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5080500 
Journal Article 
Perfluoroalkyl substances exposure and risk of polycystic ovarian syndrome related infertility in Chinese women 
Wang, W; Zhou, W; Wu, S; Liang, F; Li, Y; Zhang, J; Cui, L; Feng, Y; Wang, Y 
2019 
Yes 
Environmental Pollution
ISSN: 0269-7491
EISSN: 1873-6424 
247 
824-831 
English 
Perfluoroalkyl substances (PFASs) are a family of synthetic, fluorinated organic compounds. They have been widely used in industrial applications and consumer products and widespread in the environment, wildlife and human. Experimental and epidemiologic evidence suggested that PFASs are capable of interfering with endocrine processes and have potential reproductive and developmental toxicities. Polycystic ovarian syndrome (PCOS), one of the main reasons of female infertility, is a common endocrine disorder in reproductive age women. We performed a case-control study to evaluate associations between PCOS-related infertility and PFASs concentrations in plasma. A total of 180 infertile PCOS-cases and 187 healthy controls were recruited from the Center for Reproductive Medicine of Shandong University. Blood specimens were collected at enrollment and analyzed for ten PFASs using liquid chromatography-tandem mass spectrometry. Multivariable logistic regression procedure was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for each PFAS. Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) were the dominant PFASs in the plasma of participants, with the median concentration of 5.07 ng/mL and 4.05 ng/mL, respectively. The median levels of individual PFAS were not significantly different between PCOS-cases and controls. While adjusted for the potential confounders (age, BMI, household income, education level, employment status, age at menarche, menstrual volume), the plasma concentration of perfluorododecanoic acid (PFDoA), a 12 carbons lengths of perfluorocarboxylic acids, was associated with a significantly increased risk of PCOS-related infertility (medium vs low tertile: OR = 2.36, 95% CI: 1.12, 4.99, P = 0.02; high vs low tertile: OR = 3.04, 95% CI: 1.19, 7.67, P = 0.02), with the P trend 0.01. No significant relationship was observed between PCOS-related infertility and other PFAS analytes in the adjusted model, despite perfluoroundecanoic acid showed a negative association (P trend 0.03). The potential reproductive health effects of PFASs and the underlying mechanisms merit further investigation in the future. 
Perfluoroalkyl substances; Polycystic ovarian syndrome; Infertility; Perfluorododecanoic acid; Case-control study 
PFAS
• Additional PFAS (formerly XAgency)
     Literature Search November 2019
          PubMed
          Web of Science
          Other Sources
               TEDX
     Screened Studies
          Included
               Include (TIAB)
               Include (Full Text)
     Perfluorododecanoic acid
• Expanded PFAS SEM (formerly PFAS 430)
     Litsearch: September 2019
          PubMed
          Web of Science
          Other Sources
               PFAS TOX Database
     Screened Studies
          Included
               Include (TIAB)
          Excluded
               Exclude (Full Text)
     Perfluorooctane
     Potassium perfluorooctanoate
     Sodium perfluorooctanoate
     Perfluorododecanoic acid
• PFAS 150
     Literature Search Update December 2020
          PubMed
          WOS
     Literature Search August 2019
          PubMed
          Web of Science
          Other sources
               PFAS TOX Database
     Screened Studies
          Included
               Include (TIAB)
               Include (Full Text)
     Ammonium perfluorooctanoate
     Perfluorinated compounds
     Perfluorooctane
     Perfluorooctanesulfonic acid
     Perfluorooctanoic acid
     Perfluoroundecanoic acid
• PFBS
     Scopus: April 2021
• PFDA
     Scopus: April 2021
     June 2022 Pelch Database
     Submitted to EPA
     Literature Searches (through April 2023 update and post-public comment/peer review)a    
          Other
               Published PFAS SEMs
          Title & Abstract Screening
               Tagged as Supplemental
                    Full Text Screening
                         Studies Meeting PECO
                              Human health effects studies
• PFHxS
     Database searches
          Scopus
          Pelch PFAS SEM
     Excluded
          TiAb
     Literature Search Update April 2023
          Included Met PECO
• PFNA
     June 2022 Pelch Database
• PFOA (335-67-1) and PFOS (1763-23-1)
     Literature Search Update (2013-2019)
          PubMed
          WOS
• PFOA and PFOS OW MCLG Approaches
     Cited in White Papers