Eskenazi, B, Ames, J, Rauch, S, Signorini, S, Brambilla, P, Mocarelli, P, Siracusa, C, Holland, N, Warner, M, Eskenazi, Brenda, Ames, Jennifer, Rauch, Stephen, Signorini, Stefano, Brambilla, Paolo, Mocarelli, Paolo, Siracusa, Claudia, Holland, Nina, Warner, Marcella, Eskenazi, B, Ames, J, Rauch, S, Signorini, S, Brambilla, P, Mocarelli, P, Siracusa, C, Holland, N, Warner, M, Eskenazi, Brenda, Ames, Jennifer, Rauch, Stephen, Signorini, Stefano, Brambilla, Paolo, Mocarelli, Paolo, Siracusa, Claudia, Holland, Nina, and Warner, Marcella
STUDY QUESTION: Is there an association between 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) exposure and fecundability and infertility among Seveso women and their daughters? SUMMARY ANSWER: TCDD exposure is associated with a decrease in fecundability and increased risk of infertility in women, as well as their daughters. WHAT IS KNOWN ALREADY: In animal studies, maternal exposure to TCDD is associated with decreased fertility in offspring. Effects of TCDD are mediated by activation of the aryl hydrocarbon receptor (AHR) pathway. STUDY DESIGN, SIZE, DURATION: The Seveso Women's Health Study (SWHS) has followed 981 women exposed to TCDD in a 1976 accident since 1996. In 2014, we initiated the Seveso Second Generation Study to follow-up their children. PARTICIPANTS/MATERIALS, SETTING, METHODS: We obtained information on pregnancy history including time of trying to conceive from SWHS women and their daughters who were 18 years or older. We considered TCDD exposure as initial 1976 serum TCDD concentration and estimated TCDD at pregnancy. We examined relationships of TCDD exposure with time to pregnancy (TTP, the monthly probability of conception within the first 12 months of trying) and infertility (≥12 months of trying to conceive). We also assessed contributions of polymorphisms in the AHR pathway via genetic risk score. MAIN RESULTS AND THE ROLE OF CHANCE: Among SWHS women (n = 446), median TTP was 3 months and 18% reported taking ≥12 months to conceive. Initial 1976 TCDD (log10) was associated with longer TTP (adjusted fecundability odds ratio = 0.82; 95% CI 0.68-0.98) and increased risk of infertility (adjusted relative risk = 1.35; 95% CI 1.01-1.79). TCDD at pregnancy yielded similar associations. Among SWHS daughters (n = 66), median TTP was 2 months and 11% reported taking ≥12 months to conceive. Daughters showed similar, but non-significant, associations with maternal TCDD exposure. LIMITATIONS, REASONS FOR CAUTION: A limitation of this study is time to pregnan