Background
Although p,p'-dichlorodiphenyltrichloroethane (DDT) is banned for agricultural purpose in Saudi Arabia, it is occasionally used to control vector-borne diseases in certain regions of the country.
Material and Method
A case-control study was designed to investigate the possible effects of DDT and its metabolites on pregnancy and fertilization rate outcome. The study population was composed of 619 Saudi women (age 19-50 years) who sought in-vitro fertilization (IVF) treatment between 2002 and 2003.
Results
p,p'-DDE, the main metabolite of DDT, was the most frequently detected residue in serum or follicular fluid, with mean values of 1.646 microg/L and 0.407 microg/L, respectively. After controlling for many potential confounding variables, multiple logistic regression analysis revealed no association between pregnancy outcome or fertilization rate and p,p'-DDE levels in serum or follicular fluid.
Conclusions
The inability to identify an effect may be related to the comparatively low concentrations of DDE in our population. But because p,p'-DDE was detected in the serum of 77.7% our participants, it should be considered as a matter of public heath concern. Currently there is no active source of DDT in our region; therefore, further studies are needed to identify sources in order to develop preventive measures because we can not exclude its potential reproductive toxicity.

Keywords: Reproduction, Regression Analysis, Pregnancy Outcome, Pregnancy, Follicular Fluid - chemistry, Fertilization in Vitro, Dichlorodiphenyldichloroethane - blood, Risk Factors, Dichlorodiphenyl Dichloroethylene - blood, Demography, DDT - blood, Analysis of Variance, Saudi Arabia, young adult