Purpose There is increasing concern that environmental chemicals have a direct effect on fertility. Heavy metals such as mercury have been shown to affect various organ systems in humans including nervous system and skin, however they could also act as endocrine disrupting chemicals adversely affecting fertility. Metals such as zinc and selenium are essential micronutrients with diverse functions that may be important for reproductive outcomes. We measured mercury, zinc and selenium levels in the hair, a reliable reflection of long term environmental exposure and dietary status, to correlate with the outcome of ovarian hyperstimulation for in vitro fertilisation (IVF) treatment. Methods We analysed the hair of 30 subfertile women for mercury, zinc and selenium using inductively coupled mass spectrometry. Each woman underwent one cycle of IVF treatment. Correlation between the levels of these trace metals and treatment outcomes was investigated.Results Thirty women were recruited with mean (±SD) age of 32.7(4.4) years and BMI of 25.4(5.0)kg/m 2 . Hair mercury concentration showed a negative correlation with oocyte yield (p<0.05,βcoefficient 0.38) and follicle number (p=0.03,β coefficient0.19) after ovarian stimulation. Zinc and selenium levels in hair correlated positively with oocyte yield after ovarian stimulation (p<0.05,β coefficient0.15) and (p=0.03,β coefficient0.21) respectively. Selenium levels in hair correlated significantly with follicle number following stimulation (p=0.04, βcoefficient0.22). There was no correlation between mercury, zinc and selenium in hair and their corresponding serum levels. Conclusion These data suggest that mercury had a deleterious effect whilst there was a positive effect for zinc and selenium in the ovarian response to gonadotrophin therapy for IVF. Hair analysis offers a novel method of investigating the impact of long-term exposure to endocrine disruptors and nutritional status on reproductive outcomes.
Keywords IVF . Heavy metals . Endocrine disruptorsSubfertility affects approximately 1 in 6 couples in the developed world [1], a prevalence that is likely to increase as more women delay childbirth to a later age [2]; approximately 28% of couples investigated for subfertility have a diagnosis of 'unexplained subfertility' [3]. Current treatment largely consists of assisted reproductive techniques (ART) such as IVF or IVF-ICSI, often regardless of the underlying cause. The average success rate of 25-30% for ART in Europe remains unchanged over recent years [4], prompting the search for additional factors which may influence fertility treatments and optimise success, and the identification of adverse factors such as endocrine disrupting chemicals.Capsule Mercury concentration in hair had a deleterious effect where as zinc and selenium had a beneficial effect in ovarian response to gonadotrophin therapy for IVF.