By: Dr. Amber Cooper
I realize as I begin to replay my day that I had countless concerning environmental exposures. My lunch had more trans fats than I would like to admit and I am sure that I am still under the recommended 10,000 steps or 30 minutes of recommended cardiac exercise per day. Those are in my control and I should do better. I take comfort in the fact that I am a non-smoker and my morning coffee and evening glass of red wine may have had some antioxidant benefits. My multivitamin does offer several fertility and pregnancy advantages and now there are studies suggesting men desiring pregnancy may also benefit from a multivitamin.
However, increasing evidence suggests we should also be concerned about many things that are less in our control. No matter if you live in the city, on a farm, in a suburb, or bike to work, you are exposed to environmental toxins every day. They are in the air, soil, water, and food both inside and outside the home. These are all items contributing to our often continuous, daily exposure to phthalates.Phthalates is a group of commonly used chemicals to make plastics more malleable, products more lubricated or perfumed products oily. In reality, scientists have likely only studied 5% or less of environmental chemicals when it comes to reproductive health, so much is unknown.
Endocrine Disrupting Chemical (EDC):
EDCs are chemicals that disrupt, alter, or adversely affect how hormones work in our bodies, and phthalates are just one example. They are incredibly difficult to study due to variations and combinations of exposures over one’s lifetime. Numerous publications have linked exposure to EDCs to increased incidence of cancers, cardiovascular disease, metabolic disease, obesity, earlier puberty, pregnancy complications and, more recently, infertility. Specifically, increasing EDC exposure has been associated with reduced sperm quality, increased miscarriage and time to pregnancy, polycystic ovarian syndrome (PCOS), endometriosis, and earlier age at menopause.
At what age does exposure have the most impact on fertility?
Females have the maximum number of eggs they will ever have in life when they are 20-week-old fetuses. Approximately 90% of oocytes are lost by the time a young girl starts puberty. While that seems frightening, as long as a normal pool is established in utero and nothing accelerates the loss, there should still be enough for pregnancy to occur during the reproductive years.
There may be more of a potential for men to improve sperm quickly by minimizing environmental exposures since it takes approximately 75-85 days for a sperm to progress from production to ejaculation, gaining progressive motility and maturation along the way. On the other hand, data suggests the egg a woman ovulates this month took a minimum of 6-8 months to develop from a primary, or very tiny, egg/follicle. Some researchers feel lifestyle and supplemental changes for a woman may need to be on board for many months to see an impact in egg quality, if the potential for such exists.
Can we minimize our exposure?
To many PCBs and other byproducts of industrialization, the answer is no. Over 80,000 synthetic chemicals are registered in the US and thousands of new ones added each year. However, we may be able to minimize our exposure to other EDCs or make healthier choices.
While research is still scarce on most chemicals, here are a few things to consider that could potentially be beneficial for your reproductive health based on what is currently published:
- Avoiding smoking, increasing exercise and maintaining a healthy well-balanced diet is good for many aspects of your health, including fertility
- Women and men may benefit from a multivitamin
- Always strive for a healthy weight as obesity impacts fertility, pregnancy and potentially how we process and store EDCs
- For men, medications such as pain meds, and especially testosterone, will negatively impact sperm quality and quantity
- Don’t assume the more supplements the better; remember these aren’t as well regulated and not all ingredients are listed. Interactions with other medications occur so inform your physician about all over the counter supplements and products
- Consideration of organic products may minimize exposures to harmful chemicals
- Always wash all produce (even those with peels) to remove pesticides and chemicals
- Eat less foods with preservatives and avoid artificial sweeteners
- Do not microwave on plastics as phthalates may leach into foods and liquids
- Use glass or stainless steel containers, especially for drinking water
- If using plastic bottles for food or personal care containers check the bottom of the bottle for the number that tells you about the type of plastic. Many publications and manufacturers suggest avoiding the numbers 3 and 7. Some would suggest also avoiding #6 which is polystyrene, otherwise known as Styrofoam and can leach styrene into food.
- Consider drinking filtered tap water if your tap water is safe
- Use more “green” household cleaning and lawn products as they may be less toxic
- BPA or phthalate-free labels are an improvement but not a safety guarantee
- Consider fragrance free products as this is often a source of EDCs
- Ask your salons about their hair, skin and nail products
- Fish is good for you (and baby when pregnant) just educate yourself regarding the fish and try to minimize mercury, PCBs and dioxins
- Consider unbleached or non-chlorine bleached paper, tampons and filters for coffee
- Supporting large scale policy improvements and environmental research is important
There is so much still to learn. Awareness and education are key, along with continued research. Many of these suggestions are likely beneficial for your overall health and your patients health, not just fertility.