Associations between exposure to single cadmium, lead, mercury and mixtures and women’s infertility and long-term amenorrhea

Abstract PurposeCadmium (Cd), lead (Pb), and mercury (Hg) have been shown to exhibit endocrine disrupting properties. their effects on women’s reproductive health, however, remain elusive. Here, we investigated associations between blood concentrations of single of Pb, Cd, Hg, and their mixture and infertility and long-term amenorrhea in women of reproductive age using the US National Health and Nutrition Examination Survey (NHANES) 2013-2018 cross-sectional survey. MethodsA total of 1,990 women were included for the analysis of infertility and 1,919 women for long-term amenorrhea. The methods of log-transformation and quarterization were used to analyze blood heavy metal concentrations. Statistical differences in the covariates between the outcome groups were evaluated using a chi-squared test for categorical variables and a t-test for continuous variables. Multiple logistic regression models were used to examine the associations. ResultsThe blood concentrations of Pb and heavy metal mixtures were significantly higher in ever-infertile women than pregnant women, but the concentrations of Cd and Hg were comparable. Multiple logistic regression analysis revealed that after the full adjustment, there was a significant and dose-dependent positive association between blood Pb concentrations and women’s historical infertility, a negative association between Cd and women’s long-term amenorrhea, and no associations between Hg and heavy metal mixture and women’s infertility or long-term amenorrhea. ConclusionsOur study demonstrates that exposure to heavy metals exhibit differential associations with women’s infertility and long-term amenorrhea. Disclosure summaryThe authors declare no conflict of interest.