Associations of phthalate metabolites in urine and follicular fluid with endometrial thickness in the TREE cohort.

Xiu-Ting Li, Chong Liu, Yan-Ling Deng, Yu Miao, Min Zhang, Jia-Yue Zeng, Peng-Hui Liu, A-Xue Liu, Yang-Juan Li, Jin-Qin Zhu, Ning Zhang, Juan Li, Yu-Feng Li, Tao-Ran Deng, Qiang Zeng

Journal: Environmental toxicology and pharmacology 2025;118():104781

PMID: 40782922

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Abstract

Endometrial thickness (EMT) is a crucial indicator of female fecundity and pregnancy success. Experimental studies have suggested that phthalates can disrupt EMT by exerting estrogenic effects or affecting the expression of related receptors, but human evidence is scarce. We aimed to explore the relationships of phthalate metabolites in paired urine and follicular fluid (FF) with EMT among 548 women undergoing assisted reproductive technology (ART). In single-pollutant analyses, all urinary di(2-ethylhexyl) phthalate (DEHP) metabolites were positively linked with follicular phase EMT (all p for trends ≤ 0.01) and higher risks of thick EMT (all p for trends ≤ 0.10). Meanwhile, mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) in FF showed similar positive associations (both p for trends ≤ 0.01). Bayesian kernel machine regression (BKMR) models revealed that phthalate mixtures in urine and FF were positively associated with follicular phase EMT or the risk of thick EMT. Our results indicated that DEHP exposure may increase EMT among women undergoing ART.

Address: Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.; Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: [email protected].; Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.; Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. Electronic address: [email protected].; Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. Electronic address: [email protected].

DOI: 10.1016/j.etap.2025.104781

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MeSH Terms: Female, Humans, Adult, Endometrium, Follicular Fluid, Phthalic Acids, Environmental Pollutants, Cohort Studies, Bayes Theorem, Diethylhexyl Phthalate