Environmental Exposures and Fertility: A Call for Awareness and Action

By Dr. Tiao V. Kattygnarath

As the Medical Director of CARE Fertility in Ottawa, I have witnessed firsthand the increasing concerns around reproductive health. One emerging factor contributing to fertility challenges is the environment—not just the air we breathe but also the products we use, the food we consume, and even the materials in our homes. The connection between environmental exposures and reproductive health cannot be overlooked, and as clinicians, we have a responsibility to shed light on this critical issue.

The Exposome: A Comprehensive View of Environmental Impact

The concept of the "exposome" refers to the sum total of environmental exposures throughout a person’s life. This includes natural and man-made environments, as well as cultural and societal influences. One of the most pressing threats within the exposome is the presence of endocrine-disrupting chemicals (EDCs). These chemicals interfere with hormonal systems and can negatively impact reproductive health for both men and women.

Routes of Exposure to Endocrine Disruptors

EDCs are omnipresent, and exposure can occur through various routes:

Dermal absorption: Personal care products such as lotions, shampoos, and deodorants.
Ingestion: Processed foods, plastic containers, and water bottles.
Inhalation: Airborne pollutants, cigarette smoke, and chemicals from household cleaning products.

Even in utero, fetuses can be exposed to EDCs through transplacental transition. Infants and toddlers are particularly vulnerable due to hand-to-mouth behaviours, increasing their risk of absorbing harmful substances.

Built Environment and Its Impact on Reproductive Health

The materials we interact with daily, such as PVC pipes, varnishes, and plastic furnishings, often contain EDCs. These chemicals can off-gas into the air or leach into water, contributing to cumulative exposure over time. Urban areas tend to have higher concentrations of these pollutants compared to rural settings, exacerbating the risk for those living in densely populated regions.

Social and Cultural Influences on Exposure

Certain personal care products used more frequently by women have been linked to higher levels of EDCs in their bodies, potentially explaining disparities in reproductive health outcomes. For example, studies have shown that non-Hispanic Black women often have higher urinary concentrations of bisphenol A (BPA) than their white counterparts, indicating unequal exposure patterns that may contribute to reproductive health disparities.

Consequences for Fertility and Birth Outcomes

Exposure to EDCs has been associated with various adverse reproductive health outcomes, including:

Reduced fertility: EDCs can impair spermatogenesis, disrupt menstrual cycles, and decrease ovarian reserve.
Pregnancy complications: Higher risks of miscarriage, preterm birth, and lower birth weight.
Developmental issues in offspring: Exposure during critical windows of development can lead to congenital abnormalities and other long-term health challenges.

Recognizing Windows of Vulnerability

Life course epidemiology highlights the importance of identifying windows of vulnerability—periods when exposure to harmful substances can have the greatest impact. Preconception, prenatal, and early childhood are particularly sensitive periods where interventions could yield significant benefits.

A Call to Action for Patients and Healthcare Providers

Reducing exposure to EDCs is challenging but not impossible. As clinicians, we must educate patients about potential sources of exposure and advocate for policies that limit the use of harmful chemicals in everyday products. Simple changes, such as choosing BPA-free containers, avoiding heavily processed foods, and opting for natural personal care products, can help reduce the overall burden of EDCs.

Products to Avoid to Minimize EDC Exposure:

Plastic food containers and water bottles (especially those labeled with recycling codes 3, 6, or 7)
Canned foods (lined with BPA-containing materials)
Non-stick cookware (containing perfluorinated chemicals)
Personal care products with parabens, phthalates, and triclosan
Household cleaners with synthetic fragrances and harsh chemicals
Pesticides and herbicides used in gardening
Plastic toys and items with soft vinyl or PVC
Air fresheners and scented candles with artificial fragrances

Furthermore, continued research and robust policy interventions are essential to mitigate the effects of environmental exposures on reproductive health. By working together, we can protect future generations and foster healthier reproductive outcomes.

Conclusion

The environment plays a critical role in shaping reproductive health, and acknowledging this link is crucial for addressing fertility challenges. Through awareness, education, and proactive measures, we can pave the way for safer, healthier environments that support fertility and overall well-being.

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CARE Fertility and Women’s Health is a leading fertility clinic, offering personalized care and advanced reproductive technology to help individuals and couples achieve their dream of parenthood. With state-of-the-art genetic testing, individualized treatment plans, and holistic support, we specialize in complex fertility cases and boast some of the highest success rates in Canada.

Stay Informed!