To better understand possible effects of bisphenol A (BPA) exposure on ovarian reserve in women with polycystic ovary syndrome (PCOS), we measured creatinine adjusted urinary BPA (BPA_Cre) concentrations and used regression models to evaluate the association between urinary BPA level and antral follicle count (AFC), antimullerian hormone (AMH), day-3 follicle stimulating hormone levels (FSH) and inhibin B (INHB) in 268 infertile women diagnosed with PCOS. BPA was detected in all women with a median concentration of 2.35 ng/mL (the 25th and 75th percentiles of 1.47 ng/mL and 3.95 ng/mL). A unit increase in BPA_Cre was associated with a significant decrease of 0.34 in AFC (β = −0.34, 95% CI = −0.60, −0.08; p = 0.01). Likewise, BPA was negatively associated with AMH and day-3 FSH levels, but neither of them reached statistical significance. No association was observed between BPA and INHB. Our results suggest that in women with PCOS, BPA may affect ovarian follicles and, therefore, reduce ovarian reserve.

Background: Per- and poly-fluoroalkyl substances (PFASs) are a group of synthetized industrial pollutants which have been detected worldwide in both environment and humans and gradually raised public health concerns. Previous studies suggested that PFASs had reproductive toxicity and may do harm to pregnancy and children. However, it is still uncertain that whether effect of PFAS exposure on offsprings begins from embryo quality or post-implantation pregnancy outcomes. This study explores the association between exposure to PFASs and embryo quality or pregnancy outcomes to promote maternal–infant health. Methods: This study included 246 women who underwent their first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles from July 2017 to August 2018 and measured concentrations of 23 PFAS congeners of follicular fluid samples. Generalized linear regression model with ln-transformed concentration values was performed to evaluate the association between individual PFAS congener and embryo quality and pregnancy outcomes. Weight quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) were used to estimate mixed effect of PFAS exposure on the above outcomes. Results: PFAS exposure had no significant association with high-quality blastocyst rate. Whereas, PFAS exposure had significantly adverse effect on miscarriage and live birth rate with the predominant risk of perfluoro-n-butanoic acid (PFBA) (For miscarriage, Q4 vs. Q1 OR: 6.44 (95%CI: 1.47, 33.72), Adjusted p = 0.03; For live birth, Q4 vs. Q1 OR: 0.35 (95%CI: 0.14, 0.82), Adjusted p = 0.04). BKMR model also suggested that there was potential joint effect between mixed PFAS chemicals and miscarriage or live birth. Conclusion: For women undergoing IVF/ICSI, exposure to PFASs was associated with higher miscarriage and lower live birth rate but had no adverse effect on embryo quality.

Objective: To investigate the relationship between the number of previous implantation failures (IFs) and embryo ploidy status, as well as subsequent clinical outcomes, in women with recurrent implantation failure (RIF) undergoing preimplantation genetic testing for aneuploidy (PGT-A). Methods: This retrospective cohort study included 422 women with RIF who underwent their first PGT-A cycle between 2017 and 2022. Participants were stratified by maternal age (<38 years, n = 292; ≥38 years, n = 130) and by the number of previous IFs, categorized as 3, 4, or ≥5. The primary outcomes were embryo ploidy rates (euploidy, aneuploidy, and mosaicism). Secondary outcomes included reproductive outcomes after single euploid blastocyst transfer (biochemical pregnancy, clinical pregnancy, ongoing pregnancy, live birth, and pregnancy loss) and neonatal birth weight. Results: Women aged ≥38 years had a significantly lower euploidy rate than those <38 years (24.8% vs. 47.3%, p < 0.001). Ploidy distribution did not differ significantly across IF categories. Among women aged <38 years with ≥5 IFs, a greater number of previous embryo transfer attempts was independently associated with higher odds of live birth after euploid embryo transfer (adjusted OR = 1.258, 95% CI: 1.051–1.505; p = 0.012). Neonatal weight did not differ significantly across IF categories. Conclusions: The number of previous IFs was not independently associated with embryo ploidy or clinical outcomes after euploid transfer, whereas advanced maternal age was strongly associated with a lower likelihood of obtaining euploid embryos. In younger women with ≥5 IFs, a greater number of previous embryo transfer attempts was associated with live birth after euploid transfer; however, this exploratory subgroup finding should be interpreted cautiously and requires prospective validation. Because this study did not directly evaluate therapeutic strategies, any potential role for individualized endometrial evaluation or optimization should be considered as hypothesis-generating rather than supported by the present data.

Assisted reproductive technologies (ART) have been proven to be associated with the increased risk of pregnancy complications such as gestational hypertens