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Environmental exposure of bisphenol a and its association with polycystic ovary syndrome (pcos) and depletion of ovarian reserve among infertile women

Author: 
Mona E. Elkafrawy, Hanaa Farouk Ahmed, Doaa M. Effat, Amal A.M. Ahmed, Samia S.M. Barghash and Gamil EIbrahim
Subject Area: 
Health Sciences
Abstract: 

Background: The main cause of polycystic ovary disease has not been established, there are only hypotheses dictate its etiopathogenesis, environmental factor is one of these theories. Objective of research: To test the relation between bisphenol A (BPA) and poly- cystic ovarian syndrome (PCOs) and to evaluate the impact of BPA exposure on ovarian reserve of infertile women. Patients and methods: One hundred and sixty infertile women, 80 of whom were non PCOs and the other 80 women were PCOs, selected from outpatient's clinic, after they met inclusion and exclusion criteria. PCOs cases were selected according to Rotterdam criteria (2003). All the participants, at 3 day of cycle were subjected to 1-Venous blood sample for hormonal assay to FSH, LH, TSH, E2, AMH, and serum prolactin. 2- Urine sample to detect BPA and 3- Transvaginal U/S to detect the size of the uterus, ovarian volume and number of AFCs. Results: There was a highly significant increase in ovarian volume, FSH, LH and E2 hormones and PBA levels in PCOs group in comparison to non PCOs group, p<0.001.But there was no significant difference between the studied groups in AFCn, serum prolactin, TSH, and serum AMH hormone,p >0.05. In PCOs group, there was a direct correlation between BPA and age, r= 0.276, p =0.013* .But there was an inverse correlation between BPA and each of AFCn and AMH in PCOs & non PCOs groups as follows, r= -0.245, p=0.029*and r= -0.521, p =0.017* & r=-0.251, p=0.024*,r=-1.000,p=0.000* respectively. The crude model, a unit increase in BPA was associated with a significant lower of 0.656 in AFCn (_ = -0.656, 95% CI = (0.518, – 0.794; p = 0.026*). Similar relation was found in the adjusted model (_ = - 0.660, 95% CI = -0.509 – 0.760); p = 0.031*). While adjusting other characteristic data, there was significant decrease of --0.790 in AMH hormone (= --0.790), 95% CI = (--0.624 – 0.957), p = <0.001**. Conclusion: Urinary BPA is increased in infertile women, PCOs and non PCOs groups, implying that BPA may influence the hormonal profile of infertile women. As result of a higher significant increase of PBA level in PCOs group in comparison to non PCOs group, this indicates that BPA may be an environmental issue or cofactor implicated in the pathogenesis of PCOs. Furthermore, the association between BPA exposure and lower of antral follicles count and AMH level in infertile women, suggests that BPA may impair human ovarian function, reserve, and fecundity.

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