Fertil Steril
August 15, 2005

First Study Links Dioxin Exposure to Endometriosis in Humans

Increased dioxin-like compounds in the serum of women with peritoneal
endometriosis and deep endometriotic (adenomyotic) nodules.

Heilier JF, Nackers F, Verougstraete V, Tonglet R, Lison D, Donnez

Industrial Toxicology and Occupational Medicine Unit, Universite
Catholique de Louvain, Brussels, Belgium.

OBJECTIVE: To investigate the possible association between the body
burden of dioxin-like compounds and endometriotic disease.

DESIGN: Case-control study. SETTING: Gynecology ward in a university

PATIENT(S): Seventy-one women with peritoneal endometriosis (n = 25)
or deep endometriotic (adenomyotic) nodules (n = 25) and controls (n =
21). INTERVENTION(S): Collection of 200 mL of blood (fasted) and face-
to-face interview.

MAIN OUTCOME MEASURE(S): Assessment of dioxin (PCDD), furan (PCDF),
and dioxin-like PCB serum concentrations (picograms toxic equivalent
[TEQ]/g lipids).

RESULT(S): Age and body mass index were traced by linear multiple
regression as determinants of total TEQ levels. After standardization
for these variables (30 years and 22.5 kg/m2), the mean TEQ levels
were 24.21 (controls), 30.62 (peritoneal endometriosis), and 37.60
(deep endometriotic [adenomyotic] nodules) pg TEQ/g lipids. Logistic
regressionanalysis indicated a significantly increased risk of deep
endometriotic (adenomyotic) nodules (odds ratio [OR], 3.3; 95%
confidence interval [CI], 1.4-7.6) for an increment of 10 pg in total
TEQ levels/g lipids. An increased risk was also found for peritoneal
endometriosis (OR, 1.9; 95% CI, 0.9-3.8) for total TEQ levels and for
dioxins alone (OR, 3.2; 95% CI, 1.0-9.9). CONCLUSION(S): The results
provide the first epidemiological evidence of an association between
increased PCDD/PCDF and PCB body burden and endometriosis.