J Korean Med Sci.  2021 Jan;36(2):e1. 10.3346/jkms.2021.36.e1.

The Association of Ovarian Reserve with Exposure to Bisphenol A and Phthalate in Reproductive-aged Women

  • 1Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Korea
  • 2Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
  • 3Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
  • 4Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Korea


Exposure to endocrine disrupting chemicals (EDCs) that influence the hormonal and homeostatic systems is known to be associated with gynecologic health risks in many countries. In this study, we evaluated exposure to EDCs associated with diminished ovarian reserve (DOR) and gynecologic health risks.
This cross-sectional study was performed from September 2014 to November 2014 and included 307 Korean reproductive-aged women. Anthropometric measurements, laboratory tests with urine and blood sampling and pelvic ultrasound examinations were performed.
Urinary bisphenol A (BLA) level was significantly higher in the DOR group with antiMüllerian hormone lower than 25 percentile (1.89 ± 2.17 ug/g and 1.58 ± 1.08 ug/g, P < 0.05). Urinary mono-(2-ethyl-5-hydroxyhexyl) phthalate, mono-(2-ethyl-5-oxohexyl) phthalate and mono-N-butyl phthalate, and substrates of phthalate were evaluated and no significant difference was observed between the DOR group and non-DOR group. Logistic regression analysis suggested an increase in infertility in high BPA exposure group and the odds ratio (OR, 4.248) was statistically significant after adjustment for age, birth control pills, and the age of menarche, parity, and waist circumference. High phthalate exposure was associated with endometrial polyp after adjustment (OR, 2.742).
BPA exposure might be associated with DOR and infertility. Meanwhile, endometrial polyp is increased in women with high phthalate exposure. Therefore, the risk of exposures to EDCs for reproduction should be a matter of concern in reproductive-aged women.


Endocrine Disrupting Chemicals; Bisphenol A; Phthalate; Diminished Ovarian Reserve
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