Industrial chemicals such as persistent organic pollutants (POPs) have been associated with reduced fertility in women, including longer time-to-pregnancy (TTP), higher odds for infertility, and earlier reproductive senescence. Fertility is highly dependent on the ovarian reserve, which is composed of a prenatally determined stock of non-growing follicles. The quantity and quality of the follicles decline with age, thereby eventually leading to menopause. In the clinical setting, assessing ovarian reserve directly through the histological analysis of follicular density in ovaries is not practical. Therefore, surrogate markers of ovarian reserve, such as serum anti-Müllerian hormone (AMH) are typically used. Here, we studied associations between chemical exposure and ovarian reserve in a cohort of pregnant women undergoing elective caesarean section (n = 145) in Stockholm, Sweden. Full data (histological, clinical, serum) were available for 50 women. We estimated the size of the reserve both directly by determining the density of follicles in ovarian cortical tissue samples, and indirectly by measuring AMH in associated serum samples. Concentrations of 9 organochlorine pesticides (OCPs), 10 polychlorinated biphenyls (PCBs), 3 polybrominated diphenylethers (PBDEs) and 9 perfluoroalkyl substances (PFAS) were determined in serum, and clinical data were retrieved from electronic medical records. Healthy follicle densities (median 0, range 0–193 follicles/mm³) and AMH levels (median 2.33 ng/mL, range 0.1–14.8 ng/mL) varied substantially. AMH correlated with the density of growing follicles. Twenty-three chemicals detected in more than half of the samples were included in the analyses. None of the chemicals, alone or as a mixture, correlated with AMH, growing or atretic follicles. However, HCB, transnonachlor, PCBs 74 and 99 were associated with decreased non-growing follicle densities. HCB and transnonachlor were also negatively associated with healthy follicle density. Further, mixture of lipophilic POPs (PBDE 99, p,p’-DDE, and PCB 187) was associated with lower non-growing follicle densities. In addition, exposure to HCB, p,p’-DDE, and mixture of OCPs were significantly associated with higher odds of infertility. The results suggest that exposure to chemicals may reduce the size of ovarian reserve in humans, and strongly encourage to study mechanisms behind POP-associated infertility in women in more detail.

诸如持久性有机污染物 (POP) 等工业化学品与女性生育能力降低有关，包括更长的怀孕时间 (TTP)、更高的不孕几率和更早的生殖衰老。生育能力高度依赖于卵巢储备，它由出生前确定的非生长卵泡存量组成。卵泡的数量和质量随着年龄的增长而下降，从而最终导致更年期。在临床环境中，直接通过卵巢中卵泡密度的组织学分析来评估卵巢储备是不切实际的。因此，通常使用卵巢储备的替代标志物，例如血清抗苗勒管激素 (AMH)。这里，我们在瑞典斯德哥尔摩接受选择性剖腹产的一组孕妇（n = 145）中研究了化学物质暴露与卵巢储备之间的关联。可获得 50 名女性的完整数据（组织学、临床、血清）。我们通过确定卵巢皮质组织样本中的卵泡密度直接和间接通过测量相关血清样本中的 AMH 来估计储备的大小。测定血清中 9 种有机氯农药 (OCP)、10 种多氯联苯 (PCB)、3 种多溴二苯醚 (PBDE) 和 9 种全氟烷基物质 (PFAS) 的浓度，并从电子病历中检索临床数据。健康的卵泡密度（中位数 0，范围 0-193 个卵泡/mm 我们通过确定卵巢皮质组织样本中的卵泡密度直接和间接通过测量相关血清样本中的 AMH 来估计储备的大小。测定血清中 9 种有机氯农药 (OCP)、10 种多氯联苯 (PCB)、3 种多溴二苯醚 (PBDE) 和 9 种全氟烷基物质 (PFAS) 的浓度，并从电子病历中检索临床数据。健康的卵泡密度（中位数 0，范围 0-193 个卵泡/mm 我们通过确定卵巢皮质组织样本中的卵泡密度直接和间接通过测量相关血清样本中的 AMH 来估计储备的大小。测定血清中 9 种有机氯农药 (OCP)、10 种多氯联苯 (PCB)、3 种多溴二苯醚 (PBDE) 和 9 种全氟烷基物质 (PFAS) 的浓度，并从电子病历中检索临床数据。健康的卵泡密度（中位数 0，范围 0-193 个卵泡/mm 在血清中测定了 3 种多溴二苯醚 (PBDE) 和 9 种全氟烷基物质 (PFAS)，并从电子病历中检索临床数据。健康的卵泡密度（中位数 0，范围 0-193 个卵泡/mm 在血清中测定了 3 种多溴二苯醚 (PBDE) 和 9 种全氟烷基物质 (PFAS)，并从电子病历中检索临床数据。健康的卵泡密度（中位数 0，范围 0-193 个卵泡/mm³) 和 AMH 水平（中值 2.33 ng/mL，范围 0.1–14.8 ng/mL）差异很大。AMH 与生长中的卵泡密度相关。在超过一半的样本中检测到的 23 种化学物质被纳入分析。没有一种化学物质，单独或作为混合物，与 AMH、生长或闭锁卵泡相关。然而，六氯代苯、异壬氯、多氯联苯 74 和 99 与非生长卵泡密度降低有关。HCB 和转壬氯也与健康的卵泡密度呈负相关。此外，亲脂性持久性有机污染物（PBDE 99、p,p'-DDE 和 PCB 187）的混合物与较低的非生长卵泡密度有关。此外，接触 HCB、p,p'-DDE 和 OCP 混合物与更高的不孕几率显着相关。