Exposure to Multiple Endocrine-Disrupting Chemicals and Associations with Female Infertility: A Case-Control Study

Parabens (PBs) and their metabolites (MBs), triclocarban (TCC), triclosan (TCS), bisphenols (BPs), benzophenones (BzPs), and phthalate metabolites (mPAEs) are typical endocrine-disrupting chemicals (EDCs) used in industrial production and daily life. Studies have suggested that these EDCs affect the reproductive system and may cause infertility; however, epidemiological evidence linking EDC exposure to infertility is still lacking. Herein, a total of 302 serum samples from women of reproductive age were collected, and six categories of typical EDCs were analyzed. The results revealed that EDCs are ubiquitous in female serum. The geometric mean (GM) concentrations of ∑PBs, ∑MBs, ∑(TCS+TCC), ∑BPs, ∑BzPs, and ∑mPAEs were 3.36, 297, 3.87, 4.39, 0.257, and 4.56 ng/mL, respectively. The serum concentrations of ∑PBs, ∑MBs, ∑(TCS+TCC), and ∑mPAEs from infertile women (GM: 4.16, 397, 4.01, and 7.33, respectively) were higher than those from fertile women (2.45, 192, 3.65, and 2.27, respectively) (p < 0.05). The results of binary logistic regression and random forest suggest that mPAEs, such as mBP/miBP and mEHP, may contribute to infertility. This study provides insight into the relationship between the EDC exposure and reproductive outcomes.