Urinary bisphenol A concentration is correlated with poorer oocyte retrieval and embryo implantation outcomes in patients with tubal factor infertility undergoing in vitro fertilisation.
Level 3 - non-randomized controlled study
Prospective observational cohort study evaluating exposure biomarkers and clinical outcomes
PubMed 31648075 · doi:10.1016/j.ecoenv.2019.109816
What was done
In a prospective cohort study at a single reproductive medicine center in China between September 2013 and October 2016, researchers analyzed 351 women undergoing IVF treatment (fresh and frozen embryo transfer cycles). Single-spot urine samples were collected on the day of oocyte retrieval, and BPA concentrations were quantified using solid-phase extraction paired with liquid chromatography-tandem mass spectrometry (LC-MS/MS). Multivariable generalized linear mixed models assessed associations between urinary BPA levels and IVF outcomes after adjusting for age, BMI, baseline follicle-stimulating hormone (FSH), baseline estradiol, and antral follicle count.
What was found
After adjustment for key confounders (age, BMI, baseline FSH, baseline estradiol, and antral follicle count), women with high urinary BPA concentrations showed a significant decrease in the total number of retrieved oocytes, clinical pregnancy rate, and embryo implantation rate. The abstract reports directional significance but does not provide specific numerical values, odds ratios, or confidence intervals.
Why it matters
This study adds human clinical evidence to existing animal models demonstrating that environmental BPA exposure may impair ovarian response and uterine receptivity during assisted reproduction.
Limits
BPA exposure was assessed via a single-spot urine sample on the retrieval day, which may not capture chronic or peri-conceptional exposure due to BPA's short biological half-life. The abstract lacks exact numerical risk estimates, exposure stratification cutoffs, and confidence intervals. The cohort is restricted to women undergoing IVF at a single center, limiting generalizability to natural conception or other infertility etiologies.
Cited by
- supports Women with higher BPA levels had lower implantation success during IVF.