Urinary triclosan concentrations and diminished ovarian reserve among women undergoing treatment in a fertility clinic

Urinary triclosan concentrations were inversely associated with antral follicle count among a prospective cohort at an academic fertility center, an association stronger among younger and leaner women.

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Volume 108, Issue 2, Pages 312–319


Lidia Mínguez-Alarcón, Ph.D., M.P.H., Georgios Christou, M.D., Carmen Messerlian, Ph.D., Paige L. Williams, Ph.D., Courtney C. Carignan, Ph.D., Irene Souter, M.D., Jennifer B. Ford, R.N., Antonia M. Calafat, Ph.D., Russ Hauser, M.D. for the show EARTH Study Team 



To investigate the association between urinary triclosan concentrations and antral follicle count (AFC), a well-accepted marker of ovarian reserve, among women from a fertility center.


Prospective cohort study.


Hospital fertility center.


A total of 109 women.


Urinary triclosan concentrations quantified by online solid phase extraction-high performance liquid chromatography-isotope dilution tandem mass spectrometry.

Main Outcome Measure(s)

AFC through transvaginal ultrasonography on the third day of an unstimulated menstrual cycle or on the third day of a progesterone withdrawal bleed.


The geometric mean of the specific gravity–adjusted urinary triclosan concentrations for the 225 samples provided by the 109 women was 13.0 μg/L (95% confidence interval [CI], 8.9, 19.1). Women had median (with interquartile range) AFC of 13 (8, 18). The specific gravity–adjusted urinary triclosan concentrations were inversely associated with AFC (−4%; 95% CI, −7%, −1%). Women with triclosan concentrations above the median had lower AFC compared with those whose triclosan concentrations were equal to or below the median, with an adjusted difference of −3.2 (95% CI, −3.9, −1.6) among those with a body mass index <25 kg/m2 and −1.8 (95% CI, −3.2, −0.3) among those who were <35 years old.


Specific gravity–adjusted urinary triclosan concentrations were inversely associated with AFC in women seeking care at a fertility center. This association was modified by age and body mass index, with the younger and leaner women showing larger decreases in AFC.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. 


Go to the profile of Ron Strine
over 4 years ago

September 6, 2017
Dear Author,

This request is in response to your publication, titled “Urinary triclosan concentrations and diminished ovarian reserve among women undergoing treatment in a fertility clinic. Fertility and Sterility, 2017, 108 (2), 312-319.        
Upon review of this publication, it was noted that “the results of this study were suggestive of a cumulative effect of chronic triclosan exposure that is potentially contributing to reduced fecundability and a need to seek treatment for infertility at a younger age.”
On behalf of manufacturer of a product with triclosan as an ingredient, as per the Pharmacovigilance regulations, we are required to investigate, collect, and submit adverse event reports.
Please note that patient confidentiality will be maintained at all times. Please take a few moments to review the requested information below:

Individual patient identifiers including demographics

Date of birth (as mentioned in the article)

Patients current conditions/concomitant medications

Any additional information you could provide would be greatly appreciated.

Ron Strine
QA Specialist/DCO
Dentsply Sirona Preventive
cc:  PR 1620327