By Steven M. Schrader, PhD and James S. Kesner, PhD

Infertility is a significant health issue in the U.S. as well as globally. In addition to the large health and fiscal impacts of infertility, the inability to conceive can be devastating to individuals or couples. Research suggest that between 12% and 18% of couples struggle with infertility,^[1] which may be caused by a wide variety of factors including genetic abnormalities, aging, acute and chronic diseases, treatments for certain conditions, behavioral factors, and exposure to environmental, occupational, and infectious hazards. However, many questions about infertility remain unanswered.

The Centers for Disease Control and Prevention (CDC) released the National Public Health Action Plan for the Detection, Prevention and Management of Infertility. This plan was created in consultation with many governmental and nongovernmental partners. NIOSH contributed to this Action Plan, specifically related to reducing exposures to occupational agents that can harm reproductive health and fertility in women and men.

Environmental and occupational hazards account for an unknown proportion of infertility cases, but are known to affect reproductive health and fertility in women and men, and suspected of causing declining human sperm quality in industrialized countries.^{[2], [3], [4]} An evaluation conducted in developed countries in the 1980s by the World Health Organization (WHO) found that 37% of infertility cases were attributable to female factors, 8% were attributable to male factors, 35% of infertility cases were linked to both male and female factors, and 5% were due to unknown cause(s). The remaining 15% of women in this infertile population became pregnant.^[5] Another evaluation conducted in 1988-1989 estimated that male factors account for the infertility in approximately 20% of the couples, with another 30-40% of cases attributable to reproductive abnormalities that were present in both partners.^[6]

Although some occupational exposures have been shown to impair fertility (e.g., lead, some pesticides, and some solvents), the overall contribution of occupational exposures to male and female infertility is unknown. Less than 5% of all chemicals used in the U.S. have been tested, even in laboratory animals, to determine if they are toxic to reproductive health.

The CDC National Public Health Action Plan recommends that surveillance of possible risk factors for infertility should include data on:

• sociodemographic characteristics (e.g., age, race/ethnicity, education, place of residence, socioeconomic status),
• health behaviors (e.g., use of alcohol, tobacco, caffeine, illicit drugs, anabolic steroids), body weight and related factors, adherence to screening and treatment recommendations related to risk factors,
• physical and mental health conditions (e.g., genetic disorders, STDs, obesity, depression, cancer),
• environmental exposures (e.g., household chemicals),
• occupational exposures (e.g., physical work practices , several solvents, several pesticides, some metals like lead, phthalates, bisphenol A) and
• prenatal and intergenerational exposures (e.g., diethylstilbestrol and sleep).

The report also emphasizes that...click here to read the rest of the post.