Environmental contaminants, female reproductive health and fertility

Introduction Evidence continues to accumulate suggesting that environmental exposures adversely impact human reproductive function. Chemical exposures in the workplace, home, and ambient environment have demonstrated effects on women's reproductive health and concerns have been raised about a broad spectrum of factors that influence women's health including the social, biological, and physical environment. The current body of scientific evidence oft en relies on either a proxy of exposure such as consumption of polychlorinated biphenyl (PCB)-contaminated fish or a single blood measurement to assess the risk for an individual reproductive or developmental outcome such as time-to-pregnancy or menstruation. Epidemiologists have long articulated that research should be designed to capture the highly timed and interrelated nature of human reproduction and development. Recognition of the need to consider life-course approaches in research design is growing, particularly given the testicular dysgenesis or ovarian dysgenesis hypotheses that suggest an in utero origin for fecundity- and fertility-related disorders. We define the environment to be inclusive of all non-genetic factors, but restrict our review to focus on chemical and pollutant exposure while recognizing the importance of other excluded factors (e.g. social, physical, and medical iatrogenic). A key premise underlying this chapter is that exposure to environmental chemicals and pollutants is ubiquitous and includes exposures of which women are not aware.