Abstract
Lead and cadmium are known to be potential female reproductive toxins. However, studies on the relationship between these metals and infertility are limited. This study examines the association between self-reported infertility and blood lead and cadmium levels in US women by comparing metal levels in infertile and pregnant women. Data on blood lead, blood cadmium, and infertility from women aged 20-39 years who participated in the 2013-2014 and 2015-2016 National Health and Nutrition Examination Surveys were analyzed (n = 124, 'pregnant' n = 42, 'infertile' n = 82). Blood lead and cadmium levels were measured using inductively coupled plasma mass spectrometry, and infertility and pregnancy status were assessed using a self-reported questionnaire. Low blood lead and cadmium levels (geometric mean of blood lead = 0.50 µg/dL and blood cadmium = 0.26 µg/L) were positively associated with self-reported infertility after adjusting for confounding effects (odds ratio (OR) for lead per two-fold increase in blood metal levels = 2.60; 95% confidence interval (95% CI), 1.05-6.41 and OR for cadmium per two-fold increase = 1.84; 95% CI, 1.07-3.15). Although our findings require confirmation, they suggest that even low blood cadmium and lead levels may be deleterious to female fecundity.