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. 2023 Aug 24;24(17):13147.
doi: 10.3390/ijms241713147.

Bioaccumulation of Non-Essential Trace Elements Detected in Women's Follicular Fluid, Urine, and Plasma Is Associated with Poor Reproductive Outcomes following Single Euploid Embryo Transfer: A Pilot Study

Andrea Palomar  1 , Roberto Gonzalez-Martin  1 , Alicia Quiñonero  1 , Nuria Pellicer  1 , Rocio Fernandez-Saavedra  2 , Isabel Rucandio  2 , Rodolfo Fernandez-Martinez  2 , Estefania Conde-Vilda  2 , Alberto J Quejido  2 , Caroline Zuckerman  3 , Christine Whitehead  3 , Richard T Scott  3   4 , Francisco Dominguez  1
Affiliations

Bioaccumulation of Non-Essential Trace Elements Detected in Women's Follicular Fluid, Urine, and Plasma Is Associated with Poor Reproductive Outcomes following Single Euploid Embryo Transfer: A Pilot Study

Andrea Palomar et al. Int J Mol Sci. .

Abstract

This study aims to determine the association of non-essential trace elements present in follicular fluid, plasma, and urine with reproductive outcomes of women undergoing intracytoplasmic sperm injection (ICSI), preimplantation genetic testing for aneuploidies (PGT-A) and single frozen euploid embryo transfer (SET/FET). This single-center, prospective cohort study included sixty women undergoing ICSI with PGT-A and SET/FET between 2018 and 2019. Urine, plasma and follicular fluid samples were collected on the vaginal oocyte retrieval day to simultaneously quantify ten non-essential trace elements (i.e., Ba, Sr, Rb, Sn, Ti, Pb, Cd, Hg, Sb, and As). We found several associations between the levels of these non-essential trace elements and clinical IVF parameters. Specifically, the increased levels of barium in follicular fluid were negatively associated with ovarian function, pre-implantation development and embryo euploidy, while elevated strontium concentrations in this biofluid were negatively associated with impaired blastulation and embryo euploidy. Elevated plasma strontium levels were negatively associated with ovarian function, fertilization and blastulation. Enhanced presence of other trace elements in plasma (i.e., rubidium and arsenic) were associated with a diminished ovarian function and limited the number of recovered oocytes, mature oocytes and zygotes, respectively. Fully adjusted models suggested significantly lower odds of achieving a live birth when increased concentrations of barium and tin were found in urine.

Keywords: IVF outcomes; biofluids; infertility; live birth; non-essential trace elements; ovarian response.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Relationships of ten non-essential trace elements between and within follicular fluid, plasma, and urine. (A–I) Correlation matrices representing the relationships of the non-essential trace elements between biofluids. (J–L) Correlation matrices representing the relationships of the elements within each biofluid. FF, follicular fluid; P, plasma; and U, urine. Blue represents a positive correlation, while red represents a negative correlation. Color intensity is proportional to the correlation strength. Strikethrough values represent non-significant associations (p > 0.05).
Figure 2
Figure 2
Odds ratios (95% confidence interval) for reproductive outcomes following ICSI and SET/FET. Forest plots present the odds ratios (95% confidence interval) for implantation, clinical pregnancy, live birth per single frozen embryo transfer (SET/FET), and reproductive goal (achievement of a live birth per initiated IVF cycle) across the detectable essential trace elements in each biofluid. * p < 0.05. Significant odds ratios are highlighted in red.
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