Objectives To explore whether work schedules and physically demanding work were associated with markers of ovarian reserve and response.
Methods This analysis included women (n=473 and n=313 for ovarian reserve and ovarian response analysis, respectively) enrolled in a prospective cohort study of couples presenting to an academic fertility centre (2004–2015). Information on occupational factors was collected on a take-home questionnaire, and reproductive outcomes were abstracted from electronic medical records. Generalised linear models and generalised linear mixed models were used to evaluate the associations.
Results Women who reported lifting or moving heavy objects at work had 1.0 fewer total oocytes (p=0.08), 1.4 fewer mature oocytes (p=0.007) and 0.7 fewer antral follicles (p=0.06) compared with women who reported never lifting or moving heavy objects at work. The inverse association between heavy lifting and oocyte yield was stronger in women >37 years and with a Body Mass Index ≥25 kg/m2. Women who worked evening/night/rotating shifts had 2.3 (p<0.001) fewer mature oocytes, on average, compared with women who worked day-only shifts. None of the occupational exposures were associated with day 3 follicle-stimulating hormone or peak oestradiol levels.
Conclusions Women working non-daytime shifts and those with physically demanding jobs had fewer mature oocytes retrieved after controlled ovarian hyperstimulation. Our results provide insight into possible mechanisms linking these occupational exposures with decreased fecundity.
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Contributors RH, JEC and AJG were involved in study concept and design, and critical revision for important intellectual content of the manuscript; PLW contributed to method modification and provided statistical expertise; LMA analysed data, drafted the manuscript and had a primary responsibility for final content; LMA, PLW, JEC, RH and AJG interpreted the data; AJG reviewed the statistical analysis; IS and JBF were involved in acquisition of the data. All authors were involved in the critical revision of the manuscript and approved the final manuscript.
Funding This work was supported by NIH grants R01ES022955, R01ES009718 and R01ES000002 from the National Institute of Environmental Health Sciences (NIEHS) and L50-HD085359 from the National Institute of Child Health and Human Development (NICHD).
Competing interests None declared.
Patient consent Obtained.
Ethics approval The study was approved by the Human Studies Institutional Review Boards of the MGH, and the Harvard T.H. Chan School of Public Health.
Provenance and peer review Not commissioned; externally peer reviewed.
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