Seafood consumption and use of Asian herbal preparation as a source of exposure to multiple trace elements in the Study of Metals and Assisted Reproductive Technologies (SMART)

As, Cd, Cs, Hg, Pb, and Zn may be associated with in vitro fertilization (IVF) outcomes. Seafood and Asian herbal preparations are identified as sources of exposure to these essential and non-essential trace elements in humans. The goal of the study is to assess associations between seafood consumption and the use of Asian herbal preparations and levels of essential and non-essential trace elements in biologic specimens collected from couples undergoing IVF. Fifty-nine couples completing a first IVF cycle at the University of California, San Francisco (UCSF) Center for Reproductive Health were recruited to participate in the Study of Metals and Assisted Reproductive Technologies (SMART). Of these, 25 women and 15 men who completed a dietary questionnaire and provided blood and/or urine specimens were included to the analyses. Urine specimens were analyzed for As, Cd, Cs, and Zn and blood specimens were analyzed for Cd, Hg, and Pb using inductively coupled plasma-mass spectrometry (ICP-MS). Bivariate analyses and multiple linear regression analyses were used to assess associations between the levels of trace elements and various dietary exposures, considering potential confounders. Blood Hg and urine As levels are higher than reported for the U.S. population. Women have higher blood and urine Cd level than men. Final multivariable linear regression models are constructed for each element, adjusting for potential confounders. Several seafood groups are associated with increase in the study elements, including 'any fish', 'shellfish' and 'mollusks' for blood Hg, 'steak fish' for blood Pb, 'farmed fish' and 'shrimp' for blood Cd, 'canned fish' for urine As, 'any fish', 'steak fish' and 'canned fish' for urine Cs, and 'canned fish' for urine Zn. Some seafood groups are associated with decrease in the trace elements, including 'farmed fish' for blood Pb, 'eel' for blood Cd, 'sashimi' and 'tuna' for urine Cd, and 'raw fish' for urine As. Asian herbal preparations are not significant sources of exposure to any element. Information from this study can be used to advise IVF couples or infertile couples on dietary and behavioral choices to maximize the probability for a successful reproductive outcome.