Elevated blood mercury level has a non-linear association with infertility in U.S. women: Data from the NHANES 2013–2016

Zhu, Fangfang; Chen, Chi; Zhang, Yingxuan; Chen, Si; Huang, Xian; Li, Jingwei; Wang, Yanxi; Liu, Xiaorong; Deng, Gaopi; Gao, Jie

doi:10.1016/j.reprotox.2019.11.005

Cited by 45 publications

(40 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Infertility stems from occupational factors [eg, shift work, stress, physical (radiation), and toxic (chemicals) sources] or various lifestyle factors (age, nutrition, exercise, obesity, psychological stress, smoking, or alcohol consumption) in addition to environmental pollution factors. 5–7 …”

Section: Introductionmentioning

confidence: 99%

Association Between Body Mass Index and Female Infertility in the United States: Data from National Health and Nutrition Examination Survey 2013–2018

Zhu¹,

Zhou²,

Zhu³

et al. 2022

IJGM

View full text Add to dashboard Cite

Purpose This study aimed to investigate the effects of body mass index (BMI) on infertility in women of childbearing age. Patients and Methods We performed a cross-sectional study using data from 3624 participants from the National Health and Nutrition Examination Survey (NHANES). We used BMI and fertility status in the survey as independent and dependent variables, respectively. We evaluated their relationship and used smoothed curve fitting and multivariate logistic regression analysis as well as a generalized additive model (GAM) to determine the effect of BMI. Results Logistic regression model analysis linked BMI and infertility after adjusting for potential confounders OR 1.03, 95%Cl: 1.02–1.05). There was a non-linear relationship between BMI and infertility, with each unit increase in BMI reducing the risk of infertility by 33% when BMI was <19.5 kg/m 2 . In contrast, when BMI ≥19.5 kg/m 2 , each unit increase in BMI predicted a 3% increase in the risk of infertility. Conclusion The relationship between infertility and BMI presented a U-shaped curve. Therefore, a BMI that lay at the extremes of the spectrum tended to predict infertility. We believe that this study will support the maintenance of suitable BMI levels in women preparing for pregnancy.

show abstract

Section: Introductionmentioning

confidence: 99%

Association Between Body Mass Index and Female Infertility in the United States: Data from National Health and Nutrition Examination Survey 2013–2018

Zhu¹,

Zhou²,

Zhu³

et al. 2022

IJGM

View full text Add to dashboard Cite

show abstract

“…However, the nature of this study helps establish an association but not causation between fish intake (exposure) and fertility (outcome); adding to that, it may be prone to selection and recall bias. Furthermore, a positive, insignificant, and non-linear association between Hg and infertility was found in a cross-sectional study of 1,796 participants from the National Health and Nutrition Examination Survey (2013∼2016) ( Zhu et al, 2020 ). Analyses identified an inflection point of 5.278 μg/L, when blood Hg>5.278 μg/L, a 1 unit increase in Hg (log 2 ) was associated with 157% greater adjusted odds of infertility.…”

Section: Resultsmentioning

confidence: 99%

Can Nutrition Help in the Treatment of Infertility?

Aoun

Khoury

Malakieh

2021

Prev. Nutr. Food Sci.

View full text Add to dashboard Cite

Infertility is defined as the inability to conceive after 12 months of unprotected intercourse or six months for women aged 35 years or older. The physical, emotional, psychological, and financial statuses of infertile couples are tremendously affected especially after undergoing diagnostic and/or curative treatments. Human fertility is influenced by multiple factors including female or male, and modifiable or non-modifiable factors. There is growing evidence that nutrition may play an important role in adjusting fertility-related outcomes in both men and women. The objective of our study was to summarize the latest data on nutritional factors (specific food groups, nutrients, and nutritional supplements) that have an impact on female or male sexual and reproductive function. PubMed and Google Scholar platforms were used to collect appropriate articles for the review using several combinations of keywords (infertility, diet, dietary supplements, antioxidants, and beverages). Adherence to a healthy dietary pattern favoring fish, poultry, whole grains, fruits, vegetables, and healthy fats, was related to better fertility in both genders. Despite the multifactorial etiology of sexual infertility, nutrition may affect the sexual/reproductive function in both women and men.

show abstract

“…Although earlier investigations did not report associations for FF Hg with IVF outcomes, our GAM-based approach allowing for non-linear associations may have uncovered previously undetected relationships. In fact, a study of reproductive age women using a nationally representative 2013–2016 US data set, reported a non-linear dose–response association for blood Hg concentrations and clinical infertility, with a threshold of ∼5.3 µg/l ( Zhu et al , 2020 ). Our results are particularly concerning given that the FF Hg ( Al-Saleh et al , 2008 ; Bloom et al , 2012b ; Tolunay et al , 2016 ) and Pb ( Paksy et al , 2001 ; Silberstein et al , 2004 ; Al-Saleh et al , 2008 ; Bloom et al , 2012b ; Tolunay et al , 2016 ; Wdowiak et al , 2018 ) concentrations in our study population are lower than reported by other studies.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, concentrations of toxic elements in FF may provide more accurate indicators of the biologically effective doses that influence reproductive outcomes, in comparison to blood or urine ( Butts et al , 2021 ). Additionally, toxic elements may have non-monotonic or threshold-type effects on IVF outcomes ( Zhu et al , 2020 ), which have been under-investigated.…”

Section: Introductionmentioning

confidence: 99%

Toxic elements in follicular fluid adversely influence the likelihood of pregnancy and live birth in women undergoing IVF

Butts

Bloom

McGough

et al. 2021

Human Reproduction Open

View full text Add to dashboard Cite

STUDY QUESTION Are follicular fluid (FF), arsenic (As), mercury (Hg), cadmium (Cd) and lead (Pb) concentrations associated with IVF outcomes among women undergoing IVF? SUMMARY ANSWER There was a non-linear association between higher FF Hg concentration and a lower likelihood of biochemical pregnancy and live birth. Higher FF Pb concentration was also associated with a lower probability of live birth. WHAT IS KNOWN ALREADY Previous research suggests that toxic elements may affect fertility among couples conceiving with and without assistance. However, the results have been inconsistent, possibly related in part to exposure misclassification. Very few studies have used ovarian FF to measure toxic elements, as it requires an invasive collection procedure, yet it may offer a more accurate estimate of a biologically effective dose than blood or urine. STUDY DESIGN, SIZE, DURATION This is a prospective study of 56 women undergoing IVF, from October 2015 to June 2017. FF was collected for analysis on the day of oocyte retrieval. PARTICIPANTS/MATERIALS, SETTING, METHODS As, Cd, Hg and Pb were determined in 197 FF specimens, using inductively coupled plasma tandem mass spectrometry. FF glutathione peroxidase, glutathione reductase, total glutathione-S-transferase, superoxide dismutase, arylesterase and paraoxonase (PON1p) activities were measured using kinetic enzyme assays. MAIN RESULTS AND THE ROLE OF CHANCE Non-linear associations were detected, in which the probabilities of biochemical pregnancy (P = 0.05) and live birth (P = 0.05) were lower in association with FF Hg greater than ∼0.51 µg/l Hg, adjusted for age, race, cigarette smoking and recent seafood consumption. Higher FF Pb was also associated with a lower likelihood of live birth (relative risk (RR) = 0.68, 95% CI: 0.46, 1.00; P = 0.05). We also found a suggestive, although imprecise, antagonizing mediating effect of PON1p activity on the association between FF Pb and live birth (−28.3%; 95% CI: −358%, 270%). LIMITATIONS, REASONS FOR CAUTION The results should be interpreted judiciously given the limited sample size and difficulty accounting for correlated data in generalized additive models and mediation analyses. Additionally, women undergoing IVF are highly selected with respect to age and socioeconomic status, and so the generalizability of the results may be limited. WIDER IMPLICATIONS OF THE FINDINGS Overall, the results suggest that FF Hg was associated with a lower likelihood of biochemical pregnancy and live birth, with a potential threshold effect, and that higher FF Pb was associated with a lower probability of live birth. These results may help to guide clinical recommendations for limiting the exposure of patients to Hg and Pb and ultimately improve IVF success rates. STUDY FUNDING/COMPETING INTEREST(S) This work was funded in part by the National Institute of Environmental Health Sciences (NIEHS), grant number 1R56ES023886-01, to the University at Albany (M.S.B.), and in part by the National Institute of Environmental Health Sciences (NIEHS), grant number 1U2CES026542-01, to the Wadsworth Center (P.J.P.). The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A

show abstract

Elevated blood mercury level has a non-linear association with infertility in U.S. women: Data from the NHANES 2013–2016

Cited by 45 publications

References 54 publications

Association Between Body Mass Index and Female Infertility in the United States: Data from National Health and Nutrition Examination Survey 2013–2018

Association Between Body Mass Index and Female Infertility in the United States: Data from National Health and Nutrition Examination Survey 2013–2018

Can Nutrition Help in the Treatment of Infertility?

Toxic elements in follicular fluid adversely influence the likelihood of pregnancy and live birth in women undergoing IVF

Contact Info

Product

Resources

About