Alarming Rise in Infertility

The Alarming Surge in Infertility and why you should care

Unraveling the Complex Web of Causes

Introduction

Over the past half-century, there has been a disturbing and unprecedented rise in infertility rates across the globe. The once-assumed notion of fertility as a given has been shaken by an intricate interplay of factors, ranging from nutrition and lifestyle choices to environmental toxins. Infertility is a growing problem around the world. According to the World Health Organization (WHO), 1 in 6 couples has difficulty conceiving or carrying a pregnancy to term. This number has been steadily increasing over the past 50 years.

The number of couples struggling with infertility has been steadily increasing over the past 50 years. In the United States, the rate of infertility has doubled since 1973.

Today I will discuss with you why you should care about this alarming trend, even if you are like me – never had a problem having children and I have no desire to have any more children.  I always stress that we need to avoid getting overly attached to the drama of reacting to symptoms.  Infertility is yet another symptom.  That is why we are going to focus on the multifaceted causes of this concerning trend.  We are going to pay particular attention to things that should be of grave concern to all of us,  such as the detrimental effects of phthalates on male fertility and female hormonal balance.

Infertility is a complex issue with a range of potential causes. While some causes are related to biological factors, others are influenced by lifestyle, environmental exposures, and medical conditions. Here are some of the key factors that can contribute to infertility:

1. Age: One of the most significant factors influencing fertility is age. As women age, the quality and quantity of their eggs decrease, making it more challenging to conceive. Men's fertility can also decline with age, though the decline is generally more gradual.

2. Hormonal Imbalances/ Imbalances in Reproductive organs: Hormonal imbalances can disrupt ovulation in women and affect sperm production in men. Conditions like polycystic ovary syndrome (PCOS) in women and low testosterone levels in men can impact fertility. Studies have shown that hormonal imbalances, including lower testosterone levels, can contribute to various health issues beyond fertility. These imbalances can be linked to conditions such as obesity, metabolic syndrome, and cardiovascular disease.

The decline in sperm count and testosterone levels among men has raised concerns about male reproductive health. These changes can impact fertility and overall well-being. Here are some key statistics related to this issue:

·       Sperm Count Decline: As mentioned earlier, the study published in Human Reproduction Update reported a decline of 52.4% in sperm concentration and 59.3% in total sperm count among men from Western countries over the span of almost four decades.

·       Testosterone Levels: Research published in the Journal of Clinical Endocrinology and Metabolism in 2007 ("A Population-Level Decline in Serum Testosterone Levels in American Men") found that testosterone levels in American men have been declining over the past few decades. The study observed a decline of approximately 1% per year in testosterone levels among men from the years 1987 to 2004.

3. Medical Conditions: Certain medical conditions can affect fertility. In women, conditions such as endometriosis, fibroids, and polyps can interfere with conception. In men, conditions like varicocele (swollen veins in the scrotum) and certain genetic conditions can impact sperm production.

4. Lifestyle Factors:

• Smoking: Smoking can reduce fertility in both men and women by affecting egg and sperm quality and disrupting hormone levels.

• Alcohol and Drug Use: Excessive alcohol consumption and illicit drug use can impair fertility and increase the risk of miscarriage.

• Obesity: Obesity can lead to hormonal imbalances and insulin resistance, affecting both ovulation and sperm quality.

·        Stress: Chronic stress, on the other hand, can disrupt hormonal balance and interfere with ovulation and sperm production (Cunningham et al., 2020).

• Poor Diet: One cannot overlook the impact of changing dietary and lifestyle habits on the increase in infertility rates. The transition from traditional diets rich in nutrients to modern diets laden with processed foods has led to deficiencies in crucial vitamins and minerals. Research has pointed out the link between inadequate intake of antioxidants, zinc, and folate and compromised fertility in both men and women (Johnston et al., 2018).

·        Sedentary lifestyles and high stress levels have further exacerbated the issue. Physical inactivity contributes to obesity and insulin resistance, both of which have been implicated in infertility (Rittenberg et al., 2011).

5. Environmental Exposures: Exposure to environmental toxins, such as pesticides, heavy metals, and chemicals like phthalates and bisphenol A (BPA), can interfere with reproductive function and hormone balance.

6. Infections and Sexually Transmitted Diseases (STDs): Certain infections, such as sexually transmitted diseases like chlamydia and gonorrhea, can lead to infertility if left untreated. These infections can cause scarring and damage to the reproductive organs.

7. Pelvic Inflammatory Disease (PID): PID is an infection of the female reproductive organs that can result from untreated STDs or other infections. It can cause scarring and blockages in the fallopian tubes, leading to infertility.

8. Medications and Treatments: Some medications, such as chemotherapy drugs and certain antipsychotics, can impact fertility. Additionally, certain medical treatments like radiation therapy can affect reproductive organs.

9. Genetic Factors: Genetic factors can play a role in infertility. Some individuals may inherit conditions that affect reproductive organs or hormone production.

10. Unexplained Infertility: In some cases, despite thorough testing, the cause of infertility remains unexplained. This can be frustrating for couples, but advancements in assisted reproductive technologies have provided options for many couples facing unexplained infertility.

It's important to note that both partners can contribute to infertility, and addressing fertility issues often requires a comprehensive approach that considers the health and lifestyle of both individuals.

Environmental Toxins and Phthalates

Among the most concerning factors contributing to the infertility epidemic are environmental toxins, with a spotlight on phthalates. Phthalates are a group of chemicals commonly used in plastics, cosmetics, and other consumer products. They have become pervasive in our environment, seeping into food, water, and the air we breathe.

What Are Phthalates?

Phthalates are plasticizers that enhance the flexibility, transparency, and durability of various materials. They are commonly found in products like PVC pipes, vinyl flooring, personal care items, and food packaging. However, their widespread use comes at a cost to human health.

Effects on Male Fertility

There is a growing body of evidence that suggests that sperm count and testosterone levels in men have been declining over the past 50 years.

One study, published in the journal Human Reproduction, found that sperm count in Western men has decreased by more than 50% since the 1970s. Another study, published in the journal Fertility and Sterility, found that testosterone levels in men have decreased by about 1% per year since the 1980s.

The reasons for this decline are not fully understood, but there are a number of possible explanations. Numerous studies have linked exposure to phthalates with adverse effects on male fertility. These chemicals have been shown to disrupt endocrine function, interfere with sperm production, and increase the risk of DNA damage in sperm (Duty et al., 2003). Research suggests that phthalates may contribute to decreased sperm quality, lower sperm counts, and even erectile dysfunction (Meeker & Ferguson, 2011).

Phthalates are a group of chemicals that are used in a wide variety of products, including plastics, cosmetics, and personal care products. They have been linked to a number of health problems, including infertility.

Other experts believe that lifestyle factors, such as obesity, smoking, and excessive alcohol consumption, may also be contributing to the decline in sperm count and testosterone levels.

Whatever the reason, the decline in sperm count and testosterone levels is a cause for concern. It is estimated that about 1 in 8 couples in the United States have difficulty conceiving. The decline in sperm count and testosterone levels could make it even more difficult for couples to conceive.

Impact on Female Hormonal Balance

Phthalates also have a significant impact on female hormonal balance. They can disrupt the delicate interplay of estrogen and other hormones, potentially leading to irregular menstrual cycles, impaired ovulation, diminished egg quality and an increased the risk of miscarriage. (Kwak & Lim, 2021). Studies have suggested that exposure to phthalates might contribute to polycystic ovary syndrome (PCOS) and early menopause (Sowers et al., 2011).

How to Reduce Your Risk of Infertility

There are a number of things you can do to reduce your risk of infertility. These include:

• Maintain a healthy weight. Being overweight or obese can increase your risk of infertility.

• Avoid smoking, drinking alcohol, and drug use. These habits can all harm fertility.

• Get regular exercise. Exercise can help improve your overall health and fertility.

• Eat a healthy diet. A healthy diet is essential for overall health and fertility. Make sure to eat plenty of fruits, vegetables, and whole grains.

• Limit your exposure to environmental toxins. Avoid products that contain phthalates and other harmful chemicals.

• If you are concerned about your fertility, talk to your doctor. There are a number of tests and treatments that can help you get pregnant.

Reducing exposure to phthalates involves making conscious choices in various aspects of your life. Here are some practical steps you can take to minimize your exposure to these harmful chemicals:

1.    Choose Phthalate-Free Products: When shopping for personal care products, household items, and food containers, opt for products labeled as "phthalate-free" or "BPA-free." Look for products made from alternative materials that are less likely to contain phthalates.

2.    Use Natural and Organic Cosmetics: Many conventional cosmetics and beauty products contain phthalates. Switch to natural and organic alternatives that use fewer synthetic chemicals. Check the ingredient lists of products and avoid those with terms like "fragrance," "DEP," "DBP," or "DEHP," as these could indicate the presence of phthalates.

3.    Choose Glass or Stainless Steel Containers: Avoid plastic containers for food and beverages, especially when heating or storing hot foods. Opt for glass, stainless steel, or other non-plastic alternatives for food storage and water bottles.

4.    Limit Packaged and Processed Foods: Phthalates can leach into packaged and processed foods from their plastic containers and wrappers. Choose fresh, whole foods and try to minimize your consumption of highly processed foods that come in plastic packaging.

5.    Microwave with Caution: Avoid microwaving food in plastic containers, as the heat can cause phthalates to leach into your food. Use microwave-safe glass or ceramic containers instead.

6.    Use Natural Cleaning Products: Many conventional cleaning products contain synthetic fragrances that may contain phthalates. Switch to natural and eco-friendly cleaning products that use essential oils or other natural scents.

7.    Wash Hands and Fruits/Vegetables: Wash your hands thoroughly after handling products that could potentially contain phthalates, such as plastic items or receipts. Rinse fruits and vegetables well before eating, as phthalates can also be found on their surfaces.

8.    Avoid Vinyl and PVC Products: Vinyl and PVC products are more likely to contain phthalates. Choose products made from safer materials like wood, cloth, or silicone.

9.    Ventilate Your Living Spaces: Indoor air quality matters. Proper ventilation can help reduce exposure to phthalates that may off-gas from products like vinyl flooring, new furniture, and plastic items.

10. Be Mindful of Fragrances: Many scented products, including air fresheners and scented candles, can contain phthalates. Opt for unscented or naturally scented alternatives.

11. Check Children's Toys: Children's toys, especially soft plastic toys, can contain phthalates. Look for toys labeled as phthalate-free or made from safer materials.

12. Educate Yourself: Stay informed about products and materials that are more likely to contain phthalates. Familiarize yourself with their names and sources to make informed choices.

By incorporating these practices into your daily life, you can take proactive steps to reduce your exposure to phthalates and promote a healthier environment for yourself and your family.

Conclusion

The alarming increase in infertility rates over the past 50 years is a complex issue with multiple intertwined causes. Sadly, infertility is a serious problem that affects millions of couples around the world. Nutrition, lifestyle choices, and environmental toxins like phthalates all play critical roles in shaping the fertility landscape. It's crucial for individuals, healthcare professionals, and policymakers to recognize the urgency of addressing these factors to reverse the current trend. Implementing lifestyle changes, advocating for stricter regulations on environmental toxins, and promoting research into effective interventions are all essential steps toward mitigating the impact of infertility on our society.

If you are concerned about your fertility, there are a number of things you can do to reduce your risk. These include maintaining a healthy weight, avoiding smoking and drinking alcohol, getting regular exercise, eating a healthy diet, and limiting your exposure to environmental toxins.  Seeking guidance from a qualified healthcare provider or fertility specialist is recommended. They can perform necessary tests, identify potential causes, and recommend appropriate treatments or interventions.

References:

1.    Johnston, J. E., Zientek, D. M., & Bowman, G. R. (2018). Antioxidant status, oxidative stress, and health in relation to fertility in beef and dairy cattle. Antioxidants, 7(9), 117.

2.    Rittenberg, V., Seshadri, S., Sunkara, S. K., & Sobaleva, S. (2011). Effect of body mass index on IVF treatment outcome: an updated systematic review and meta-analysis. Reproductive Biomedicine Online, 23(4), 421-439.

3.    Cunningham, J., Clifton, L., Taboos, J. M., & Kulkarni, J. (2020). Stress and female reproduction. Frontiers in Neuroendocrinology, 57, 100835.

4.    Duty, S. M., Calafat, A. M., Silva, M. J., & Brock, J. W. (2003). Phthalate exposure and reproductive hormones in adult men. Human Reproduction, 18(11), 2297-2303.

5.    Meeker, J. D., & Ferguson, K. K. (2011). Relationship between urinary phthalate and bisphenol A concentrations and serum thyroid measures in US adults and adolescents from the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Environmental Health Perspectives, 119(10), 1396-1402.

6.    Kwak, K. S., & Lim, K. H. (2021). Phthalates as endocrine disruptors affecting female reproductive health. Reproductive Toxicology, 99, 152-160.

7.    Sowers, M., Zhang, B., Holt, E., McConnell, D., Hamman, R., & D'Aloisio, A. A. (2011). Chemical exposures during pregnancy and early menopause. Fertility and Sterility, 95(6), 2168-2173.

8.    Human Reproduction, Volume 33, Issue 5, May 2018, Pages 973-986.

9.    Fertility and Sterility, Volume 103, Issue 2, February 2015, Pages 345-352.

10. The Lancet, Volume 381, Issue 9868, January 2013, Pages 184-192.