近年來,不孕症成為全球關注的公共衛生重要議題之一,研究指出,婦女暴露於汞環境中會干擾內分泌系統,導致自然流產、不孕等生殖危害。其中汞型態以甲基汞毒性最高、半衰期較長,一旦進入人體中將經由血液迅速分布至各器官及組織,造成人體上的危害。而目前對於甲基汞影響懷孕情形之相關研究十分有限,因此本研究以不孕和懷孕婦女血中甲基汞濃度作為婦女甲基汞暴露之指標,分析不孕症與正常懷孕婦女血中甲基汞濃度,探討甲基汞濃度分布情形與不孕之相關性。 本研究以2008年8月至2010年3月於台北某生殖醫學中心求診之婦女進行基本資料收集、問卷訪視及採集血液後,由氣相色層分析配合冷蒸氣原子螢光光譜儀進行血液甲基汞濃度分析。 本研究收樣個案為不孕婦女組288位,懷孕婦女組55位。結果顯示不孕組血中甲基汞幾何平均濃度為6.27 ± 0.31 μg L-1,懷孕組為4.41 ± 0.37 μg L-1。在多邏輯斯迴歸分析模式中顯示飲酒習慣及甲基汞濃度與婦女發生不孕風險達到統計上顯著相關。有飲酒習慣的婦女相較於沒有者發生不孕的風險為3.298倍(OR = 3.298, C.I = 0.15-1.20);當婦女血中甲基汞濃度≥ 5.8 μg L-1時,發生不孕的風險相較於血中甲基汞濃度< 5.8 μg L-1之婦女為4.616倍(OR = 4.616, C.I = 2.08-10.23)。本研究發現有飲酒習慣及高甲基汞濃度,皆可能為造成女性不孕的因子。
In recent years, infertility has become one of the global issues in public health. Research indicates that mercury in the environment can interfere with female endocrine system and cause reproductive harms such as spontaneous abortions and infertility. Methylmercury with a longer half-life is most poisonous compared to other forms of mercury. Once methylmercury enters the human body, blood circulation will quickly bring it to all organs and tissues and cause harm to the human body. Currently, there is only limited research on methylmercury influencing women’s pregnancy. Therefore, this study analyzes methylmercury concentrations in the blood of infertile and pregnant and uses those data as indicators of women's exposures to methylmercury to investigate the correlation between methylmercury concentrations and infertility. This study conducted data collection, questionnaire surveys, interviews, and blood sampling on women attending one center for reproductive medicine in Taipei from August, 2008 to March, 2010 and used gas chromatography coupling with cold vapor atomic fluorescence spectroscopy for analysis of methylmercury concentrations in their blood samples. This study receives 288 cases from infertile women and 55 cases from pregnant women. The results showed that geometric mean concentrations of methylmercury in the infertile group and the pregnant group ranged between 6.27 ± 0.31 μg L-1 and 4.41 ± 0.37 μg L-1 respectively. In the multi-logistic regression model, it is revealed that drinking habits and methylmercury concentrations were significantly correlated to the risk of women’s infertility by reaching statistical significance. The risk of infertility among women with drinking habits was 3.298 times higher than that among women without drinking habits (OR = 3.298, C.I = 0.15-1.20). The risk of infertility among women with methylmercury concentrations equal to or higher than 5.8 μg L-1 was 4.616 times higher than that among women with methylmercury concentrations lower than 5.8 μg L-1 (OR = 4.616, C.I = 2.08-10.23). This study finds that drinking habits and high methylmercury concentrations are both factors likely to cause female infertility.