Environment and Reproductive Health; Human Exposure to Bisphenol A, Phthalates and Fertility and Pregnancy Outcomes
Condition: Infertility
MeSH terms: Infertility
Study type: Observational

Summary: 
      The purpose of the study is to investigate the relationship between environmental agents and
      reproductive health. Environmental agents of interest include exposure to chemicals such as
      polychlorinated biphenyls (PCBs), flame retardants, dioxins, bisphenol A, phthalates,
      pesticides, and metals like lead and cadmium. We are also interested in the relationship
      between reproductive health and lifestyle risk factors, such as exposure to environmental
      tobacco smoke. Enrollees are asked to participate in this study because they and their
      partner are patients of the MGH Fertility Center, trying to get pregnant, either naturally or
      by undergoing Intrauterine Insemination (IUI) and/or In Vitro Fertilization (IVF).
    

Detailed description: 
      Specific Aim #1: To determine the association of a mixture of paternal urinary concentrations
      of phthalate metabolites, BPA and parabens with the primary outcomes of implantation failure
      and live birth, and the secondary outcomes of chemical pregnancy (with no subsequent clinical
      pregnancy) and spontaneous abortion.

      Hypothesis 1: Higher paternal urinary concentrations of a mixture of anti-androgenic
      phthalate metabolites of DEHP, DBP, DiBP, BBzP, and DiNP is associated with increased risk of
      implantation failure and reduced live birth rate, and increased risk of chemical pregnancy
      and spontaneous abortion.

      Hypothesis 2: Higher paternal urinary concentrations of a mixture of estrogenic chemicals
      (BPA and parabens) is associated with increased risk of implantation failure and reduced live
      birth rate, and increased risk of chemical pregnancy and spontaneous abortion.

      Specific Aim #2: To determine the association of a mixture of maternal urinary concentrations
      of phthalate metabolites, BPA and parabens with implantation failure and live birth rate, and
      the secondary outcomes of chemical pregnancy and spontaneous abortion.

      Hypothesis 2: Higher maternal urinary concentrations of a mixture of anti-androgenic
      phthalate metabolites of DEHP, DBP, DiBP, BBzP, and DiNP is associated with increased risk of
      implantation failure and reduced live birth rate, and increased risk of chemical pregnancy
      and spontaneous abortion.

      Hypothesis 3: Higher maternal urinary concentrations of a mixture of estrogenic BPA and
      parabens is associated with increased risk of implantation failure and reduced live birth
      rate, and increased risk of chemical pregnancy and spontaneous abortion.

      Specific Aim #3: To determine the joint effect of maternal and paternal urinary
      concentrations of phthalate metabolites, BPA and parabens with primary outcomes of interest
      including implantation failure and live birth rate, and the secondary outcomes of chemical
      pregnancy and spontaneous abortion.
    

Intervention name(s): Completion questionnaires/providing biological samples
Intervention type(s): Other
Intervention description(s): Participant completes baseline interview at enrollment, then completes online questionnaire on lifestyle and medical history. Diet questionnaire is completed at home and mailed back. Online questionnaire about personal care product use and medications is completed at each scheduled study visit.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Study subjects will be recruited from couples seeking treatment of infertility at the MGH
        IVF Clinic. Men and women must be at least 18 years old to participate in the study.
      
Biospecimen description: 
      Whole blood, urine, semen, follicular fluid, amniotic fluid
    
Keywords: Semen; Infertility; ART - Assisted Reproduction Technology; Phthalates; Bisphenol A