Abstract
BACKGROUND: Consuming fruits and vegetables (FVs) with high pesticide residues has been related to lower sperm counts. Whether this translates into lower fertility is unclear. OBJECTIVES: To test the hypothesis that male preconception intake of FV with high pesticide residue levels is associated with lower success rates in infertility treatment outcomes. METHODS: In a prospective cohort, 244 males (median age: 36.6 y) and their female partners (median age: 35 y) underwent 437 assisted reproductive technology (ART) cycles for infertility treatment in 2007-2021 (Massachusetts General Hospital). The United States Department of Agriculture food pesticide residue surveillance data were used to assess pesticide residue exposure from FV intake. Associations of FVs with high and low pesticide residue with ART outcomes [fertilization rate, low fertilization (<50%), implantation, clinical pregnancy, pregnancy loss, and live birth] were evaluated using generalized linear mixed models. RESULTS: Intake of FVs with high pesticide residue was inversely associated with fertilization rate, whereas intake of FVs with low pesticide residue was positively associated with fertilization rate. The adjusted fertilization rates for couples with a male partner in the lowest and highest quartiles of intake were 0.78 [95% confidence interval (CI): 0.73, 0.83] and 0.69 (95% CI: 0.62, 0.75) for FVs with high pesticide residue (P(trend) = 0.04) and 0.71 (95% CI: 0.65, 0.77) and 0.81 (95% CI: 0.75, 0.85) for FVs with low pesticide residue, respectively (P(trend) = 0.02). These relations were restricted to conventional insemination cycles. Similarly, intake of FVs with high pesticide residue was inversely associated with the probability of live birth [0.58 (95% CI: 0.32, 0.80) compared with 0.14 (95% CI: 0.04, 0.38)] and positively related to the probability of pregnancy loss [0.09 (95% CI: 0.01, 0.43) compared with 0.77 (95% CI: 0.27, 0.97)] in conventional insemination cycles. CONCLUSIONS: Intake of FVs with high pesticide residue in males is associated with adverse infertility treatment outcomes with ART, particularly in conventional insemination cycles. Implications for natural fertility are unclear.