Exposure to non-persistent chemicals in consumer products and fecundability: a systematic review

Abstract

Exposure to non-persistent chemicals in consumer products is ubiquitous and associated with endocrine-disrupting effects. These effects have been linked to infertility and adverse pregnancy outcomes in some studies and could affect couple fecundability, i.e. the capacity to conceive a pregnancy, quantified as time to pregnancy (TTP).OBJECTIVE AND RATIONALE: Few epidemiologic studies have examined the impact of non-persistent chemicals specifically on TTP, and the results of these studies have not been synthesized. We undertook a systematic review to summarize the strength of evidence for associations of common non-persistent chemicals with couple fecundability and to identify gaps and limitations in the literature, with the aim of informing policy decisions and future research. SEARCH METHODS:We performed an electronic search of English language literature published between 1 January 2007 and 25 August 2017 in MEDLINE, EMBASE.com, Global Health, DART/TOXLINE, POPLINE and DESTAF. We included human retrospective and prospective cohort, cross-sectional and case-control studies that examined phthalates, bisphenol A, triclosan, triclocarban, benzophenones, parabens and glycol ethers in consumer products, and considered TTP or fecundability as an outcome among women, men and couples conceiving without medical assistance. We excluded editorials, opinion pieces, introductions to special sections, articles that described only lifestyle (e.g. caffeine, stress) or clinical factors (e.g. semen parameters, IVF success). Standardized forms for screening, data extraction and study quality were developed using DistillerSR software and completed in duplicate. We used the Newcastle-Ottawa Scale to assess risk of bias and devised additional quality metrics based on specific methodological features of fecundability studies. OUTCOMES:The search returned 3456 articles. There were 15 papers from 12 studies which met inclusion criteria, of which eight included biomarkers of chemical exposure. Studies varied widely in terms of exposure characterization, precluding a meta-analytic approach. Among the studies that measured exposure using biospecimens, results were equivocal for associations between either male or female phthalate exposure and TTP. There was preliminary support for associations of female exposure to some parabens and glycol ethers and of male exposure to benzophenone with longer TTP, but further research and replication of these results are needed. The results provided little to no indication that bisphenol A, triclocarban or triclosan exposure was associated with TTP.WIDER IMPLICATIONS: Despite a growing literature on couple exposure to non-persistent endocrine-disrupting chemicals and fecundability, evidence for associations between biologically measured exposures and TTP is limited. Equivocal results with different nonpersistent chemical compounds and metabolites complicate the interpretation of our findings with respect to TTP, but do not preclude action, given the documented endocrine disrupting effects on other reprod...

Safety review of phenoxyethanol when used as a preservative in cosmetics

“…As the study of Garlantézec et al . is the only study that showed such results, Hipwell et al . concluded in their review that it was not possible to draw a final conclusion without additional data.…”

“…However, the June 2015 high‐throughput Endocrine Disruptor Screening Program conducted by the US‐EPA determined that phenoxyethanol has no oestrogenic activity . Moreover, a systematic review has been recently published studying the association between exposure to non‐persistent chemicals in consumer products and fecundability . Amongst the 12 studies included in this review, only one observational study conducted by Garlantézec et al .…”

“…9 Moreover, a systematic review has been recently published studying the association between exposure to nonpersistent chemicals in consumer products and fecundability. 20 Amongst the 12 studies included in this review, only one observational study conducted by Garlant ezec et al 21 in 2013 dealt with glycol ethers, including phenoxyethanol (Table 3). More recently, the same team also recently published two other observational studies on glycol ethers, including phenoxyethanol.…”

“…With the exception of phenoxyacetic acid, no associations between other glycol ether metabolites and a longer time to pregnancy were observed. As the study of Garlant ezec et al 21 is the only study that showed such results, Hipwell et al 20 concluded in their review that it was not possible to draw a final conclusion without additional data. Furthermore, this kind of observational epidemiological study is prone to considerable scientific inconsistencies and weaknesses.…”

Association between peri‐conceptional bisphenol A exposure in women and men and time to pregnancy—The HOPE study

“…Fecundability, as measured by time to pregnancy (TTP), is used as a sensitive reproductive outcome appropriate for studying the impact of environmental exposures. Decreased fecundability has been associated with life style exposures including tobacco, alcohol, and obesity; occupational exposures including pesticides; and environmental chemicals in consumer products . Longer TTP has been associated with adverse pregnancy outcomes including miscarriage, preterm birth, and low birthweight as well as reports of increased adverse outcomes in the neonate and child development .…”