Urinary triclosan concentrations and diminished ovarian reserve among women undergoing treatment in a fertility clinic

Abstract

Objective To investigate the association between urinary triclosan concentrations and antral follicle count (AFC), a well-accepted marker of ovarian reserve, among women from a fertility center. Design Prospective cohort study. Setting Women attending the Massachusetts General Hospital Fertility Center. Patient(s) A total of 109 women. Intervention(s) None. Urinary triclosan concentrations were quantified by online solid phase extraction-high performance liquid chromatography-isotope dilution tandem mass spectrometry. Main outcomes measure(s) AFC through transvaginal ultrasonography on the 3rd day of an unstimulated menstrual cycle or on the 3rd day of a progesterone withdrawal bleed. Results The geometric mean (GM) (95% CI) of the specific gravity (SG)-adjusted urinary triclosan concentrations for the 225 samples provided by the 109 women was 13.0 (8.9, 19.1) μg/L. Women had median (interquartile range, IQR) AFC of 13 (8, 18). SG-adjusted urinary triclosan concentrations were inversely associated with AFC (-4%, 95% CI= -7%, -1%, p-value=0.009). Women with triclosan concentrations above the median had lower AFC compared to those with triclosan concentrations equal to or below the median, with an adjusted difference of -3.2 (95% CI -3.9, -1.6) among those with body mass index (BMI)<25 kg/m2 and -1.8 (95% CI -3.2, -0.3) among those who were <35 years old. Conclusion(s) SG-adjusted urinary triclosan concentrations were inversely associated with AFC in women seeking care at a fertility center. This association was modified by age and BMI, with younger and leaner women showing larger decreases in AFC.

The Impact of Endocrine-Disrupting Chemicals on Female Fertility

“…Moreover, urinary triclosan concentrations were inversely related to antral follicle count (AFC), which is a marker of ovarian reserve in women seeking infertility treatments. In plus, the association was stronger among younger women (<35 years) and lean women (<25 kg/m 2 ) [78].…”

“…Triclosan is an antibacterial agent found in consumer products and personal care products, including toothpaste, mouthwash, detergents, surgical scrubs, sutures, anti-bacterial soaps, and shampoos [51,78]. It seems that triclosan exposure leads to an increased time to pregnancy [24,51,78].…”

Endocrine Disruption by Mixtures in Topical Consumer Products

“…Similarly, some EDCs were linked to decreased fertility and diminished ovarian reserves in women [30][31][32][33][34]. Animal studies confirmed that EDC exposure can affect mammary gland and uterine development, both in terms of timing and in terms of morphological changes and in silico analyses contributed to predict the mechanics behind this [16,35,36].…”

Exposure to bisphenol A, chlorophenols, benzophenones, and parabens in relation to reproductive hormones in healthy women: A chemical mixture approach

“…Experimental studies show that benzophenones (Kawamura et al, 2003; Suzuki et al, 2005; Weisbrod et al, 2007), dichlorophenols (Ma et al, 2012), and triclosan (Kumar et al, 2009; Stoker et al, 2010) influence the endocrine system (Kumar et al, 2009). Among women undergoing in vitro fertilization, triclosan was associated with a decline in implantation and embryo quality (Hua et al, 2017) and with lower antral follicle count (Mínguez-Alarcón et al, 2017). This is in contrast to our finding of decreased FSH for the phenol factor, which included triclosan.…”

“…Similar experimental studies show that parabens are estrogen agonists (Darbre and Harvey, 2008; Sun et al, 2016), antiandrogenic (Chen et al, 2007) and inhibited cytochrome P450 substrates (Ozaki et al, 2016). In women, endocrine disrupting effects have been observed among women undergoing IVF, pregnant women, and women with and without occupational exposures, although findings are equivocal (Aker et al, 2016; Hao et al, 2011; Miao et al, 2015; Mínguez-Alarcón et al, 2017; Mok-Lin et al, 2010; Nishihama et al, 2016; Smith et al, 2013).…”