Abstract

Background: Beedi-rolling is a traditional occupation in India that predominantly involves women and exposes them to tobacco dust. Tobacco exposure is associated with various health risks, including disruptions in hormonal pathways critical for female fertility. Aims: This case-control study aimed to investigate the association between polymorphisms in estrogen receptor genes (ESR1 and ESR2) and the follicle-stimulating hormone receptor gene (FSHR) with female infertility in beedi-rollers. Methods: A total of 500 beedi-rollers (BR) and 500 non-beedi-rollers (NBR) of reproductive age were recruited. DNA was extracted from blood samples and genotyped for ESR1, ESR2, and FSHR polymorphisms using PCR and Sanger sequencing. Statistical Analysis: Statistical analysis was conducted using SPSS version 30, including chi-square tests for genotype distribution, odds ratios for assessing the risk of infertility, and logistic regression models to adjust for potential confounders. Results: Reproductive health problems were more prevalent among BR compared to NBR, with significantly higher incidences of infertility (p = 0.02), premature ovarian insufficiency (p < 0.001), and miscarriage (p < 0.001). Genotypic analysis revealed a significant association between ESR2 (CG/GG) and FSHR (CT/TT) polymorphisms and infertility risk among BR. Combined genotype analysis demonstrated that carriers of ESR2 (CG/GG) and FSHR (CT/TT) exhibited the highest susceptibility (p = 0.02). Conclusions: The findings highlight that prolonged exposure to tobacco dust and specific genetic predispositions contribute to infertility in beedi-rollers. This study underscores the importance of genetic screening to mitigate infertility risks in vulnerable occupational groups.

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