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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Relationship between risk factors for infertility in women and lead, cadmium, and arsenic blood levels: a cross-sectional study from Taiwan

BMC Public Health > Ausgabe 1/2015
Hsiao-Ling Lei, Hsiao-Jui Wei, Hsin-Yi Ho, Kai-Wei Liao, Ling-Chu Chien
Wichtige Hinweise

Competing interests

The authors have no competing interests to declare.

Authors’ contributions

HLL was involved in preparing the data, interpreting the results, and writing and critically reviewing the manuscript. HJW was involved in providing clinical expertise, transferring eligible women of childbearing age to our study, and interpreting the results. HYH was involved in providing clinical expertise, interpreting the results, and revising the manuscript. KWL was involved in coordinating the study, analyzing the metals, and preparing the data. LCC was involved in conceiving the study topic, designing the study, providing statistical advice, interpreting the results, and providing critical comments. All authors have read and approved the final article.



The World Health Organization reported that more than 10 % of women are severely affected by infertility, making the condition a major worldwide public health problem. Lead (Pb), cadmium (Cd), and arsenic (As) are environmental pollutants that may contribute to reproductive disorders. This cross-sectional study investigated the association between blood concentrations of Pb, Cd, and As and risk factors for infertility in women.


Women who were infertile (N = 310) or pregnant (N = 57) were recruited from the gynecology and obstetrics department of a hospital. The participants were interviewed to obtain their sociodemographic, reproductive, and lifestyle information. The concentrations of Pb, Cd, and As in their blood samples were measured using inductively coupled plasma mass spectrometry.


Our findings suggested that the concentrations of Pb and As, but not Cd, were significantly higher in the blood of infertile women than in that of pregnant women. A higher percentage of the infertile women consumed more alcohol, used Chinese herbal medicine more frequently, and lacked physical activity compared with the pregnant women. After accounting for potentially relevant predictors, we observed that blood Pb levels might be elevated by using Chinese herbal medicine 1–6 times per week (aOR = 2.82, p = 0.05). In addition, engaging in physical activity 1–2 times per week (aOR = 0.37, p = 0.05) might assist in reducing Pb accumulation in infertile women, though the p value was borderline.


Lack of physical activity and frequent use of Chinese herbal medicine may be associated with elevated blood Pb levels in infertile women. Chinese herbal medicine use was observed to increase the Pb body burden of both infertile and pregnant women in this study. The risk–benefit for Chinese herbal medicine intake should be evaluated by women of childbearing age.
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