The association between essential trace element (copper, zinc, selenium, and cobalt) status and the risk of early embryonic arrest among women undergoing assisted reproductive techniques

Abstract

BackgroundEarly embryonic arrest (EEA) leads to repeated cessation of fresh cycles among infertile women undergoing in vitro fertilization (IVF). Whether the levels of some essential trace elements [copper (Cu), zinc (Zn), selenium (Se) and cobalt (Co)] in the bodies of women are related to the risk of EEA warrants study.ObjectiveOur study aimed to investigate the associations of peripheral blood levels of Cu, Zn, Se, and Co and their mixtures with the risk of EEA.MethodsA total of 74 EEA cases (123 IVF cycles) and 157 controls (180 IVF cycles) from the reproductive center of the First Affiliated Hospital of Anhui Medical University in Hefei, China, between June 2017 and March 2020 were included in our study. Demographic and clinical data were collected from electronic medical records. Cu, Zn, Se, and Co levels were measured in blood samples collected on the day of oocyte retrieval when infertile women entered clinical treatment for the first time using an inductively coupled plasma mass spectrometer (ICP−MS). Generalized estimating equation (GEE) models were used to evaluate the associations of four essential trace element concentrations individually with the risk of EEA, and Bayesian kernel machine regression (BKMR) was used to explore the associations between four essential trace element mixtures and the risk of EEA.ResultsSe concentrations of infertile women were significantly lower in the case group compared with the control group. Co levels were significantly higher in the case group compared with the control group. The differences in Cu and Zn concentrations between the two groups were not significant. Based on single-metal models, Co was positively associated with the risk of EEA before and after adjustment for all confounders (odd ratio (OR) = 1.72, 95% confidence interval (CI): 1.18−2.52; OR = 2.27, 95% CI: 1.37−3.77, respectively), and Se was negatively associated with the risk of EEA before adjustment for all confounders (OR = 0.18, 95% CI: 0.07−0.51). BKMR analyses showed that Se was significantly and negatively associated with the risk of EEA when all the other three metals (Cu, Zn, and Co) were fixed at the 25th, 50th, or 75th percentiles, whereas Zn displayed a significant and positive association with the risk of EEA when all the other three metals (Cu, Se and Co) were fixed at the 25th, 50th, or 75th percentiles. Co did not show any effect on the risk of EEA when all the other metals (Cu, Zn, and Se) were fixed at the 25th, 50th, or 75th percentiles. In addition, an increasing trend of the joint effect of four essential trace elements on the risk of EEA was found, although it was not statistically significant.ConclusionThe levels of essential trace elements (Cu, Zn, Se, and Co) might correlate with the risk of EEA to some extent. The present study might provide a real-world perspective on the relationship between essential trace elements and the risk of EEA when considering them as a single element or as mixtures.

Investigation of serum elements and biochemical variables as a risk factor for female infertility

“…Cobalt concentration is observed to be signi cantly increased in the primary infertility group in comparison to women with secondary infertility and normal pregnancy (p < 0.01). Results are in agreement with the ndings of Cao et al (2022) who observed cobalt levels are signi cantly higher in infertile women who experienced early embryonic arrest (EEA) as compared to controls [13]. A signi cant difference was seen in both primary (OR = 1.33, p = 0.03) and secondary infertility groups (OR = 1.31, p = 0.04), which suggests that the risk of infertility (both primary and secondary) increases with elevated cobalt concentration.…”

Evaluation of Copper /Zinc Ratio, Total Protein, Albumin and Reproductive Hormones among Infertile Women in Port Harcourt, Nigeria

“…In this study, the mean Cu/Zn ratio was significantly higher in infertile group compared to the control group on day 3 and 21 of the menstrual cycle. This disagrees with the findings of Cao et al, [33] but agrees with the report of Al-Saraf et al, [7]. Furthermore, a high Cu/Zn ratio has been reported to be a risk factor for implantation failure as Cu/Zn ratio is a better predictor of clinical pregnancy rates than Cu or Zn alone [27].…”

Assessing the combined effect of multiple metal exposures on pregnancy and birth outcomes: Methodological insights in systematic review research

“…Source: Haddaway, Page, Pritchard, and McGuinness [ 7 ]. Note: Three studies [ [8] , [9] , [10] ] met more than one exclusion criterion, contributing to the overall count of 17 studies excluded, even though there are 14 unique studies in the list. …”