Infertility and the Environment: The Medical Context

ABSTRACT

Approximately 10 to 15% of the population experiences infertility. Although 85 to 90% of couples or individuals who experience infertility have a diagnosis for their infertility, underlying causes of infertility rarely are found. Extensive literature reporting adverse effects of environmental contaminants on wildlife and laboratory animal reproductive tract development, and reproductive function and epidemiologic studies with humans, suggests that many environmental chemicals and heavy metals may contribute to infertility. This article introduces the medical context in which infertility patients are evaluated and lays the foundation for health care professional and patient conversations, and medical education regarding environmental contaminants and human reproductive health for the future.

Environment - infertility - endocrine disrupters - fecundity - chemicals

REFERENCES

• 1 Colburn T, Dumanoski D, Myers J P. Our Stolen Future: Are We Threatening Our Fertility, Intelligence, and Survival?. Dutton, NY; Plume Publishing 1996
• 2 Sharpe R, Franks S. Environment, lifestyle and infertility: an intergenerational issue.  Nat Cell Biol. 2002;  4(suppl 1) S33-S40
• 3 Schettler T. 2003 Infertility and related reproductive disorders. http://Available at: http:www.healthandenvironment.org/infertility/peerreviewed Accessed December 15, 2005
• 4 Younglai E V, Holloway A C, Foster W G. Environmental and occupational factors affecting fertility and IVF success.  Hum Reprod Update. 2005;  11 43-57
• 5 Giudice L C, Swan S, Myers P, Carlson A. Vallombrosa Consensus Statement on Environmental Contaminants and Human Fertility Compromise. October 2005 http://Available at: www.healthandenvironment.org/working_groups/fertility Accessed December 15, 2005
• 6 Cramer D W, Walker A M, Schiff I. Statistical methods in evaluating the outcome of infertility therpay.  Fertil Steril. 1979;  32 80-86
• 7 Fertility . Family planning, and reproductive health of US women: Data from the 2002 National Survey of Family Growth.  Available at: http://www/cdc/gov/nchs/products/pubd/series/sr23/pre-1/sr23_25 Accessed December 15, 2005; 
• 8 Wilcox L S, Mosher W D. Use of infertility services in the U.S  Obstet Gynecol. 1993;  82 122-127
• 9 Heindel J J. Role of exposure to environmental chemicals in the developmental basis of reproductive disease and dysfunction.  Semin Reprod Med. 2006;  24 168-177
• 10 Data C DC. 2002 Assisted reproductive technology success rates. December 2004 Available at: http://www.cdc.gov Accessed December 15, 2005
• 11 Goswami D, Conway G S. Premature ovarian failure.  Hum Reprod Update. 2005;  11 391-410
• 12 The International HapMap Consortium . The international HapMap project.  Nature. 2003;  426 789-796
• 13 Birnbaum L S, Fenton S E. Cancer and developmental exposure to endocrine disruptors.  Environ Health Perspect. 2003;  111 389-394
• 14 Trubo R. Endocrine-disrupting chemicals probed as potential pathways to illness.  JAMA. 2005;  294 291-293
• 15 DeRosa C, Richter P, Pohl H, Jones D E. Environmental exposures that affect the endocrine system: public health implications.  J Toxicol Environ Health B Crit Rev. 1998;  1 3-26
• 16 Sonnenschein C, Soto A M. An updated review of environmental estrogen and androgen mimics and antagonists.  J Steroid Biochem Mol Biol. 1998;  65 143-150
• 17 National Research Council .Hormonally Active Agents in the Environment. Washington, DC; National Academy Press 2000
• 18 Louis G MB, Lynch C B, Cooney M A. Environmental influences on female fecundity and fertility.  Semin Reprod Med. 2006;  24 147-155
• 19 Swan S H. Does our environment affect our fertility? Some examples to help reframe the question.  Semin Reprod Med. 2006;  24 142-146
• 20 Hauser R. The environment and male fertility: recent research on emerging chemicals and semen quality.  Semin Reprod Med. 2006;  24 156-167
• 21 Centers for Disease Control and Third National Report on Human Exposure to Environmental Chemicals, 2005.  Available at: http://www.cdc.gov/exposurereport/3rd/default.htm Accessed December 15, 2005; 
• 22 Available at: http://nationalchildrensstudy.gov/ Accessed December 15, 2005
• 23 Luoma J. Challenged conceptions: environmental chemicals and fertility. October 2005 http://www.healthandenvironment.org/working_groups/fertility Accessed December 15, 2005