What you need to know about infertility rising in the west - Hint: Plastics!

Summary

Some studies suggest infertility in the West is increasing due to delayed childbearing, lifestyle factors like smoking and obesity, and environmental contaminants, while other studies indicate no major change in prevalence despite these factors.

Introduction

Infertility rates in Western countries have been on the rise, prompting significant research into the underlying causes. This synthesis aims to consolidate findings from multiple studies to comprehensively understand why infertility is increasing in the West.

Key Insights

• Delayed Childbearing:

  • Women are increasingly delaying childbearing due to career and educational pursuits, leading to a condensed reproductive window at an older age, which negatively impacts fertility.

• Lifestyle Factors:

  • Obesity, in particular, is linked to ovulatory defects and other reproductive issues.

• Male Infertility:

  • Male factors contribute significantly to infertility, with issues such as reduced semen quality and reproductive diseases being prevalent.

• Environmental Contaminants:

  • Exposure to environmental contaminants, including heavy metals, pesticides, and endocrine-disrupting chemicals, is associated with adverse effects on fertility and reproductive health.

• Infections and Health Care Quality:

  • Infections, particularly sexually transmitted infections, and inadequate health care contribute to secondary infertility. This is more pronounced in developing regions but also affects Western countries.

Plastics & Infertility

• Microplastics and Male Fertility:

  • Microplastics (MPs) can accumulate in human tissues and have been shown to negatively affect sperm quality and male reproductive success in mammals.

  • Exposure to polystyrene nanoplastics (PS NPs) in male rats led to decreased testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels, along with DNA damage and altered sperm morphology.

  • Sperm exposure to nanoplastics in aquatic species like the European whitefish reduced sperm motility and offspring performance, indicating potential transgenerational effects.

• Plasticizers and Endocrine Disruption:

  • Common plasticizers such as bisphenol A (BPA) and phthalates disrupt endocrine function, decreasing steroidogenesis (testosterone & estradiol) and reproductive defects in mammals and aquatic species.

  • BPA exposure during the perinatal period in rats resulted in significant impairments in male fertility across multiple generations, affecting sperm count, motility, and testicular function.

• Epigenetic and Transgenerational Effects:

  • Plastic-derived endocrine disruptors (EDCs) like BPA, DEHP, and DBP can cause epigenetic changes that are inherited across generations, leading to reproductive diseases and sperm epimutations.

  • These EDCs can modulate DNA methylation and epimutations in reproductive cells, affecting early development and potentially leading to adult-onset diseases.

• Acute and Chronic Effects on Sperm:

  • Acute exposure to DEHP, a common plasticizer, has been shown to impair sperm capacitation and acrosome reaction and increase reactive oxygen species (ROS) production, further reducing fertility.

Plastic Reduction

Here are some practical ways to reduce plastic use that may help improve fertility:

1. Avoid heating or microwaving plastic:

   • Heat can cause plastics to release more chemicals. Don't microwave or heat food in plastic containers or wrap.

   • Exposure: 1.75 million particles per litre of food and drink.

   • If you follow only one of these tips, please ensure it’s this one!

2. Avoid plastic food containers and water bottles:

   • Many plastics contain endocrine-disrupting chemicals like BPA and phthalates, which can interfere with hormonal balance and potentially impact fertility. Switch to glass, stainless steel, or silicone food storage containers and reusable water bottles.

   • Exposure: 50 to 10,000 particles per litre of food and drink.

3. Choose fresh or frozen foods over canned:

   • Many canned foods are lined with plastic that can leach chemicals into the food. Opt for fresh or frozen alternatives when possible.

   • Exposure: 100 to 200 particles per litre of food.

4. Use natural personal care products:

   • Many personal care products like shampoo, soap, and cosmetics contain phthalates and other plastics. Switch to natural, organic, and plastic-free alternatives.

   • Exposure: 100,000 microbeads per millilitre.

5. Avoid plastic wrap and non-stick cookware:

   • These often contain perfluorinated chemicals (PFCs) that can disrupt hormone function. Use parchment paper, glass, or ceramic instead.

6. Limit processed foods:

   • Many processed foods are packaged in plastic, which can transfer chemicals into the food.

7. Vacuum with HEPA filters:

   • HEPA filters can help remove microplastics from indoor air that may disrupt hormones when inhaled.

Conclusion

The increase in infertility in Western countries is multifaceted, involving delayed childbearing, lifestyle factors, male infertility, environmental contaminants, and increased awareness and use of ART. Addressing these issues requires a comprehensive approach that includes lifestyle modifications, better management of environmental exposures, and improved access to reproductive health services.

Sources:

1. G. Forti et al. "Evaluation and Treatment of the Infertile Couple." The Journal of Clinical Endocrinology and Metabolism, 83 (1998): 4177-4188.

2. R. Nachtigall et al. "International disparities in access to infertility services.." Fertility and sterility, 85 4 (2006): 871-5 .

3. S. Brugo-Olmedo et al. "Definition and causes of infertility.." Reproductive biomedicine online, 2 1 (2001): 41-53 .

4. A. Talmor et al. "Female obesity and infertility.." Best practice & research. Clinical obstetrics & gynaecology, 29 4 (2015): 498-506 .

5. D. Dunson et al. "Increased Infertility With Age in Men and Women." Obstetrics & Gynecology, 103 (2004): 51-56.

6. S. D’Angelo et al. "Microplastics: A Threat for Male Fertility." International Journal of Environmental Research and Public Health, 18 (2021).

7. Mathieu-Denoncourt, J., Wallace, S., Solla, S., & Langlois, V. (2015). Plasticizer endocrine disruption: Highlighting developmental and reproductive effects in mammals and non-mammalian aquatic species.. General and comparative endocrinology, 219, 74-88 .

8. Fatemeh Amereh et al. "The emerging risk of exposure to nano(micro)plastics on endocrine disturbance and reproductive toxicity: From a hypothetical scenario to a global public health challenge.." Environmental pollution, 261 (2020): 114158 .

9. S. Basak et al. "Plastics derived endocrine‐disrupting compounds and their effects on early development." Birth Defects Research, 112 (2020): 1308 - 1325.

10. S. Yaripour et al. "Pre-fertilization exposure of sperm to nano-sized plastic particles decreases offspring size and swimming performance in the European whitefish (Coregonus lavaretus).." Environmental pollution, 291 (2021): 118196 .

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