Female Infertility and “Emerging” Organic Pollutants of Concern

Abstract

Modern chemical instrumentation has fostered a revolution of sorts, in which epidemiologic studies of female infertility can now devote attention to very low level, Bbackground^exposures to Bemerging^non-persistent organic pollutants, rather than on Blegacy^persistent organic pollutants. Predicated on widespread and frequent contact, and substantial experimental evidence of estrogen-disruptive effects, concern for phthalate diesters, environmental phenols (bisphenol A and triclosan), and ultraviolet filters (benzophenones) as risk factors for female infertility has grown. We reviewed the contemporary epidemiologic evidence for these emerging environmental pollutants as risk factors for female infertility. We conclude that the epidemiologic evidence is insufficient to date, to substantiate background exposures as risk factors for female infertility. However, very few epidemiologic investigations have been published. To more definitively address concerns, additional epidemiologic investigations are needed, including longitudinal collection of multiple biospecimens, simultaneous consideration of couplelevel exposures, and incorporating mixtures of these and additional emerging organic pollutants.

The Impact of Endocrine-Disrupting Chemicals on Female Fertility

“…Urine phthalates also associate with the occurrence of endometriosis [3,27]. Taking into account that the endometriosis-associated inflammatory response includes peritoneal oxidative stress as a major constituent, it is relevant to the positive association between phthalates exposure and inflammation markers, along with negative association with endogenous antioxidants, such as bilirubin [5,28].…”

“…Studies proved that high levels of phthalates around the time of conception lead to pregnancy loss [3,32].…”

“…Bisphenol A is widely used in the fabrication of epoxy resin can liners, polycarbonate plastics, medical equipment, dental sealants, and heat transfer papers [3,5,22,[33][34][35]. It has a dual mechanism of action, exerting both pro-and anti-estrogenic effects depending on tissue [35].…”

“…The failure to obtain a clinical pregnancy after one year of regular and unprotected heterosexual intercourse defines infertility [1][2][3]. It is estimated to affect almost 8 to 12% of young couples worldwide [1].…”

“…Many studies proved that these substances might impose adverse effects on the menstrual cycles [12], time to pregnancy [10], ovarian reserve [6], and reproductive senescence, being responsible for earlier age at menopause [7,17]. Endocrine disruptors also impair in vitro fertilization outcomes [12,18] and lead to pregnancy loss [3,[19][20][21].…”