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Hallberg, I., Duque Björvang, R., Hadziosmanovic, N., Koekkoekk, J., Pikki, A., van Duursen, M., . . . Damdimopoulou, P. (2023). Associations between lifestyle factors and levels of per- and polyfluoroalkyl substances (PFASs), phthalates and parabens in follicular fluid in women undergoing fertility treatment. Journal of Exposure Science and Environmental Epidemiology, 33, 699-709
Open this publication in new window or tab >>Associations between lifestyle factors and levels of per- and polyfluoroalkyl substances (PFASs), phthalates and parabens in follicular fluid in women undergoing fertility treatment
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2023 (English)In: Journal of Exposure Science and Environmental Epidemiology, ISSN 1559-0631, E-ISSN 1559-064X, Vol. 33, p. 699-709Article in journal (Refereed) Published
Abstract [en]

Background: Concerns have been raised whether exposure to endocrine-disrupting chemicals (EDCs) can alter reproductive functions and play a role in the aetiology of infertility in women. With increasing evidence of adverse effects, information on factors associated with exposure is necessary to form firm recommendations aiming at reducing exposure.

Objective: Our aim was to identify associations between lifestyle factors including the home environment, use of personal care products (PCP), and dietary habits and concentrations of EDCs in ovarian follicular fluid.

Methods: April-June 2016, 185 women undergoing ovum pick-up for in vitro fertilisation in Sweden were recruited. Correlation analyses were performed between self-reported lifestyle factors and concentration of EDCs analysed in follicular fluid. Habits related to cleaning, PCPs, and diet were assessed together with concentration of six per- and polyfluoroalkyl substances (PFASs) [PFHxS, PFOA, PFOS, PFNA, PFDA and PFUnDA], methyl paraben and eight phthalate metabolites [MECPP, MEHPP, MEOHP, MEHP, cxMinCH, cxMiNP, ohMiNP, MEP, MOHiBP]. Spearman's partial correlations were adjusted for age, parity and BMI.

Results: Significant associations were discovered between multiple lifestyle factors and concentrations of EDCs in ovarian follicular fluid. After correcting p values for multiple testing, frequent use of perfume was associated with MEP (correlation rho = 0.41 (confidence interval 0.21-0.47), p < 0.001); hens' egg consumption was positively associated with PFOS (rho = 0.30 (0.15-0.43), p = 0.007) and PFUnDA (rho = 0.27 (0.12-0.40), p = 0.036). White fish consumption was positively associated with PFUnDA (rho = 0.34 (0.20-0.47), p < 0.001) and PFDA (rho = 0.27 (0.13-0.41), p = 0.028). More correlations were discovered when considering the raw uncorrected p values. Altogether, our results suggest that multiple lifestyle variables affect chemical contamination of follicular fluid.

Impact statement: This study shows how lifestyle factors correlate with the level of contamination in the ovary by both persistent and semi-persistent chemicals in women of reproductive age. Subsequently, these data can be used to form recommendations regarding lifestyle to mitigate possible negative health outcomes and fertility problems associated with chemical exposure, and to inform chemical policy decision making. Our study can also help form the basis for the design of larger observational and intervention studies to examine possible effects of lifestyle changes on exposure levels, and to unravel the complex interactions between biological factors, lifestyle and chemical exposures in more detail.

Place, publisher, year, edition, pages
Springer Nature, 2023
Keywords
Dietary exposure, Personal exposure, Phthalates, Endocrine disruptors, PFAS
National Category
Occupational Health and Environmental Health Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-514758 (URN)10.1038/s41370-023-00579-1 (DOI)001078027600003 ()37481638 (PubMedID)
Funder
EU, Horizon 2020, 825100EU, Horizon 2020, EU952516Swedish Research Council Formas, 942-2015-476Swedish Research Council Formas, 2015-00623Swedish Research Council Formas, 2013-01966
Available from: 2023-10-24 Created: 2023-10-24 Last updated: 2023-11-28Bibliographically approved
Pontoppidan, K., Olovsson, M. & Grundström, H. (2023). Clinical factors associated with quality of life among women with endometriosis: a cross-sectional study. BMC Women's Health, 23(1), Article ID 551.
Open this publication in new window or tab >>Clinical factors associated with quality of life among women with endometriosis: a cross-sectional study
2023 (English)In: BMC Women's Health, E-ISSN 1472-6874, Vol. 23, no 1, article id 551Article in journal (Refereed) Published
Abstract [en]

Background

Endometriosis often leads to a decrease in Quality of Life (QoL), due to its impact on various aspects of women's lives, such as social life, mental health, sex life, and working capacity. Although previous studies have assessed QoL in women with endometriosis, few studies have explored the impact of different clinical variables on QoL. The aim of this study was to investigate how women with endometriosis perceive their QoL, and to analyze which clinical factors are associated with QoL.

Methods

The Endometriosis Health Profile-30 and the ENDOCARE Questionnaire were distributed to 1000 women diagnosed with endometriosis from 10 different clinics across Sweden. The responses from 476 women were included in univariate and multivariable regression analyses, where the clinical factors were correlated with overall QoL and QoL dimensions.

Results

The women participating in this study reported a low QoL. The clinical factors that showed a significant correlation with overall QoL were age at first onset of endometriosis symptoms (beta= -0.64, p < 0.001), having more than 10 visits to general practitioners before referral to a gynecologist (beta = 5.58, p = 0.036), current or previous mental health issues (beta = 7.98, p < 0.001) patient-centeredness (beta= -2.59, p < 0.001) and use of opioids (beta = 7.14, p = 0.002).

Conclusions

This study shows that opioid use and mental health issues were associated with a worse QoL, whereas a higher degree of patient-centeredness was associated with a better QoL. The association between opioid use and a worse QoL might not entirely be caused by the opioid use itself but also by symptom severity and mental health issues. An improved patient-centeredness and more focus on taking care of mental health issues would reasonably result in a better QoL for women with endometriosis.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Endometriosis, EHP-30, Endometriosis Health Profile-30, Quality of life, Patient-centeredness
National Category
Obstetrics, Gynecology and Reproductive Medicine Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-518475 (URN)10.1186/s12905-023-02694-5 (DOI)001088979300004 ()37875883 (PubMedID)
Funder
Tornspiran FoundationMedical Research Council of Southeast Sweden (FORSS), FORSS-964282Linköpings universitet
Available from: 2023-12-19 Created: 2023-12-19 Last updated: 2023-12-19Bibliographically approved
Grundström, H., Kilander, H., Wikman, P. & Olovsson, M. (2023). Demographic and clinical characteristics determining patient-centeredness in endometriosis care. Archives of Gynecology and Obstetrics, 307(4), 1047-1055
Open this publication in new window or tab >>Demographic and clinical characteristics determining patient-centeredness in endometriosis care
2023 (English)In: Archives of Gynecology and Obstetrics, ISSN 0932-0067, E-ISSN 1432-0711, Vol. 307, no 4, p. 1047-1055Article in journal (Refereed) Published
Abstract [en]

Purpose

The primary aim of this study was to assess patient-centeredness of endometriosis care in a national sample of Swedish women with endometriosis. The secondary aims were to assess the importance of different dimensions of endometriosis care and to analyze demographic and clinical determinants associated with the experience of patient-centeredness.

Methods

This cross-sectional study included 476 women with confirmed endometriosis. An invitation to participate was sent to 1000 randomly selected women aged ≥ 18 years having any endometriosis diagnosis and who had visited a gynecological clinic due to endometriosis problems any time during the past five years. Participants were recruited from ten different-sized gynecology clinics all over Sweden. The invitation letter had a link to the digital survey, which consisted of demographic and clinical questions, and the ENDOCARE questionnaire (ECQ). ECQ measures experiences, importance and patient-centeredness of ten dimensions of endometriosis care. Univariate and multiple regression analyses were used to analyze which patient-specific demographic and clinical determinants were associated with the experience of patient-centeredness.

Results

The response rate was 48%. The results indicate that Swedish women with endometriosis experience low patient-centeredness and rate relational aspects with healthcare professionals as the most important aspects of care. Having a gynecologist with patient responsibility was an independent predictor for high patient-centeredness.

Conclusion

Women with endometriosis in Sweden experience low patient-centeredness, reflecting the urgent need for improvement. More effort should be given to develop the relational aspects of care. Women with endometriosis should have a responsible gynecologist to care for treatment and follow-up.

Place, publisher, year, edition, pages
Springer Nature, 2023
Keywords
Endometriosis, Patient-centeredness, ENDOCARE questionnaire, ECQ
National Category
Obstetrics, Gynecology and Reproductive Medicine Nursing
Identifiers
urn:nbn:se:uu:diva-501864 (URN)10.1007/s00404-022-06887-5 (DOI)000905529100002 ()36576559 (PubMedID)
Funder
Uppsala UniversityMedical Research Council of Southeast Sweden (FORSS)
Available from: 2023-05-17 Created: 2023-05-17 Last updated: 2023-05-17Bibliographically approved
Tarvainen, I., Soto, D. A., Laws, M. J., Duque Björvang, R., Damdimopoulos, A., Roos, K., . . . Damdimopoulou, P. (2023). Identification of phthalate mixture exposure targets in the human and mouse ovary in vitro. Reproductive Toxicology, 119, Article ID 108393.
Open this publication in new window or tab >>Identification of phthalate mixture exposure targets in the human and mouse ovary in vitro
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2023 (English)In: Reproductive Toxicology, ISSN 0890-6238, E-ISSN 1873-1708, Vol. 119, article id 108393Article in journal (Refereed) Published
Abstract [en]

Chemical health risk assessment is based on single chemicals, but humans and wildlife are exposed to extensive mixtures of industrial substances and pharmaceuticals. Such exposures are life-long and correlate with multiple morbidities, including infertility. How combinatorial effects of chemicals should be handled in hazard charac-terization and risk assessment are open questions. Further, test systems are missing for several relevant health outcomes including reproductive health and fertility in women. Here, our aim was to screen multiple ovarian cell models for phthalate induced effects to identify biomarkers of exposure. We used an epidemiological cohort study to define different phthalate mixtures for in vitro testing. The mixtures were then tested in five cell models representing ovarian granulosa or stromal cells, namely COV434, KGN, primary human granulosa cells, primary mouse granulosa cells, and primary human ovarian stromal cells. Exposures at epidemiologically relevant levels did not markedly elicit cytotoxicity or affect steroidogenesis in short 24-hour exposure. However, significant effects on gene expression were identified by RNA-sequencing. Altogether, the exposures changed the expression of 124 genes on the average (9-479 genes per exposure) in human cell models, without obvious concentration or mixture-dependent effects on gene numbers. The mixtures stimulated distinct changes in different cell models. Despite differences, our analyses suggest commonalities in responses towards phthalates, which forms a starting point for follow-up studies on identification and validation of candidate biomarkers that could be developed to novel assays for regulatory testing or even into clinical tests.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Phthalates, Endocrine disrupting chemicals, Chemical mixtures, Reproduction, Ovaries, Female fertility, Risk assessment, In vitro models
National Category
Obstetrics, Gynecology and Reproductive Medicine Pharmacology and Toxicology
Identifiers
urn:nbn:se:uu:diva-507546 (URN)10.1016/j.reprotox.2023.108393 (DOI)001001785800001 ()37160244 (PubMedID)
Funder
Swedish Research Council Formas, 2018-02280EU, Horizon 2020, EU952516
Available from: 2023-07-07 Created: 2023-07-07 Last updated: 2023-07-07Bibliographically approved
Yung, H. W., Zhao, X., Glover, L., Burrin, C., Pang, P.-C., Jones, C. J. P., . . . Charnock-Jones, D. S. (2023). Perturbation of placental protein glycosylation by endoplasmic reticulum stress promotes maladaptation of maternal hepatic glucose metabolism. iScience, 26(1), Article ID 105911.
Open this publication in new window or tab >>Perturbation of placental protein glycosylation by endoplasmic reticulum stress promotes maladaptation of maternal hepatic glucose metabolism
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2023 (English)In: iScience, E-ISSN 2589-0042, Vol. 26, no 1, article id 105911Article in journal (Refereed) Published
Abstract [en]

Placental hormones orchestrate maternal metabolic adaptations to support pregnancy. We hypothesized that placental ER stress, which characterizes early-onset pre-eclampsia (ePE), compromises glycosylation, reducing hormone bioactivity and these maladaptations predispose the mother to metabolic disease in later life. We demonstrate ER stress reduces the complexity and sialylation of trophoblast protein N-glycosylation, while aberrant glycosylation of vascular endothelial growth factor reduced its bioactivity. ER stress alters the expression of 66 of the 146 genes annotated with "protein glycosylation"and reduces the expression of sialyltransferases. Using mouse placental explants, we show ER stress promotes the secretion of mis-glycosylated glycoproteins. Pregnant mice carrying placentas with junctional zone-specific ER stress have reduced blood glucose, anomalous hepatic glucose metabolism, increased cellular stress and elevated DNA methyltransferase 3A. Using pregnancy-specific glycoproteins as a readout, we also demonstrate aberrant glycosylation of placental proteins in women with ePE, thus providing a mechanistic link between ePE and subsequent maternal metabolic disorders.

Place, publisher, year, edition, pages
Cell Press, 2023
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-505274 (URN)10.1016/j.isci.2022.105911 (DOI)000996454600001 ()36660474 (PubMedID)
Available from: 2023-07-31 Created: 2023-07-31 Last updated: 2023-10-03Bibliographically approved
Strömberg, C., Olovsson, M. & Grundström, H. (2022). Age-related differences in experienced patient-centred care among women with endometriosis. Journal of Obstetrics and Gynaecology, 42(7), 3356-3361
Open this publication in new window or tab >>Age-related differences in experienced patient-centred care among women with endometriosis
2022 (English)In: Journal of Obstetrics and Gynaecology, ISSN 0144-3615, E-ISSN 1364-6893, Vol. 42, no 7, p. 3356-3361Article in journal (Refereed) Published
Abstract [en]

Younger women with endometriosis report lower quality of life and seek more care. Patient-centeredness is a central part of quality of care. The aim of this study was to investigate if women younger than 35 years experience endometriosis care as less patient-centred than women 35 years and older. The ENDOCARE Questionnaire was sent to 1000 randomly selected women with verified endometriosis from 10 clinics in Sweden. Answers from 469 women were analysed using Mann-Whitney's U-test and Spearman's correlation. Our findings show that younger women experience care as less patient-centred regarding 'Physical comfort,' 'Continuity,' 'Access to care,' 'Technical skills,' and overall patient-centeredness score in comparison with older women. On the contrary, younger women experience more patient-centeredness in 'Emotional support'. Positive correlations were found for age and 'Access to care' and 'Technical skills', while a negative correlation was found for age and 'Emotional support'. Impact Statement What is already known on this subject? There is a need for improvement of quality of endometriosis care. Patient-centeredness is an important part of care improvement work. Many factors have an impact on experienced patient-centeredness in endometriosis care, whereof age is one possible determinant. Given the impact of age on QoL and care seeking behaviour, age may also have influence on the experience patient-centeredness. What do the results of this study add? Our findings show that younger women experience their endometriosis care as less patient-centred than older women. What are the implications of these findings for clinical practice and/or further research? Our results highlight the need of improvement of endometriosis care, especially for younger women. The results contribute to the understanding of the experience of patient-centeredness, which may be used as a guidance to how healthcare recourses should be allocated. Further research is needed to identify other factors contributing to the experience of patient-centeredness. Future studies could also evaluate how different interventions can improve patient-centeredness.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2022
Keywords
Endometriosis, patient-centeredness, ENDOCARE Questionnaire, ECQ, age
National Category
Obstetrics, Gynecology and Reproductive Medicine Nursing
Identifiers
urn:nbn:se:uu:diva-496942 (URN)10.1080/01443615.2022.2125796 (DOI)000863879200001 ()36194085 (PubMedID)
Funder
Medical Research Council of Southeast Sweden (FORSS), 964282
Available from: 2023-02-22 Created: 2023-02-22 Last updated: 2023-02-22Bibliographically approved
Hallberg, I., Persson, S., Olovsson, M., Moberg, M., Ranefall, P., Laskowski, D., . . . Sjunnesson, Y. C. B. (2022). Bovine oocyte exposure to perfluorohexane sulfonate (PFHxS) induces phenotypic, transcriptomic, and DNA methylation changes in resulting embryos in vitro. Reproductive Toxicology, 109, 19-30
Open this publication in new window or tab >>Bovine oocyte exposure to perfluorohexane sulfonate (PFHxS) induces phenotypic, transcriptomic, and DNA methylation changes in resulting embryos in vitro
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2022 (English)In: Reproductive Toxicology, ISSN 0890-6238, E-ISSN 1873-1708, Vol. 109, p. 19-30Article in journal (Refereed) Published
Abstract [en]

Knowledge on the effects of perfluorohexane sulfonate (PFHxS) on ovarian function is limited. In the current study, we investigated the sensitivity of oocytes to PFHxS during in vitro maturation (IVM), including conse-quences on embryo development at the morphological, transcriptomic, and epigenomic levels. Bovine cumulus-oocyte complexes (COCs) were exposed to PFHxS during 22 h IVM. Following fertilisation, developmental competence was recorded until day 8 of culture. Two experiments were conducted: 1) exposure of COCs to 0.01 mu g mL(-1) -100 mu g mL(-1) PFHxS followed by confocal imaging to detect neutral lipids and nuclei, and 2) exposure of COCs to 0.1 mu g mL(-1) PFHxS followed by analysis of transcriptomic and DNA methylation changes in blastocysts. Decreased oocyte developmental competence was observed upon exposure to & nbsp;>= 40 mu g mL(-1) PFHxS and altered lipid distribution was observed in the blastocysts upon exposure to 1-10 mu g mL(-1) PFHxS (not observed at lower or higher concentrations). Transcriptomic data showed that genes affected by 0.1 mu g mL(-1) PFHxS were enriched for pathways related to increased synthesis and production of reactive oxygen species. Enrichment for peroxisome proliferator-activated receptor-gamma and oestrogen pathways was also observed. Genes linked to DNA methylation changes were enriched for similar pathways. In conclusion, exposure of the bovine oocyte to PFHxS during the narrow window of IVM affected subsequent embryonic development, as reflected by morphological and mo- lecular changes. This suggests that PFHxS interferes with the final nuclear and cytoplasmic maturation of the oocyte leading to decreased developmental competence to blastocyst stage.

Place, publisher, year, edition, pages
ElsevierElsevier BV, 2022
Keywords
Per- and polyfluoroalkyl substances, PFAS & nbsp, Female fertility & nbsp, Bovine, IVP, Oocyte maturation, Embryo quality & nbsp, Embryo quality Reproductive toxicity
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-473796 (URN)10.1016/j.reprotox.2022.02.004 (DOI)000774360900003 ()35219833 (PubMedID)
Funder
Swedish Research Council Formas, 942-2015-476
Available from: 2022-05-04 Created: 2022-05-04 Last updated: 2024-01-15Bibliographically approved
Bergman-Larsson, J., Gustafsson, S., Méar, L., Huvila, J., Tolf, A., Olovsson, M., . . . Edqvist, P.-H. D. (2022). Combined expression of HOXA11 and CD10 identifies endometriosis versus normal tissue and tumors. Annals of Diagnostic Pathology, 56, Article ID 151870.
Open this publication in new window or tab >>Combined expression of HOXA11 and CD10 identifies endometriosis versus normal tissue and tumors
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2022 (English)In: Annals of Diagnostic Pathology, ISSN 1092-9134, E-ISSN 1532-8198, Vol. 56, article id 151870Article in journal (Refereed) Published
Abstract [en]

The gold standard for diagnosing endometriosis is by laparoscopic visual demonstration of ectopic endometrial lesions outside the uterus, preferably verified by biopsy and microscopical examination. Molecular markers to facilitate the microscopical diagnosis of endometriosis and for distinguishing endometriosis from other benign and malignant lesions are lacking. Our aim was to test and validate an immunohistochemical antibody panel for improved diagnostic accuracy of endometriosis. Both CD10 and HOXA11 have been implicated in regulation of endometrial homeostasis. Here we have analyzed the expression pattern of these two proteins using immunohistochemistry on human tissues in a tissue microarray format. CD10 and HOXA11 expression in endometriosis lesions were compared to expression patterns in a range of normal tissues and in primary- and metastatic lesions of endometrial-, cervical- and ovarian cancer. HOXA11 and CD10 were expressed in 98% and 91% of endometriosis lesions and the combined double-positive expression profile of both HOXA11 and CD10 was highly sensitive for ectopic endometrial tissue (90%). The specificity and sensitivity for this double-positive signature in endometriosis was significantly different from all investigated tissues, cancers and metastases except normal, eutopic endometrial- and cervical mucosa. The combination of HOXA11 and CD10 expression profiles provides a useful tool to identify ectopic endometrial tissue and for distinguishing endometriosis from various types of gynecological malignancies and metastases.

Place, publisher, year, edition, pages
ElsevierElsevier BV, 2022
Keywords
Endometriosis, Endometrium, Immunohistochemistry, Gynecological malignancies, Differential diagnostics
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-461725 (URN)10.1016/j.anndiagpath.2021.151870 (DOI)000726993800002 ()34844098 (PubMedID)
Funder
Swedish Cancer SocietyKnut and Alice Wallenberg Foundation
Note

De 2 första författarna delar förstaförfattarskapet

Available from: 2022-01-31 Created: 2022-01-31 Last updated: 2024-01-15Bibliographically approved
Lavogina, D., Visser, N., Samuel, K., Davey, E., Bjorvang, R. D., Hassan, J., . . . Damdimopoulou, P. (2022). Endocrine disrupting chemicals interfere with decidualization of human primary endometrial stromal cells in vitro. Frontiers in Endocrinology, 13, Article ID 903505.
Open this publication in new window or tab >>Endocrine disrupting chemicals interfere with decidualization of human primary endometrial stromal cells in vitro
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2022 (English)In: Frontiers in Endocrinology, E-ISSN 1664-2392, Vol. 13, article id 903505Article in journal (Refereed) Published
Abstract [en]

Multiple studies have shown associations between exposure to endocrine disrupting chemicals (EDCs) and reduced fertility in women. However, little is known about the target organs of chemical disruption of female fertility. Here, we focus on the hormone-sensitive uterine lining, the endometrium, as a potential target. Decidualization is the morphological and functional change that endometrial stromal cells undergo to support endometrial receptivity, which is crucial for successful implantation, placentation, and pregnancy. We investigated the effect of nine selected EDCs on primary human endometrial stromal cell decidualization in vitro. The cells were exposed to a decidualization-inducing mixture in the presence or absence of 1 mu M of nine different EDCs for nine days. Extent of decidualization was assessed by measuring the activity of cAMP dependent protein kinase, Rho-associated coiled-coil containing protein kinase, and protein kinase B in lysates using photoluminescent probes, and secretion of prolactin into the media by using ELISA. Decidualization-inducing mixture upregulated activity of protein kinases and prolactin secretion in cells derived from all women. Of the tested chemicals, dichlorodiphenyldichloroethylene (p,p'-DDE), hexachlorobenzene (HCB) and perfluorooctanesulfonic acid (PFOS) significantly reduced decidualization as judged by the kinase markers and prolactin secretion. In addition, bisphenol A (BPA) reduced prolactin secretion but did not significantly affect activity of the kinases. None of the EDCs was cytotoxic, based on the assessment of total protein content or activity of the viability marker casein kinase 2 in lysates. These results indicate that EDCs commonly present in the blood circulation of reproductive-aged women can reduce decidualization of human endometrial stromal cells in vitro. Future studies should focus on detailed hazard assessment to define possible risks of EDC exposure to endometrial dysfunction and implantation failure in women.

Place, publisher, year, edition, pages
Frontiers Media S.A.Frontiers Media SA, 2022
Keywords
endocrine disrupting chemical, phthalate, persistent organic pollutants (POPs), human endometrium, decidualization, per- and polyfluorinated alkyl substances (PFASs), primary stromal cells, infertility
National Category
Endocrinology and Diabetes Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-484809 (URN)10.3389/fendo.2022.903505 (DOI)000849703800001 ()36060944 (PubMedID)
Funder
Swedish Research Council Formas, Pandora 2018-02280EU, Horizon 2020, EU952516EU, Horizon 2020, 101008193
Available from: 2022-09-16 Created: 2022-09-16 Last updated: 2024-01-17Bibliographically approved
Bjorvang, R. D., Hallberg, I., Pikki, A., Berglund, L., Pedrelli, M., Kiviranta, H., . . . Damdimopoulou, P. (2022). Follicular fluid and blood levels of persistent organic pollutants and reproductive outcomes among women undergoing assisted reproductive technologies. Environmental Research, 208, Article ID 112626.
Open this publication in new window or tab >>Follicular fluid and blood levels of persistent organic pollutants and reproductive outcomes among women undergoing assisted reproductive technologies
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2022 (English)In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 208, article id 112626Article in journal (Refereed) Published
Abstract [en]

Persistent organic pollutants (POPs) are industrial chemicals resistant to degradation and have been shown to have adverse effects on reproductive health in wildlife and humans. Although regulations have reduced their levels, they are still ubiquitously present and pose a global concern. Here, we studied a cohort of 185 women aged 21-43 years with a median of 2 years of infertility who were seeking assisted reproductive technology (ART) treatment at the Carl von Linne Clinic in Uppsala, Sweden. We analyzed the levels of 9 organochlorine pesticides (OCPs), 10 polychlorinated biphenyls (PCBs), 3 polybrominated diphenyl ethers (PBDEs), and 8 perfluoroalkyl substances (PFASs) in the blood and follicular fluid (FF) samples collected during ovum pick-up. Impact of age on chemical transfer from blood to FF was analyzed. Associations of chemicals, both individually and as a mixture, to 10 ART endpoints were investigated using linear, logistic, and weighted quantile sum regression, adjusted for age, body mass index, parity, fatty fish intake and cause of infertility. Out of the 30 chemicals, 20 were detected in more than half of the blood samples and 15 in FF. Chemical transfer from blood to FF increased with age. Chemical groups in blood crossed the blood-follicle barrier at different rates: OCPs > PCBs > PFASs. Hexachlorobenzene, an OCP, was associated with lower anti-Miillerian hormone, clinical pregnancy, and live birth. PCBs and PFASs were associated with higher antral follicle count and ovarian response as measured by ovarian sensitivity index, but also with lower embryo quality. As a mixture, similar findings were seen for the sum of PCBs and PFASs. Our results suggest that age plays a role in the chemical transfer from blood to FF and that exposure to POPs significantly associates with ART outcomes. We strongly encourage further studies to elucidate the underlying mechanisms of reproductive effects of POPs in humans.

Place, publisher, year, edition, pages
ElsevierElsevier BV, 2022
Keywords
Persistent organic pollutants, Assisted reproductive technologies, Follicular fluid, Ovarian sensitivity index, Embryo quality, Live birth
National Category
Occupational Health and Environmental Health Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-469206 (URN)10.1016/j.envres.2021.112626 (DOI)000752019000013 ()34973191 (PubMedID)
Funder
Swedish Research Council Formas, 942-2015-476Swedish Research Council Formas, 2015-623Swedish Research Council Formas, 2016-02031EU, Horizon 2020, 825100
Available from: 2022-03-08 Created: 2022-03-08 Last updated: 2024-01-15Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-4472-840x

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