Bisphenol A and Ovarian Reserve among Infertile Women with Polycystic Ovarian Syndrome

Abstract

To better understand possible effects of bisphenol A (BPA) exposure on ovarian reserve in women with polycystic ovary syndrome (PCOS), we measured creatinine adjusted urinary BPA (BPA_Cre) concentrations and used regression models to evaluate the association between urinary BPA level and antral follicle count (AFC), antimullerian hormone (AMH), day-3 follicle stimulating hormone levels (FSH) and inhibin B (INHB) in 268 infertile women diagnosed with PCOS. BPA was detected in all women with a median concentration of 2.35 ng/mL (the 25th and 75th percentiles of 1.47 ng/mL and 3.95 ng/mL). A unit increase in BPA_Cre was associated with a significant decrease of 0.34 in AFC (β = -0.34, 95% CI = -0.60, -0.08; p = 0.01). Likewise, BPA was negatively associated with AMH and day-3 FSH levels, but neither of them reached statistical significance. No association was observed between BPA and INHB. Our results suggest that in women with PCOS, BPA may affect ovarian follicles and, therefore, reduce ovarian reserve.

Keywords: antimullerian hormone; antral follicle count; bisphenol A; day-3 follicle stimulating hormone; ovarian reserve.

Figure 1

The relationships between BPA and antral follicle count, antimullerian hormone, inhibin B, and follicle stimulating hormone levels. The x-axis refers to urinary BPA level corrected by creatinine concentration (BPA_Cre). The y-axis refers to AFC (a); AMH (b); FSH (c); and INHB (d) levels. The red line is fitted by generalized additive model showing the relationship between x and y axes. The two blue lines refer to 95% confidence intervals. All models were adjusted for age, BMI, income.