Associations of Pesticide Residue Exposure from Fruit and Vegetable Intake with Ovarian Reserve

Background: We previously reported that the intake of fruits and vegetables (FV) known to have high-pesticide contamination in the United States food supply is related to lower sperm counts. Whether the same is true for ovarian reserve is unknown. Objective: We evaluated the relation between FV intake, overall and when taking into consideration pesticide residue status, with the markers of ovarian reserve among reproductive-aged females. Methods: Participants were 633 females, 21–45 y, presenting to an academic fertility center. We combined surveillance data from the United States Department of Agriculture and self-reported food intake data to characterize exposure to pesticide residues through FV intake. Poisson and linear regression were used to evaluate associations of high-pesticide residue, low-pesticide residue, and total FV intake with markers of ovarian reserve (antral follicle count [AFC], follicle-stimulating hormone [FSH], anti-Müllerian hormone [AMH]) adjusting for potential confounders. Results: There was no association of FV intake, overall or according to pesticide residue status, with day 3 FSH or AMH concentrations in multivariable-adjusted models. Regardless of pesticide residue status, FV intake was inversely related to AFC in these models. This pattern was magnified among females who had had a fertility evaluation before joining the study (n = 508). Among females who had not had a fertility evaluation before joining the study (n = 103), however, there were diverging patterns of association for high- and low-pesticide residue FV intake and markers of ovarian reserve. In this group, day 3 FSH was 71.6% (95% confidence interval: 39.5%, 111.2%) higher among females in the highest quintile of high-pesticide residue FV intake than among females in the lowest quintile (P-trend <0.001). Low-pesticide residue and total FV intake were unrelated to day 3 FSH in this group, with differences between top and bottom quintile of intake of –8.3% (–25.8%, 13.3%) and 7.5% (–13.8%, 34.0%), respectively. Conclusions: High-pesticide residue FV intake may be related to lower ovarian reserve among females without a history of infertility treatment. Replication in populations with larger sample sizes and less susceptible to reverse causation is important.