Associations between follicular fluid trace elements and ovarian response during in vitro fertilization

Rooshna Mohsin; Victor Y Fujimoto; Aubrey L Galusha; Patrick J Parsons; Jenna R Krall; Celeste D Butts-Jackson; Evelyn Mok-Lin; Michael S Bloom

doi:10.1016/j.envres.2024.118801

Associations between follicular fluid trace elements and ovarian response during in vitro fertilization

Environ Res. 2024 Mar 29;252(Pt 1):118801. doi: 10.1016/j.envres.2024.118801. Online ahead of print.

Authors

Rooshna Mohsin¹, Victor Y Fujimoto², Aubrey L Galusha³, Patrick J Parsons³, Jenna R Krall¹, Celeste D Butts-Jackson⁴, Evelyn Mok-Lin², Michael S Bloom⁵

Affiliations

¹ Department of Global and Community Health, George Mason University, Fairfax, VA, 22030, United States.
² Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, CA, 94158, United States.
³ Laboratory of Inorganic & Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY, 12237, United States; Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, 12144, United States.
⁴ Department of Health Services Management, North Carolina Agricultural and Technical State University, Greensboro, NC, 27411, United States; Department of Epidemiology, University of North Carolina, Chapel Hill, NC, 27599, United States.
⁵ Department of Global and Community Health, George Mason University, Fairfax, VA, 22030, United States. Electronic address: mbloom22@gmu.edu.

PMID: 38555083
DOI: 10.1016/j.envres.2024.118801

Abstract

Introduction: Exposure to trace elements has been associated with ovarian response in experimental studies. We conducted a hypothesis-generating study of associations between ovarian follicular fluid (FF) trace elements and measures of ovarian response among women using in vitro fertilization (IVF).

Methods: We collected ovarian FF specimens from 56 women. We determined concentrations (μg/L) of 11 trace elements using inductively coupled plasma-tandem mass spectrometry. We estimated associations between women's FF trace elements per interquartile range difference, and measures of ovarian response using linear (peak estradiol (E2), baseline anti-mullerian hormone (AMH), and follicle stimulating hormone (FSH)) and negative binomial (baseline antral follicle count (AFC) and oocyte count) regression, adjusting for confounding factors. We used principal component analysis (PCA) to estimate the associations of the FF trace elements mixture. We also explored FF oxidative stress enzymes as causal mediators of the associations.

Results: Higher FF cobalt was associated with greater peak E2 (mean difference = 351.48 pg/mL; 95%CI: 21.76, 724.71) and AFC (rate ratio = 1.14; 95%CI: 1.01, 1.28), and higher FF copper was associated with greater peak E2 (mean difference = 335.66 pg/mL; 95%CI: 81.77, 753.08) and oocyte count (rate ratio = 1.19; 95%CI: 1.02, 1.43). Higher FF mercury was also associated with greater peak E2 (mean difference = 410.70 pg/mL; 95%CI: 61.90, 883.39). Higher FF lead was associated with lesser AFC (rate ratio = 0.85; 95%CI: 0.73, 0.98). Using PCA, the mixture of Sr, Hg, and As was associated with higher peak estradiol, AFC, and oocyte count. FF glutathione peroxidase, paraoxonase, and arylesterase activities were inconsistent mediators of the associations, but the effect estimates were imprecise.

Conclusion: Our results suggest that essential and non-essential trace elements in FF were associated with ovarian response during IVF.

Keywords: In vitro fertilization (IVF); Metals; Ovarian response; Oxidative stress; Trace elements.

Grants and funding

U2C ES026542/ES/NIEHS NIH HHS/United States