association between PCP exposure and selected outcomes (ovarian reserve and IVF outcomes among the women). The median concentration of PCP in the follicular fluid (1.38 ng/mL) was significantly higher compared with that in the urine (specific gravity-adjusted: 0.79 ng/mL). We observed that the urinary PCP concentrations were significantly associated with increased estradiol levels (12.4%; 95% CI: 0.76, 25.4%) but decreased total oocyte yield (-8.35%; 95% CI: -9.64, -7.04%), mature oocytes (-12.0%; 95% CI: -13.4, -10.6%), and fertilization proportion (-2.98%; 95% CI: -5.51, -0.39%). Moreover, there were significant associations of follicular fluid PCP concentrations with declines in the total oocyte yield (-10.6%; 95% CI: -11.9, -9.26%), mature oocytes (-10.6%; 95% CI: -12.0, -9.09%), and proportions of fertilization (-3.75%; 95% CI: -6.39, -1.03%), blastocyst formation (-8.01%; 95% CI: -16.6, -0.37%), and usable blastocysts (-13.9%; 95% CI: -23.6, -3.03%). Our results revealed that exposure to PCP was related with impaired reproductive outcomes of IVF, while additional research is needed to confirm the findings and clarify the underlying mechanisms.