Urinary triclosan concentrations and diminished ovarian reserve among women undergoing treatment in a fertility clinic

Abstract

Objective: To investigate the association between urinary triclosan concentrations and antral follicle count (AFC), a well-accepted marker of ovarian reserve, among women from a fertility center.

Design: Prospective cohort study.

Setting: Hospital fertility center.

Patient(s): A total of 109 women.

Intervention(s): Urinary triclosan concentrations quantified by online solid phase extraction-high performance liquid chromatography-isotope dilution tandem mass spectrometry.

Main outcome measure(s): AFC through transvaginal ultrasonography on the third day of an unstimulated menstrual cycle or on the third day of a progesterone withdrawal bleed.

Result(s): The geometric mean of the specific gravity-adjusted urinary triclosan concentrations for the 225 samples provided by the 109 women was 13.0 μg/L (95% confidence interval [CI], 8.9, 19.1). Women had median (with interquartile range) AFC of 13 (8, 18). The specific gravity-adjusted urinary triclosan concentrations were inversely associated with AFC (-4%; 95% CI, -7%, -1%). Women with triclosan concentrations above the median had lower AFC compared with those whose triclosan concentrations were equal to or below the median, with an adjusted difference of -3.2 (95% CI, -3.9, -1.6) among those with a body mass index <25 kg/m2 and -1.8 (95% CI, -3.2, -0.3) among those who were <35 years old.

Conclusion(s): Specific gravity-adjusted urinary triclosan concentrations were inversely associated with AFC in women seeking care at a fertility center. This association was modified by age and body mass index, with the younger and leaner women showing larger decreases in AFC.

Keywords: Antral follicle count; infertility; ovarian reserve; triclosan.

Conflict of interest statement

Conflict of Interest: None of the authors has any conflicts of interest to declare. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC). Use of trade names is for identification only and does not imply endorsement by the CDC, the Public Health Service, or the US Department of Health and Human Services.

Copyright © 2017 American Society for Reproductive Medicine. All rights reserved.

Figures

Figure 1. Effect modification by age and BMI on the association between AFCa and SG-adjusted urinary triclosan concentrations among 109 women in the EARTH Study

Abbreviations: BMI, body mass index; TCS, triclosan; AFC, Total antral follicle count; EARTH, Environmental and Reproductive Health. aData are presented as predicted marginal means (95% CI) adjusted for year of sample collection (≤2012 and >2012), physical activity (hr/week), and infertility diagnosis (male, female and unexplained). Models exploring the effect of modification by age were further adjusted for BMI (kg/m2), and models exploring the effect of modification by BMI were further adjusted for age (years). Note: the boxes above the graphics represent the AFC differences (mean and 95% CI) for women below and above median SG-adjusted urinary TCS concentrations.