by Dr. Mary Hinckley
I recently was forwarded the notes from a talk by Stephanie and Andrew Chalupka on the impact of Environmental and Occupational Exposures on Reproductive Health given at Alta Bates Medical Center. It contained a wealth of valuable information and spurred on my previous interest in this field. Below are some key points from that talk and my own research.
The most common question I get on the topic of Environmental toxins comes from patients as well as innocent by-standers I meet socially who wonder “what is in the water that everyone needs fertility treatment? “
Well, there is more in the water now, especially here in the Bay Area. We need to be proactive enough to evaluate what we exposure ourselves to and then be able to motivate others to improve our ecosystem. While some of the increase in patients needing fertility comes from the fact that it is more socially acceptable to seek fertility help as well as the fact that some couples are starting their families later in life, there are some real trends to take notice of and there are some links to environmental exposures.
It is important to realize that exposure to toxins may affect the male partner and his sperm, the female partner and her egg development, or the developing fetus through in-utero exposure. The toxins can be:
1. chemical (like PCB’s)
2. physical (like radiation) or
3. biological ( such as bacteria).
People can be exposed through eating, breathing, or touching the toxins. It can also cross the placenta or come through the breast milk. Since many toxins accumulate in fat, the fatty milk that breast fed infants receive is an area for great concern.
The toxic effects can be through disruption of hormonal pathways or through signaling pathways or gene expression.
Approximately 25% of fetal developmental defects are thought to be due to environmental exposures (think fetal alcohol syndrome of lead toxicity).
For men, the hormonal disruption can cause problems in testicular development in-utero and later in life in sperm production. Clear documentation of decreased sperm counts, motility, morphology and genetic integrity has been seen.
Women with excessive exposure can experience shortened menstrual cycles, irregular spotting, or skipped periods (think about how stressful that is for an infertile patient!) Pesticide exposure has been shown to decrease fertility. Earlier exposure may be responsible for the earlier age of menarche (the start of the menstrual cycles) in our youth today.
So what to do? Well, start by taking an inventory of what toxins you might be exposed to: in the air, on your clothes, in your food, what you cook with, in your drinking water, and in your gardens. Stop microwaving in plastic containers that are not microwave safe. Stop dishwashing plastics with a recycle 03 on them. Remove plastic water bottles from your car which overheats in the summer. Use BPA- free products, often sold at health and nutrition stores (but also at even Target now!) Have an inspection of your water pipes (www.epa.gov/safewater/faq) and consider filtration. Be careful with solvents, lead paint, and mercury. Check your fish for high mercury. Watch your cosmetics for contaminants.
Listed below is some advice about which foods may be at high risk for toxins. The Classic Dirty Dozen need to be cleaned more carefully, or consider buying organic.
The classic Dirty Dozen:
1. Celery
2. Peaches
3. Strawberries.
4. Apples
5. Blueberries
6. Nectarines
7. Bell peppers
8. Spinach
9. Kale
10. Cherries
11. Potatoes
12. Grapes
The Clean 15:
1. Onions
2. Avocado
3. Sweet corn
4. Pineapple
5. Mangos
6. Sweet peas
7. Asparagus
8. Kiwi
9. Cabbage
10. Eggplant
11. Canteloupe
12. Watermelon
13. Grapefruit
14. Sweet Potatoes
15. Honeydew Melon
It will drive you crazy to try to identify and remove every risk. However, there are some simple changes most of us can make that will have long lasting effects on our fertility as well as our next generation.
Here’s to clean living…..
Dr. Mary Hinckley is a leading Reproductive Endocrinology and Infertility specialist at the Reproductive Science Center of the San Francisco Bay Area. She has extensively published articles in peer-reviewed journals on blastocyst transfer, avoiding triplet pregnancies, monozygotic twinning, operative hysteroscopy, correction of uterine anomalies, and biochemical pathways involved in ovulation and fertilization. She serves as a member of the Society for Reproductive Endocrinologists, the Christian Medical and Dental Society and the American Society for Reproductive Medicine. Her areas of interest include laparoscopic surgery, premature ovarian failure, oocyte freezing, and recurrent pregnancy loss.
