Urinary triclosan concentrations and diminished ovarian reserve among women undergoing treatment in a fertility clinic

Objective To investigate the association between urinary triclosan concentrations and antral follicle count (AFC), a well-accepted marker of ovarian reserve, among women from a fertility center. Design Prospective cohort study. Setting Hospital fertility center. Patient(s) A total of 109 women. Intervention(s) Urinary triclosan concentrations quantified by online solid phase extraction-high performance liquid chromatography-isotope dilution tandem mass spectrometry. Main Outcome Measure(s) AFC through transvaginal ultrasonography on the third day of an unstimulated menstrual cycle or on the third day of a progesterone withdrawal bleed. Result(s) The geometric mean of the specific gravity–adjusted urinary triclosan concentrations for the 225 samples provided by the 109 women was 13.0 μg/L (95% confidence interval [CI], 8.9, 19.1). Women had median (with interquartile range) AFC of 13 (8, 18). The specific gravity–adjusted urinary triclosan concentrations were inversely associated with AFC (−4%; 95% CI, −7%, −1%). Women with triclosan concentrations above the median had lower AFC compared with those whose triclosan concentrations were equal to or below the median, with an adjusted difference of −3.2 (95% CI, −3.9, −1.6) among those with a body mass index 2 and −1.8 (95% CI, −3.2, −0.3) among those who were Conclusion(s) Specific gravity–adjusted urinary triclosan concentrations were inversely associated with AFC in women seeking care at a fertility center. This association was modified by age and body mass index, with the younger and leaner women showing larger decreases in AFC.