shows the demographic and semen parameter characteristics of the 192 study participants. Overall, participants had a mean (± SD) age of 35.4 ± 5.1 years and a mean (± SD) BMI of 28.1 ± 5.4 kg/m2. Most of the participants were white (85%), with 3% African American, and 4% Hispanic. Most men (75%) had never smoked, 15 (8%) were current smokers, and 33 (17%) were ex-smokers. Of the 192 men in our study, 21 (11%) had sperm concentrations < 20 million/mL, 84 men (44%) had < 50% motile sperm, and 35 men (18%) had < 4% normally shaped sperm. Participants in this study did not differ significantly with respect to their demographic or semen parameter characteristics compared with those in the full parent study cohort (n = 341) (data not shown).
| Table 1Demographic characteristics and semen parameters for a subset of men seeking infertility evaluation, January 2000–May 2003 (n = 192). |
We scored a median of 5,895 sperm nuclei per subject (). The observed median percentages of disomy were as follows: XX18, 0.3%; YY18, 0.3%; XY18, 0.9%; 1818, 0.04%; and total sex-chromosome disomy, 1.6%.
| Table 2Number of sperm nuclei scored and percent disomy for a subset of men seeking infertility evaluation, January 2000–May 2003 (n = 192). |
The distribution of wet-weight concentrations of
p,p´-DDE and PCBs in serum and serum lipids is provided in . The median wet-weight concentrations of Σ
4PCBs and
p,p´-DDE were 0.53 ng/g (range, 0.16– 6.14 ng/g) and 0.97 ng/g (range, 0.23–30.3 ng/g), respectively. The median percent serum lipids was 0.5% (range, 0.13–1.17%). The median lipid-adjusted concentrations for Σ
4PCBs and were 110 ng/g lipids (range, 28.9–ng/g lipids) and 198 ng/g lipids (range, 34.8–7,776 ng/g lipids), respectively (data not shown). Serum levels of individual PCB congeners were lower than serum levels of
p,p´-DDE (data not shown), a finding that is consistent with other U.S.-based studies (
Korrick et al. 2000). PCB and
p,p´-DDE levels in the present study were comparable with the general U.S. population, as reported in the
Fourth National Report on Human Exposure to Environmental Chemicals (
Centers for Disease Control and Prevention 2009). Correlations among PCB measures, including the most prevalent individual congeners and congener groupings, were high (
r = 0.6–0.9) (data not shown). However, correlations between
p,p´-DDE and most PCB measures were more modest (
r = 0.4).
| Table 3Distribution of p,p´-DDE and PCBs (ng/g serum) and serum lipids for a subset of men seeking infertility evaluation, January 2000–May 2003 (n = 192). |
After adjusting for smoking status, abstinence time, sperm concentration and motility, and serum lipids, we observed that a 10-year increase in age was associated with increased rates of XX (IRR, 1.16; 95% CI: 1.07, 1.21) and YY disomy (IRR, 1.18; 95% CI: 1.10, 1.25) but was inversely associated with XY (IRR, 0.83; 95% CI: 0.71, 0.92) and total sex-chromosome disomy (IRR, 0.95; 95% CI: 0.88, 0.98). Compared with men who had never smoked, ever smokers showed an increased rate of XX and XY disomy (IRR range, 1.05–1.07; 95% CI: 1.01–1.15) and a nonsignificant increased rate of YY disomy (IRR range, 1.02–1.05; 95% CI: 0.93, 1.11) in adjusted models. Finally, in adjusted models decreased abstinence time was associated with significantly increased rates of XX (IRR range: 1.07–1.09; 95% CI: 1.01, 1.17) and XY (IRR range: 1.06–1.10; 95% CI: 1.01, 1.21) and a nonsignificant increase in total sex-chromosome disomy (IRR range: 1.01–1.09; 95% CI: 0.93, 1.20). However, there was no overall significant linear trend (data not shown).
After adjustment for age, smoking status, abstinence time, sperm concentration and motility, serum lipids, and Σ4PCBs, serum p,p´-DDE levels above the lowest quartile were associated with increased rates of XX, XY, and total sex-chromosome disomy, but not YY disomy (). For example, the highest quartile of p,p´-DDE (≥ 1.68 ng/g) was associated with a 60% increase in the incidence rate of XX disomy (IRR = 1.6; 95% CI: 1.4, 1.7) compared with the lowest exposure quartile (≤ 0.61 ng/g). However, the dose response appeared nonlinear, with most of the increase in disomy occurring between the first and second quartile of serum p,p´-DDE and without substantial additional increases across subsequent quartiles. We observed no significant relationships between exposure to p,p´-DDE and 1818 disomy.
| Table 4Crude and adjusted IRRs (95% CIs) for 1818, XX, YY, XY, and total sex-chromosome disomy by quartiles of p,p´-DDE for a subset of men seeking infertility evaluation, January 2000–May 2003 (n = 192). |
After adjustment for age, smoking status, abstinence time, sperm concentration and motility, serum lipids, and p,p´-DDE, we observed an overall significant linear increase in the rate of YY, XY, and total sex-chromosome disomy for the second, third, and fourth quartiles of Σ4PCBs compared with the lowest quartile based on a trend test (). However, not all disomy outcomes showed significant individual quartile increases. In contrast, there was a significant decrease in the rate of XX disomy above the first quartile of Σ4PCBs. No significant relationships between exposure to PCBs and 1818 disomy were observed.
| Table 5Crude and adjusted IRRs (95% CIs) for 1818, XX, YY, XY, and total sex-chromosome disomy by quartiles of ∑4PCBs for a subset of men seeking fertility evaluation, January 2000–May 2003 (n = 192). |
In secondary analyses of alternative groupings of PCB congeners, after adjustment for age, smoking status, abstinence time, sperm concentration and motility, serum lipids, and p,p´-DDE, there was a significant increase in the rate of XY and total sex-chromosome disomy for the second, third, and fourth quartiles compared with the lowest quartile for Σestrogenic PCBs and Σdioxin-like PCBs and an increase in YY disomy for Σestrogenic PCBs. However, we observed a significant decrease in XX disomy for higher quartiles of Σestrogenic and Σdioxin-like PCBs (data not shown).
We conducted sensitivity analyses for all disomy outcomes after excluding three men who had total sex-chromosome disomy rates that far exceeded current published ranges (total sex-chromosome disomy > 5%); these men were excluded to prevent undue statistical influence from these extreme values. In the reanalysis, the results remained essentially unchanged (data not shown). We also conducted a sensitivity analysis after excluding eight men with total nuclei scored < 1,000, as disomy estimates can be impacted by too few nuclei scored. Again, in the reanalysis, the results remained essentially unchanged (data not shown).