Risk Factors For Female Infertility Research Articles

Associations of weight-adjusted-waist index and depression with secondary infertility.

Obesity and psychological factors were identified as risk factors for female infertility. The study investigated the correlation between WWI, depression, and secondary infertility, focusing on the potential mediating role of depression. According to the data from NHANES, this cross-sectional study used multiple regression analysis, subgroup analysis, and smooth curve fitting to explore the relationship between WWI, depression, and secondary infertility. The diagnostic ability of WWI was evaluated and compared to other obesity indicators using the ROC curve. The mediating effect test adopted the distribution of the product. This study involved 2778 participants, including 381 (13.7%) women with secondary infertility. Results showed that higher WWI (OR = 1.31; 95% CI, 1.11-1.56) and depression scores (OR = 1.03; 95% CI, 1.01-1.06) were associated with secondary infertility. There was a positive correlation between WWI and secondary infertility (nonlinear p = 0.8272) and this association was still consistent in subgroups (all P for interaction> 0.05). Compared with other obesity indicators, WWI (AUC = 0.588) also shows good predictive performance for secondary infertility. Mediation analysis showed that depression mediated the relationship between 3.94% of WWI and secondary infertility, with a confidence interval of Za * Zb excluding 0. WWI exhibited a relatively good correlation in predicting secondary infertility than other obesity indicators, and depression may be a mediator between WWI and secondary infertility. Focusing on the potential mediating role of depression, the risk of secondary infertility due to obesity may be beneficially reduced in women.

Insights into Modifiable Risk Factors of Infertility: A Mendelian Randomization Study.

Objective: Observational studies have linked lifestyle, diet, obesity, and biochemical measures with infertility. Whether this association is causal is unclear. We sought to identify the causal relationship between modifiable risk factors with infertility. Methods: Using single-nucleotide polymorphisms (SNPs) as a genetic instrument variable, we carried out a two-sample Mendelian randomization (MR) analysis to estimate the causal effects for 22 modifiable risk factors on female infertility (6481 cases; 75,450 participants) and male infertility (680 cases; 73,479 participants). Results: The results of the study showed that BMI (OR: 1.24, 95% CI (1.09, 1.40)), body fat percentage (OR: 1.73, 95% CI (1.13, 2.64)), and alcohol consumption (OR: 6.57,95% CI (1.2, 36.14)) are associated with a higher risk of male infertility, and total fatty acids (OR: 1.16, 95% CI (1.03, 1.30), omega-6 fatty acids (OR: 1.14, 95% CI (1.00, 1.27)), and monounsaturated fatty acids (OR: 1.14, 95% CI (1.03, 1.28) are associated with a higher risk of infertility in women. We observed that higher education (OR: 0.77, 95% CI (0.64, 0.92)) was a protective factor for female infertility. Conclusions: BMI, body fat percentage, and alcohol consumption are risk factors for male infertility; total fatty acids, omega-6 fatty acids, and monounsaturated fatty acids are risk factors for female infertility, and education is a protective factor for female infertility.

Chlamydia infection, PID, and infertility: further evidence from a case–control study in China

BackgroundChlamydia trachomatis infection and pelvic inflammatory disease (PID) are well-known risk factors for female infertility. But there is limited evidence from China. This study aimed to further explore the associations between previous/current chlamydial infection, PID, and infertility in China.MethodsWe performed a 1:2 matched case–control study with two control groups: pregnant controls and non-pregnant controls in China in 2019. Women diagnosed with infertility were selected as cases (n = 255). Controls were selected based on the following criteria: Pregnant women who were documented in the selected hospitals were chosen as Pregnant controls (n = 510), and people who sought health care in Obstetric/Gynecologic clinics, Family Planning clinics, Dermatology and STD Department or Urological department were selected as Non-pregnant controls (n = 510). Infertility induced by male factors and people who used antibiotics in the vagina within two weeks were excluded. The first-stream specimen of urine samples was tested for chlamydia by nucleic acid amplification testing (NAAT). Conditional logistic regression was used to estimate the association.ResultsThe prevalence of previous chlamydial infection and PID were significantly higher in cases (2.4%, 17.3%) than in controls (Non-pregnancy: 0.4%, 3.0%; Pregnancy: 0.4%, 9.0%). The current chlamydial infection rates were 5.9%, 7.3%, and 7.1% in infertile, pregnant, and non-pregnant women, respectively. After adjusting for confounders, PID largely elevated the risk of infertility (using non-pregnant controls: adjusted OR = 2.57, 95% CI 1.51, 4.39; using pregnant controls: adjusted OR = 6.83, 95% CI 3.47, 13.43). And the positive association between PID and tubal infertility was more obvious for both groups. For current chlamydial infection, none of the odds ratios were significant at the 0.05 level, while small sample size limited the evaluation of an association between prior chlamydial infection with infertility.ConclusionsPrevious PID was indicated to largely increase the risk of infertility, especially tubal infertility. And there should be continuing emphasis on highly sensitive and specific biomarker for prior chlamydial infection.

Types of Infertility and Its Risk Factors among Infertile Women: A Prospective Study in Dhaka City

Background: Infertility is a global health issue, and it is a multidimensional problem with social, economic, and cultural influences. Objectives: The study aimed to determine types of infertility and their contributing factors among the respondent infertile women. Methods: This prospective cross-sectional study was conducted among infertile women visiting Sir Salimullah Medical College and Hospital, Dhaka. From January to December 2020, 111 infertile women were included and evaluated for infertility types and their contributing factors. Data were collected by face-to-face interviewing, and data were analyzed statistically. Results: Primary infertility was found among 90 (81%) and secondary infertility among 21 (18.9%). Among the direct risk factors of female infertility, ovulation failure was the majority of the cases, 74 (35.1%), and its mainly observed in primarily infertile women 58 (33.9%). These observations were statistically significant. Conclusions: Infertility should be treated as a public health problem, government and non-government organizations should develop a basic policy to create effective fertility centers.

Ovarian risk factors of female infertility by transvaginal ultrasonography

Aim: To determine the Ovarian risk factors of female infertility by transvaginal ultrasonography Study design: Cross sectional validation study Methods: The study comprised women visiting the department with unexplained infertility for treatment during the period of 2018 to 2020. A total of 550 cycles were inducted primarily referred for ovarian assessment by ultrasound with patent tubes and normal utero-ovarian morphology. All those women having no conception with normal semen analysis of their husbands. Male factor infertility was also excluded. Baseline transvaginal sonography (TVS) was performed at proliferative phase, of the cycle. Mature follicles were studied by TVS. On an individual basis, the following parameters, that is, follicle size, ovarian volume and ovarian artery Doppler PI, RI were studied. Follicle size and ovarian artery Doppler flow were highly significant for a pregnancy. Results: In this research two types of infertility was compared with normal group as for as the primary infertile females were 99 (18.00%) and secondary infertile females were 144 (26.18%) and normal were 307 (55.82%). Out of 550 patients 243 (44.18%) patients were infertile and 307 (55.82%) were normal. Discussed in this research. Conclusions: Ovarian ultrasound assessment proved to be a simple, noninvasive and authentic to predict the ovarian environment and thereby helping in the prediction of the outcome in infertility. Keywords: Infertility, Doppler ultrasonography, Transvaginal ultrasonography, Resistive index, Pulsatility index

The Associations of Genital Mycoplasmas with Female Infertility and Adverse Pregnancy Outcomes: a Systematic Review and Meta-analysis.

The roles of genital mycoplasmas including Mycoplasma genitalium (M. genitalium), Mycoplasma hominis (M. hominis), Ureaplasma urealyticum (U. urealyticum), and Ureaplasma parvum (U. parvum) in reproductive diseases are equivocal. To investigate whether genital mycoplasmas are risk factors of female infertility and adverse pregnancy outcomes, we performed a systematic review and meta-analysis. Electronic databases were searched for related studies. A random-effects model or fixed-effects model was employed to generate forest plots. Pooled odd ratios (ORs) with 95% confidence intervals (CIs) were applied to measure the strength of associations. Meanwhile, heterogeneity was evaluated by H statistic and I2 statistic, and publication bias was explored by funnel plots based on Egger's test and Begg's test. The search yielded 2054 relevant records, and 35 articles were ultimately included for meta-analysis. M. genitalium was a significant risk factor for female infertility (OR, 13.03 [95% CI, 3.46-48.98]) and preterm birth (PTB) (OR, 1.81 [95% CI, 1.17-2.80]), but not for spontaneous abortion (SA) (OR, 0.58 [95% CI, 0.25-1.35]). M. hominis can significantly increase the potential risk of female infertility (OR, 1.56 [95% CI, 1.02-2.38]), SA (OR, 9.14 [95% CI, 4.14-20.18]), stillbirth (OR, 3.98 [95% CI, 1.39-11.36]), and premature rupture of membranes (PROM) (OR, 1.79 [95% CI, 1.26-2.55]), but was not associated with PTB (OR, 1.29 [95% CI, 0.78-2.15]). U. urealyticum had no significant risk effect on female infertility (OR, 0.68 [95% CI, 0.42-1.11]). Coinfections of M. hominis and Ureaplasma were significantly associated with female infertility, SA, and stillbirth, but not with PROM. On the basis of current evidences, this meta-analysis supports that M. genitalium is a risk factor for female infertility and PTB; M. hominis is a potential risk factor for female infertility, SA, stillbirth, and PROM; U. urealyticum has no significant association with female infertility; and the relationship of U. parvum with female infertility and adverse pregnancy outcomes needs to be paid more attention to and remains to be further revealed.

Risk profile of Qatari women treated for infertility in a tertiary hospital: a case-control study

BackgroundFemale infertility is a multifactorial condition constituting a worldwide public health problem. The ability to reproduce is an important product of any marriage, hence infertility may exert a negative impact on physical, financial, social and emotional wellbeing of affected couples. The cornerstone to the management of any disease, including infertility, is prevention. Identifying the modifiable risk factors of female infertility will aid at prevention, early detection, and treatment of medical conditions that can threaten fertility as well as promoting healthy behaviours that can preserve it.AimTo explore the risk profile of infertility among Qatari women and compare risk factors distribution among primary vs. secondary infertility.MethodologyA hospital-based case control study was conducted from September 17th, 2017- February 10th, 2018. Cases (n = 136) were enrolled from infertility clinic and controls (pregnant women, n = 272), were enrolled from antenatal clinic, Women Hospital, Hamad Medical Corporation (HMC). Interview questionnaire was utilized to collect data about sociodemographic, risk factors related to infertility and patient health Questionnaire (PHQ)-2. Body Mass Index (BMI) was calculated. Logistic regression was used to identify the associated factors to infertility. Statistical significance was set at 0.05.ResultsForty three primary and ninety three secondary infertility cases were included. Risk factors were age > 35 years (OR = 3.7, 95% CI: 1.41–9.83), second-hand smoking (OR = 2.44, 95% CI:1.26–4.73), steady weight gain (OR = 4.65,, 95% CI: 2.43–8.91), recent weight gain (OR = 4.87, 95% CI: 2.54–9.32), menstrual cycle irregularities (OR = 4.20, 95% CI:1.14–15.49), fallopian tube blockage (OR = 5.45, 95% CI: 1.75–16.95), and symptoms suggestive of sexually transmitted infections (STIs) including chronic lower abdominal/pelvic pain (OR = 3.46, 95% CI: 1.57–7.63), abnormal vaginal discharge (OR = 3.32, 95% CI:1.22–9.03) and dyspareunia (OR = 7.04, 95% CI: 2.76–17.95). Predictive factors for secondary infertility were; longer time from previous conception (OR = 5.8, 95% CI: 3.28–10.21), history of stillbirth (OR = 2.63, 95% CI: 1.04–6.67) or miscarriage (OR = 2.11, 95% CI: 1.21–3.68) and postpartum infection (OR = 3.75, 95% CI: 1.27–11.06). Protective factors were higher education level (OR = 0.44, 95% CI: 0.25–0.78), higher income (OR = 0.17, 95% CI: 0.06–0.49), and awareness/loyalty to fertility window (OR = 0.33, 95% CI: 0.21–0.52 and OR = 0.29, 95% CI: 0.19–0.44, consequently).ConclusionThis study highlighted the opportunities to strengthen public health as well as hospital-based health promotion programs importantly toward behavioural-related risk factors (e.g. smoking, obesity, STIs etc.). Moreover, detecting, preventing, and managing modifiable risk factors through awareness, screening and early management of chronic diseases, may contribute at reduction of incidence and severity of infertility. Such interventions can be delivered at premarital, family planning, post-natal and antenatal clinics at primary health care with early referral to secondary care if required.

RISK FACTORS FOR FEMALE INFERTILITY AT A TERTIARY HEALTH FACILITY IN AKURE, SOUTH-WEST NIGERIA

Background. The inability of couples to achieve pregnancy is a major cause of psycho-social problems in family relationship that could lead to marital disharmony.
 Objective. The aim of this study was to find out the possible risk factors for female infertility.
 Methods. A case-control design and a sample size of 400 (200 cases of infertility and 200 controls) were used in the study. Cases and controls were selected at random at the infertility and family planning clinic of the University of Medical Sciences Teaching Hospital Complex, Akure and were subjected to a predesigned interviewer administered questionnaire to collect the data. The cases were classified into primary and secondary infertility; binary and stepwise logistic regressions were used to generate the Odds ratio and 95% confidence interval of the possible risk factors and the level of significance was set at P<0.05.
 Results. The mean age of the women with infertility was 28.5±5.43 years and the mean age of those in the control group was 29.1±5.62 years. Among the cases, 155 (77.5%) had secondary infertility, while 45 (22.5%) had primary infertility. Significant risk factors for female infertility included presence of fibroids, having had fibroid operation, multiple sexual partners, previous abortion, polycystic ovary syndrome (PCOS), sexually transmitted infection (STI) and post abortion sepsis.
 Conclusion. The study showed that secondary infertility is still the most prevalent and the risk factors were multi factorial. Efforts should be intensified to reduce infertility due to preventable causes.

Медико-биологическое и социальное значение женского бесплодия

As a result of the decline in the population, Russia has faced a number of economic and social problems related to the reduction of the working-age population, as well as the need to reform the existing pension system, one of the measures aimed at improving the demographic situation is the increase in the birth rate. The aim of the study is to study the medical, biological and social significance of female infertility on the basis of a literary review. The results of the review showed a high level of infertility both in Russia and around the world. Among the main medical and biological risk factors for female infertility are the high prevalence of harmful habits, the earlier age of entry into sexual life of the high rate of sexually transmitted infections, gynaecological incidence, the high rate of abortion, the postponement of the birth of children to an older age. Social factors include low family income, poor quality of life, poor relationships with spouses and dissatisfaction with sexual intimacy. The increase in the number of families with infertility indicates an increasing need for assisted reproductive technologies. In developed countries, assisted reproductive technologies produce between 0.4 and 4.0 % children. In Russia, 160836 children were born with assisted reproductive technologies from 2007 to 2013, and the contribution of assisted reproductive technologies to annual fertility increased almost 40 times (from 0.04 to 1.55 %). The conclusion: the restoration of women's reproductive health is one of the promising directions in raising the birth rate and restoring the demographic situation.

Subclinical Hypothyroidism Is Associated with Lower Ovarian Reserve in Women Aged 35 Years or Older.

Background: Overt thyroid diseases have been identified as risk factors for female infertility. However, it remains largely unclear whether subclinical hypothyroidism (SCH), a very common thyroid disorder, is associated with female infertility. This study aimed to investigate the potential association between SCH and the ovarian reserve in women seeking infertility treatment. Methods: This retrospective study included 2568 women with normal thyroid function (n = 2279) or SCH (n = 289) who visited our clinic for infertility treatment. Ovarian reserve markers, including follicle-stimulating hormone (FSH) concentrations on days 2-4, the antral follicle count (AFC), and anti-Müllerian hormone (AMH) concentration, were compared between euthyroid women and those with SCH. Multiple linear and Poisson regression analyses were used to estimate the associations of SCH with ovarian reserve markers. These analyses were repeated separately in women aged <35 (n = 1349) and ≥35 years (n = 1219). Results: In the total study population, women with SCH had significantly lower AMH concentrations (median: 2.05 vs. 2.51 ng/mL, p = 0.015) and AFCs (median: 10.0 vs. 11.0, p = 0.013), compared with euthyroid women. In linear and Poisson regression analyses, SCH was significantly associated with a higher basal FSH concentration (mean difference = 1.13 mIU/mL [95% confidence interval (CI) 0.97 to 1.29 mIU/mL], p < 0.001), lower AMH concentration (mean difference = -0.27 ng/mL [CI -0.43 to -0.12 ng/mL], p = 0.001), and lower AFC (mean difference = -0.7 [CI -1.3 to -0.2], p = 0.005). In women aged ≥35 years, SCH was significantly associated with FSH (mean difference = 1.74 mIU/mL, p < 0.001) and AMH concentrations (mean difference = -0.40 mg/mL, p < 0.001) and AFC (mean difference = -0.8, p < 0.001). In women <35 years old, SCH was significantly associated with a higher FSH concentration (mean difference = 0.30 mIU/mL, p < 0.001), but not with AMH or AFC concentrations (p = 0.84 and 0.06, respectively). Thyroperoxidase antibody (TPOAb) positivity was not associated with measures of ovarian reserve. Conclusions: The data suggest that SCH is associated with decreased ovarian reserve during later reproductive age. TPOAb positivity was not associated with ovarian reserve. Future research is necessary to investigate the underlying molecular mechanisms regulating the diminished ovarian reserve in women with SCH and to evaluate whether levothyroxine supplementation may improve the ovarian function of women with SCH.

Аспекты репродуктивного здоровья у женщин с низкой и избыточной массой тела при рождении

The aim of the research was to determine the characteristics of menstrual function and the spectrum of disorders of reproductive health among women born with low weight and overweight. Materials and methods. The study included 122 healthy women of reproductive age, the city dwellers of the Eastern Ukraine, 53 (group I) of them were born weighing 2500 g or less, and 69 (group II) with body weight of 4000 g or more. To achieve this purpose conducted an anonymous survey and personal interviews. Were estimated characteristics of the formation of the menstrual function, its characteristics, the frequency of violation of menstrual cycle and the spectrum of pathology that requires medical, surgical or minimally invasive intervention. Results. This study determined the relationship of family history, perinatal development, the formation of the menstrual cycle and reproductive function in women with various deviations of body weight at birth. There was stated the relationship between weight at birth and fertility in the future. Were updated perinatal risk factors for female infertility. Were discovered the relationship between the deviation from normal body weight at birth and increased frequency of gynecological pathology, which require surgical or minimally invasive treatment, trigger factors for hormonal-metabolic disorders in the population of Eastern women. It was determined the necessity of a differentiated approach to medical care of women with different variants of the deviations of weight growth indicators at birth. Conclusion. Thus, the obtained data about the delay in sexual development and later about the high incidence of infertility in women who are born with low body weight are in agreement with the literature data, reflecting the parallelism of woman's ability to conceive, weight and growth parameters at birth. Key words: low birth weight, large for gestational age fetus, gynecological pathology, infertility.

Female Infertility and “Emerging” Organic Pollutants of Concern

Modern chemical instrumentation has fostered a revolution of sorts, in which epidemiologic studies of female infertility can now devote attention to very low level, “background” exposures to “emerging” non-persistent organic pollutants, rather than on “legacy” 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 couple-level exposures, and incorporating mixtures of these and additional emerging organic pollutants.

Female Infertility: A Study of Risk Factors.

Background: Infertility is a relatively common condition. It can be attributed to factors in a female partner, a male partner, or in both partners. However, certain socio-demographic and life style factors have been linked to female infertility.&#x0D; Objective: To determine the association between female infertility and selected risk factors.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; J Fac Med Baghdad&#x0D; 2014; Vol.56, No. 2&#x0D; Received June.2013&#x0D; Accepted Oct.2013&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Patients and Methods: This is a case – control study carried out in Basrah Governorate over a period of ten months, from 1st of January to 31st of October, 2006. Cases were married women who had no pregnancy for at least one year (infertile women), a total of 212 cases were included. The controls were married women who had babies aged less than one year (fertile women); the total number of controls was 213.&#x0D; Results: the study found that the risk of infertility increases steadily with the increase in age. The risk of female infertility also increased in women with menstrual cycle disturbances (like irregular menstrual cycle length and scanty or heavy menstrual blood loss), women with previous history of abortion, women with previous caesarean section, and in women with previous history of ectopic pregnancy. Infertility was also found to be associated with obesity and with daily caffeine consumption.&#x0D; Conclusion: the independent risk factors for female infertility were history of previous CS, menstrual cycle disturbance, regular daily caffeine intake and obesity.

Epidemiology of Female Infertility; A Review of Literature

The prevalence of infertility is varies worldwide ranging from 3% to 7%. The consequences of infertility are societal repercussions, personal suffering, psychological effects, clinical depression and sexual dysfunction. Therefore, the aim of the present study was a systematic review of the literature to determine the main risk factors of female infertility. MEDLINE, EMBASE and Cochrane Database were searched from 1980–2013. Information about study objectives, participants and type of study were searched systematically with extensive key words to optimize the sensitivity of data collection. Eighty-two published articles were included in the overall review. Ovarian factors, tubal and peritoneal factors, anomalies, advanced ages (over 35 years), hormonal disorders, habits, genetic factors, medical conditions and life style are the main causes of infertility in women. Changes of lifestyle, identifying and controlling chronic diseases, rapid and suitable treatments for sexually transmitted diseases can increase the chance of women fertility process.

Study on environmental and psychological risk factors for female infertility

To investigate the environmental and psychological risk factors for female infertility and to provide a scientific basis for the prevention and control of female infertility. In a hospital-based case-control study, a self-designed questionnaire was used to survey the cases and controls (1:1) with nation and age (± 2 years) as matching variables. Univariate and multivariate conditional logistic regression models were employed to analyze the datasets. The univariate analysis showed that female infertility was related to the following factors: eating fried foods, alcohol consumption, smoking, staying up late, perm, housing decoration, contact with heavy metals, exposure to radiation, contact with pesticides, working in hot environment, mental stress, uneasiness, helplessness, and despair. The multivariate analysis showed that staying up late (OR = 2.937), housing decoration (OR = 2.963), exposure to radiation (OR = 2.506), contact with pesticides (OR = 2.908), and mental stress (OR = 4.101) were the main risk factors for female infertility. Furthermore, there was an interaction between staying up late and mental stress. Female infertility is caused by multiple factors including staying up late, housing decoration, exposure to radiation, contact with pesticides, and mental stress, and there is an interaction between staying up late and mental stress.

Organochlorine compound levels in fertile and infertile women from Rio de Janeiro, Brazil

The aim of the study was quantify organochlorine compounds in women seeking for infertility treatment (n = 15) and in spontaneously pregnant ones (n = 21). A questionnaire was applied regarding lifestyle, occupational and reproductive history. Blood samples were collected from both groups. From the pesticides studied, pp'DDE was detected in 100% of infertile women, at higher mean levels than in pregnant women (3.02 mcg/L vs. 0.88 mcg/L; p = 0.001; power of 69%), without correlation with the etiology of infertility. Levels of the polychlorinated biphenyls (PCBs) were low, with positive samples in 100% in the infertile women for PCBs 138, 153, 180, while in pregnant women, they were 85.7% for congeners 138 and 153. Only PCB180 showed significance, with frequency of 71.4% (p = 0.019). The risk factors for female infertility were: age, consumption of untreated water and of canned foods. Exposure to the most prevalent organochlorine compounds described in literature was confirmed in the study, indicating that pp'DDE may adversely influence female fertility.

Proceedings of the Summit on Environmental Challenges to Reproductive Health and Fertility: executive summary

The 2007 Summit on Environmental Challenges to Reproductive Health and Fertility convened scientists, health care professionals, community groups, political representatives, and the media to hear presentations on the impact of environmental contaminants on reproductive health and fertility, and to discuss opportunities to improve health through research, education, communication, and policy. Environmental reproductive health focuses on exposures to environmental contaminants, particularly during critical periods of development, and their potential effects on future reproductive health, including conception, fertility, pregnancy, adolescent development, and adult health. Approximately 87,000 chemical substances are registered for commercial use in the United States, with ubiquitous human exposures to environmental contaminants in air, water, food, and consumer products. Exposures during critical windows of susceptibility may result in adverse effects with lifelong and even intergenerational health impacts. Effects can include impaired development and function of the reproductive tract and permanently altered gene expression, leading to metabolic and hormonal disorders, reduced fertility and fecundity, and illnesses such as testicular, prostate, uterine, and cervical cancers later in life. This executive summary reviews effects of pre- and postnatal exposures on male and female reproductive health, and provides a series of recommendations for advancing the field in the areas of research, policy, health care, and community action.

Proceedings of the Summit on Environmental Challenges to Reproductive Health and Fertility: executive summary

The 2007 Summit on Environmental Challenges to Reproductive Health and Fertility convened scientists, health care professionals, community groups, political representatives, and the media to hear presentations on the impact of environmental contaminants on reproductive health and fertility, and to discuss opportunities to improve health through research, education, communication, and policy. Environmental reproductive health focuses on exposures to environmental contaminants, particularly during critical periods of development, and their potential effects on future reproductive health, including conception, fertility, pregnancy, adolescent development, and adult health. Approximately 87,000 chemical substances are registered for commercial use in the United States, with ubiquitous human exposures to environmental contaminants in air, water, food, and consumer products. Exposures during critical windows of susceptibility may result in adverse effects with lifelong and even intergenerational health impacts. Effects can include impaired development and function of the reproductive tract and permanently altered gene expression, leading to metabolic and hormonal disorders, reduced fertility and fecundity, and illnesses such as testicular, prostate, uterine, and cervical cancers later in life. This executive summary reviews effects of pre- and postnatal exposures on male and female reproductive health, and provides a series of recommendations for advancing the field in the areas of research, policy, health care, and community action.

Risk factors for female infertility in an agricultural region.

Recent studies have suggested that agricultural occupations or exposure to pesticides may impair female fertility. The Fertility Risk Factor Study retrospectively examined agricultural and residential exposures and the risk of female infertility. Cases and controls (N = 322 each) came from women who sought treatment at a large group medical clinic in Wisconsin. Women and their male partners provided information on health, occupational and lifestyle exposures in response to a telephone interview during 1997-2001. Mixing and applying herbicides 2 years before attempting conception was more common among infertile women (odds ratio [OR] = 27; 95% confidence interval [CI] = 1.9-380), as was the use of fungicides (OR = 3.3; CI = 0.8-13). Residing on a farm, ranch or in a rural area during this time period was protective of female fertility. Households supplied with central Wisconsin groundwater were at less risk for infertility than households using municipal sources (OR = 0.6; CI = 0.4-0.9). Behavioral risk factors included alcohol consumption (OR = 1.8; 1.2-2.5), smoking (1.6; 0.9-2.9), passive smoke exposure (1.8; 1.2-2.5), steady weight gain in adult life (3.5; 2.0-6.1), and having a male partner over the age of 40 (4.5; 1.2-16.3). Drinking 3 or more glasses of milk per day was protective of female fertility (0.3; 0.1-0.7). These results suggest that certain agricultural, residential and lifestyle choices may modify the risk of female infertility.