Association between endocrine disrupting chemicals and female infertility: a study based on NHANES database

Abstract

Background: Controversy persists regarding the impact of endocrine disrupting chemicals (EDCs) on female infertility, and the specific EDCs that cause female infertility remain unclear. This study aims to examine the associations between various EDCs metabolites and female infertility using data from the female population in the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2006. Methods: A cross-sectional study on reproductive-age women aged 18–45 years was conducted, with data retrieved from the NHANES database. Multivariate logistic regression analysis was performed to evaluate the association between EDCs metabolites and female infertility. Subgroup analysis was applied to stratify by age and body mass index (BMI). Results were summarized using an odds ratio (OR) with a 95% confidence interval (CI). Results: A total of 3,982 women were enrolled, comprising 463 infertile women and 3,519 control women. The results showed that increased exposure to EDCs metabolites (including DnBP, DEHP, DiNP, DEHTP, PAEs, Equol, PFOA, and PFUA) was significantly associated with female infertility, with odds ratios of 2.10 (95% CI: 1.59, 2.48), 1.36 (95% CI: 1.05, 1.79), 1.62 (CI: 1.31, 1.97), 1.43 (95% CI: 1.22, 1.78), 1.43 (95% CI: 1.26, 1.75), 1.41 (95% CI: 1.17, 2.35), 1.34 (95% CI: 1.15, 2.67), and 1.58 (95% CI: 1.08, 2.03), respectively. Sensitivity analyses confirmed the robustness of these findings. The subgroup analysis also indicated that increased age and BMI may exacerbate the risk of female infertility among those exposed to EDCs metabolites. Conclusions: This study indicates that exposure to EDCs metabolites such as PAEs, equol, and PFASs are associated with female infertility. These findings provide valuable evidence for preventing female infertility from the perspective of EDCs exposure.