Association Between Pesticide Residue Intake From Consumption of Fruits and Vegetables and Pregnancy Outcomes Among Women Undergoing Infertility Treatment With Assisted Reproductive Technology

Abstract

for the EARTH Study Team IMPORTANCE Animal experiments suggest that ingestion of pesticide mixtures at environmentally relevant concentrations decreases the number of live-born offspring. Whether the same is true in humans is unknown.OBJECTIVE To examine the association of preconception intake of pesticide residues in fruits and vegetables (FVs) with outcomes of infertility treatment with assisted reproductive technologies (ART). DESIGN, SETTING, AND PARTICIPANTSThis analysis included 325 women who completed a diet assessment and subsequently underwent 541 ART cycles in the Environment and Reproductive Health (EARTH) prospective cohort study (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) at a fertility center at a teaching hospital. We categorized FVs as having high or low pesticide residues using a validated method based on surveillance data from the US Department of Agriculture. Cluster-weighted generalized estimating equations were used to analyze associations of high-and low-pesticide residue FV intake with ART outcomes. MAIN OUTCOMES AND MEASURES Adjusted probabilities of clinical pregnancy and live birth per treatment cycle. RESULTSIn the 325 participants (mean [SD] age, 35.1 [4.0] y; body mass index, 24.1 [4.3]), mean (SD) intakes of high-and low-pesticide residue FVs were 1.7 (1.0) and 2.8 (1.6) servings/d, respectively. Greater intake of high-pesticide residue FVs was associated with a lower probability of clinical pregnancy and live birth. Compared with women in the lowest quartile of high-pesticide FV intake (<1.0 servings/d), women in the highest quartile (Ն2.3 servings/d) had 18% (95% CI, 5%-30%) lower probability of clinical pregnancy and 26% (95% CI, 13%-37%) lower probability of live birth. Intake of low-pesticide residue FVs was not significantly related to ART outcomes. CONCLUSIONS AND RELEVANCEHigher consumption of high-pesticide residue FVs was associated with lower probabilities of pregnancy and live birth following infertility treatment with ART. These data suggest that dietary pesticide exposure within the range of typical human exposure may be associated with adverse reproductive consequences.

A Systematic Review of Organic Versus Conventional Food Consumption: Is There a Measurable Benefit on Human Health?

“…Findings from two cross-sectional reports on semen parameters detailed mixed findings, and although the majority of tested parameters showed no significant differences, higher sperm concentration in O consumers [50] and lower normal sperm in NO consumers [51] offer preliminary data that is worthy of further exploration. In female fertility, very positive associations between low dietary pesticide exposure and successful pregnancy and birth outcomes in women undergoing assisted reproduction have been reported in one study [52]. Given the declining fertility rates and poorer semen quality being reported worldwide [74], higher odds of achieving clinical pregnancy and live birth with an organic diet is a significant and important finding.…”

“…From a total of 20 publications including 13 cohorts, seven prospective cohorts were identified, with the majority involving mother/child pairs. These included the Norwegian Mother and Child Cohort Study [55,56]; KOALA Birth Cohort [58][59][60]; ALLADIN study [61]; PELAIGE Mother-Child Cohort [62] and the EARTH study [52]. Two adult-only cohorts involved development of cancer incidence in the Million Women Study [65], and self-reported health factors in the Nutri-Net Santé Cohort Study [20,53,63,64].…”

“…The Environment and Reproductive Health (EARTH) study examined associations between high or low dietary pesticide exposure in a group of women using assisted reproduction technology (ART) at the Massachusetts General Hospital Fertility Center [52]. They compared pregnancy/birth outcomes from 325 women (contributing 541 ART cycles) against a dietary pesticide score.…”

Diet and female fertility: doctor, what should I eat?

“…For example, in both human and nonhuman studies, intake of soy food and folates was found to be protective against the adverse reproductive effects of bisphenol-A (166)(167)(168)(169). A recent study has shown that the presence of high pesticide residues in fruits and vegetables might modify the beneficial effects of fruits and vegetables on reproductive success (170). Because environmental contaminants are widely dispersed, future studies may need to consider coexposure to environmental contaminants (and mixtures of these contaminants) when investigating the associations between food/nutrients and health outcomes to better form dietary recommendations and guide action for general and susceptible populations.…”

Assessing exposure of young Australian children to toxicants in the home environment using a web-based questionnaire

“…The feasibility of applying this improved dietary insecticide exposure-assessment questionnaire to epidemiological research was then demonstrated by its application to a study of men and women undergoing treatment at a reproductive technology clinic. Significant associations were reported between higher (top quartile versus bottom quartile) intake of high-insecticide residue fruits and vegetables and lower (18% 95% CI: 5%-30%) incidence of pregnancy (421).…”