Phthalates are a class of chemicals found in a large variety of consumer products. Available experimental and limited human data show adverse effects of some phthalates on ovarian function, which has raised concerns regarding potential effects on fertility. The aim of the current study was to determine whether urinary concentrations of metabolites of phthalates and phthalate alternatives are associated with intermediate and clinical in vitro fertilization (IVF) outcomes. We enrolled 136 women undergoing IVF in a Tertiary University Affiliated Hospital. Participants provided one to two urine samples per cycle during ovarian stimulation and before oocyte retrieval. IVF outcomes were abstracted from medical records. Concentrations of 17 phthalate metabolites and two metabolites of the phthalate alternative di(isononyl) cyclohexane-1,2-dicarboxylate (DINCH) were measured. Multivariable Poisson regression models with log link were used to analyze associations between tertiles of specific gravity adjusted phthalate or DINCH metabolites and number of total oocytes, mature oocytes, fertilized oocytes, and top quality embryos. Multivariable logistic regression models were applied to evaluate the association between tertiles of specific gravity adjusted phthalate or DINCH metabolites and probability of live birth. Urinary concentrations of the sum of di-2-ethylhexyl phthalate metabolites (∑ DEHP) and the individual metabolites mono-2-ethyl-5-hydroxyhexyl phthalate, mono-2-ethyl-5-oxohexyl phthalate, and mono-2-ethyl-5-carboxypentyl phthalate were negatively associated with the number of total oocytes, mature oocytes, fertilized oocytes, and top quality embryos. Of the low molecular weight phthalates, higher monoethyl phthalate and mono-n-butyl phthalate concentrations were associated with significantly fewer total, mature, and fertilized oocytes. None of the urinary phthalate metabolite concentrations were associated with a reduced probability implantation, clinical pregnancy or live birth. Metabolites of DINCH were not associated with intermediate or clinical IVF outcomes. Our results suggest that DEHP may impair early IVF outcomes, specifically oocyte parameters. Additional research is needed to elucidate the potential effect of DEHP on female fertility in the general population.

邻苯二甲酸盐是在多种消费品中发现的一类化学物质。现有的实验数据和有限的人类数据表明，某些邻苯二甲酸酯对卵巢功能有不利影响，这引起了人们对生育能力的潜在影响。当前研究的目的是确定尿液中邻苯二甲酸酯和邻苯二甲酸酯替代品的代谢物浓度是否与中间和临床体外受精（IVF）结果相关。我们在一家第三大学附属医院招募了136名接受试管婴儿的妇女。参与者在卵巢刺激过程中以及取卵之前每个周期提供一到两个尿液样本。试管婴儿的结局摘自病历。邻苯二甲酸酯替代品二（异壬酰基）环己烷-1的17种邻苯二甲酸酯代谢物和两种代谢物的浓度，测量了2-二羧酸盐（DINCH）。使用具有对数链接的多变量Poisson回归模型分析比重调整的邻苯二甲酸酯或DINCH代谢物的三分位数与总卵母细胞，成熟卵母细胞，受精卵母细胞和优质胚胎的数量之间的关联。应用多变量logistic回归模型评估比重调整的邻苯二甲酸酯或DINCH代谢物的三分位数与活产可能性之间的关联。尿中邻苯二甲酸二-2-乙基己酯代谢物总和的浓度（∑ 应用多变量logistic回归模型评估比重调整的邻苯二甲酸酯或DINCH代谢物的三分位数与活产可能性之间的关联。尿中邻苯二甲酸二-2-乙基己酯代谢物总和的浓度（∑ 应用多变量logistic回归模型评估比重调整的邻苯二甲酸酯或DINCH代谢物的三分位数与活产可能性之间的关联。尿中邻苯二甲酸二-2-乙基己酯代谢物总和的浓度（∑ DEHP）和单个代谢物邻苯二甲酸单-2-乙基-5-羟基己酯，邻苯二甲酸单-2-乙基-5-氧己基酯和邻苯二甲酸单-2-乙基-5-羧基戊基酯与成熟卵母细胞总数呈负相关卵母细胞，受精卵母细胞和优质胚胎。低分子量的邻苯二甲酸酯，邻苯二甲酸单乙酯和更高单的Ñ邻苯二甲酸丁酯的浓度与总的，成熟的和受精的卵母细胞明显减少有关。尿中邻苯二甲酸酯代谢物的浓度均与植入率降低，临床妊娠或活产无关。DINCH的代谢产物与中间或临床IVF结果无关。我们的结果表明，DEHP可能会损害早期的IVF结果，特别是卵母细胞参数。需要进一步的研究来阐明DEHP对普通人群女性生育能力的潜在影响。