[Pharmwaste] Multiplication problem - What's to blame for the rise in infertility?

[DeBiasi,Deborah]

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Monday > January 22 > 2007 
  
Multiplication problem
What's to blame for the rise in infertility?s

  
Shelley Page 
The Ottawa Citizen 


Sunday, January 21, 2007


 
In Margaret Atwood's The Handmaid's Tale, war raged across the fictional
republic of Gilead, where pollution had rendered 99 per cent of women
sterile. In this near future dystopia, fertile women were enslaved as
handmaids for privileged, barren couples who led the country's
fundamentalist regime. The novel was riveting, yet fantastical; too
farfetched a vision to buy into.

Two decades on, the film Children of Men, based loosely on a P.D. James
novel, seems chillingly prescient. England in 2027 is a bleak world
where humans can no longer conceive. The youngest human is 18 years of
age. Human extinction looms. The mass infertility is unexplained but
erupted after the world-wide flu pandemic of 2008. The movie infuses
watchers with doom, in part because it seems familiar, like Iraq might
be now, or Toronto in the future.

Perhaps it's the world I inhabit, but the plot seems plausible, if not
possible. It feels like half the couples I know struggle to achieve
pregnancy, some spending thousands on fertility treatments. Some
conceive, many don't. The men have too few sperm, or else it's
defective, like tadpoles that can only swim in circles. Women have
blocked tubes or wonky eggs, early menopause or thyroid problems.
Miscarriage is common and devastating.

The infertile are sometimes told they have only themselves to blame.
They waited too long, the experts conclude. They were too busy to get
busy: self-serving hedonists or over-achievers climbing ladders. Their
eggs are old, their sperm is lame.

But we suspect it's more, don't we?

It's not just advanced age that's affecting fertility. Women under 25
make up the fastest-growing segment of U.S. women with impaired
fertility, according to a December 2005 report from the U.S. Centers for
Disease Control.

That same National Survey on Family Growth found that in 2002
approximately 12 per cent of couples in the U.S. experienced impaired
fecundity (the capacity to conceive and carry a child to term). This was

up 20 per cent from 6.1 million couples in 1995.

In Canada, infertility affects at least half a million couples.

The president of the American Infertility Association recently said he
fears toxins -- the pollution threat hypothesized in The Handmaid's Tale
and Children of Men -- are behind the infertility. But what is the
proof?

The leading environmental sciences journal in the world recently devoted
an issue to the role pollutants play in fertility. Environmental Health
Perpectives acknowledged that the problem has much to do with the
"modern tendency to delay childbearing until later in life, when
fertility naturally declines," but it also explored other influencing
factors such as obesity.

The cover story noted that environmental exposure assessments, plus
studies of wildlife, animals and humans, suggest other factors may be
subtly undermining our ability to reproduce, including exposure to
low-level environmental contaminants such as phthalates, polychlorinated
biphenyls (PCBs), dioxins, pesticides and other chemicals.

The links between environmental pollutants and infertility are more
clear cut in animals. Fish, amphibians and reptiles have all experienced
impaired fertility after exposure to endocrine disruptors, substances in
the environment believed to alter hormone function. Polar bears and
seals have been affected. So, too, have alligators.

Long-term studies from Lake Apopka in Florida, the site of a severe
pesticide spill in 1980, show that male alligators have penises that
were 25 per cent smaller than normal males. Their testosterone levels
were as low as a typical female's -- a serious threat to their
fertility. The females in the polluted lake have twice the normal amount
of estrogen. Zoologist Lou Guillette concluded that pesticide exposure
had feminized the population of alligators.

If pollution affects animals, we might also assume it affects humans.
But trying to tease out which system -- or multiple systems -- may have
been altered is difficult work. Many studies show a decline in sperm
counts, for example. Others don't.

The Study for Future Families, funded by the U.S. Environmental
Protection Agency, recently recorded significant reductions in sperm
concentration, motility and total motile sperm in men from Columbia,
Missouri, compared with men in New York City, Minneapolis and Los
Angeles.

The men from Missouri had residue of pesticides in their urine:
alachlor, atrazine, metolachlor and diazinon. Turns out they also had
higher exposure levels to agricultural pesticides. Did pesticides
disable the sperm? It's difficult to prove.

A study from the February 2006 issue of the International Journal of
Andrology found as many as 30 per cent of young Danish men have low
sperm counts, plus 10 per cent more may be infertile. The country also
has an unusually high rate of testicular cancer: four to five times
higher than the Finnish rate. Danish boys have higher rates than Finnish
boys of hypospadias, in which the urethra opens along the underside of
the penis shaft rather than the tip.

Danish researchers coined the term TDS -- testicular dysgenesis syndrome
-- to describe this cluster of findings. So while they don't have an
explanation, they have a name.

Is there a female equivalent to TDS? Perhaps, but female fertility is
more difficult to study.

Men can make a trip to the washroom to produce a sample for study.
Women's infertility may only surface near the end of their reproductive
years when they're struggling to get pregnant. So how does a doctor
distinguish if age is to blame or something else?

It's difficult to establish how pollution affects women's fertility. A
2000 study showed that women who ate sport fish from Lake Ontario for
three to six years took longer to get pregnant. But this is not a
smoking gun, just a hint.

The European Commission is studying Arctic populations, including the
Inuit of North America, because their exposure to persistent organic
pollutants such as PCBs and DDT metabolites are among the highest in the
world. Results published in March 2006 in Human Reproduction suggested
exposure to PCB and DDE made it more difficult for women to get
pregnant. Additional results published in the May 2006 Environmental
Health Perspectives showed there are fewer boys in the Arctic
populations than would otherwise be expected -- an altered sex ratio of
offspring -- related to PCB and DDE exposures.

Many experts say they must study populations and their exposures over
generations to understand infertility trends. Gathering this information
requires the participation not only of demographers, epidemiologists,
biologists, wildlife researchers, geneticists and toxicologists, it also
requires governments to support such projects.

The Canadian Association of Physicians for the Environment acknowledges
the uncertainties but says it's a priority to protect children from the
toxic substances that might forever damage their fertility. The
association's Children's Environmental Health Project advocates for
policies that will identify and eliminate hormonally active agents in
the environment.

Recently, the Stephen Harper government identified 200 toxic and
ubiquitous chemicals and gave industry three years to prove they are
safe. It not, the chemicals may be banned. Environmentalists like Rick
Smith, of Environmental Defense, calls it a good start.

After decades of worrying about overpopulation, it seems strange that
declining fertility is now an urgent issue. Governments, including
Canada, struggle with incentives to put working women back on the Mommy
Track because a growing population is good for the country. But it's not
just an issue of forcing ambivalent women to have children, it's about
protecting the fertility of girls who one day might want to have
children, as well as understanding the challenges faced by women who
want to become mothers now.

Gut feelings aside, we need to know how environmental toxins are
affecting our fertility before we wake up as real-life characters in a
Children of Men saga.

(c) The Ottawa Citizen 2007 




Deborah L. DeBiasi
Email:   dldebiasi at deq.virginia.gov
WEB site address:  www.deq.virginia.gov
Virginia Department of Environmental Quality
Office of Water Permit Programs
Industrial Pretreatment/Toxics Management Program
Mail:          P.O. Box 1105, Richmond, VA  23218 (NEW!)
Location:  629 E. Main Street, Richmond, VA  23219
PH:         804-698-4028
FAX:      804-698-4032