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Environnement et fertilité féminine : étude du rôle des perturbateurs endocriniens sur la réserve ovarienne
Summary
Researchers investigated whether endocrine-disrupting chemicals—including persistent organic pollutants, heavy metals, phenols, and phthalates—affect ovarian reserve markers in women seeking fertility treatment, finding limited overall evidence of association but identifying specific links between p,p'-DDE and increased risk of diminished ovarian reserve and PCB 180 cord blood levels with elevated AMH in teenage girls.
Endocrine disrupting chemicals (EDCs) are suspected to affect the female reproductive system. However, little attention has been given to their potential impact on the ovarian reserve, a key component of female fertility. The overarching aim of this thesis was to study the impact of EDCs on the ovarian reserve. Specifically, we looked at the effects of four families of EDCs (53 persistent organic pollutants (POPs), 4 heavy metals, 4 phenols, and 8 phthalates), as single-exposure analysis and as mixtures, on different indicators of the ovarian reserve including anti-Müllerian hormones (AMH), antral follicle count (AFC), follicle-stimulating hormones (FSH) and diminished ovarian reserve (DOR). In addition, we explored whether in utero exposure to POPs were associated with AMH in teenage girls. We conducted our research among two populations of women seeking reproductive assistance at fertility centres in two countries (France and the United States) and in the French mother-child PELAGIE cohort. Overall, we found limited evidence that EDCs were associated with markers of the ovarian reserve or with DOR, both individually and as mixtures. In the French AROPE case-control study, p,p’-DDE was significantly associated with an increased risk of DOR, whereas β-HCH was significantly associated with a decreased risk of DOR. Furthermore, we observed non-significant increased risks of DOR for cadmium and chromium with a close to significant association for the second tercile of cadmium. We also observed that increased PCB 180 measured in cord blood significantly increased AMH levels in teenage girls in the PELAGIE cohort. In the American EARTH cohort, phenols and phthalates were not associated with various ovarian reserve markers (AFC, FSH or DOR). This work includes the first studies on the associations between POPs and heavy metals, and DOR. Further studies are necessary to validate our results and explore the influence of EDCs during various susceptibility windows on the ovarian reserve at different life stages.