Infertility effects approximately 7.3 million couples in the US. One of seven couple will experience difficulty conceiving. About 40-50% of these the cause is unknown. It may be related to toxicity, oxidative damage, poor nutritional status or nutritional deficiencies, heavy metal or environmental toxicity, systemic disorders, hormonal imbalances, xenobiotic exposure, age-related decline, or obesity.

According to a recent study published two weeks ago in Environmental Health Perspectives, researchers investigated the relationship of preconception phthalate metabolite exposure in fertility along with potential mechanisms including reproductive hormones, inflammation, and oxidative stress.

Phthalates are endocrine-disrupting chemicals linked to adverse pregnancy outcomes, however, their evidence to establish and maintain pregnancy have been inconclusive.

This study included 1,228 women from the Effects of Aspirin in Gestation and Reproduction (EAGer) trial who were attempting to conceive for up to 6 menstrual cycles and throughout pregnancy if they became pregnant. Twenty phthalate metabolites were measured in a consecutive 3-day pooled urine sample at enrollment. Pregnancy was determined through urinary hCG levels at the expected date of menses during each cycle and pregnancy loss as an observed loss following positive hCG. Hs-CRP and isoprostanes were measured at enrollment and reproductive hormones were measured during the follicular phase, ovulation, and luteal phase. Discrete-time Cox proportional hazards models evaluated the relationship of phthalate metabolites with the probability of achieving pregnancy and weighted Poisson models with robust variance evaluated the risk of pregnancy loss.

As a result, higher mono-(2-ethylhexyl) phthalate was associated with a lower probability of achieving pregnancy. No consistent associations were observed with pregnancy loss. Preconception phthalates were consistently associated with higher hs-CRP and isoprostanes levels as well as lower estradiol and higher follicle-stimulating hormone across the menstrual cycle.

Women’s preconception exposure to phthalates was associated with a lower probability of achieving pregnancy, changes in reproductive hormones, and increased inflammation and oxidative stress. The pre-and periconception periods may represent sensitive windows for intervening to limit the reproductive toxicity of phthalate exposure.

It is also essential to minimize further exposure by eating organic produce, drink filtered water, use household products that are fragrance-free and free of phthalates and BPA, and replace non-stick pans with glass, ceramic, or cast iron.

We all live in an ever-increasing toxic environment. More than 80,000 chemicals are introduced into the world each year and in all honesty our indoor environment is likely more toxic than our outdoor environment. We are exposed to pesticides, herbicides, chemical solvents, xenobiotics, and industrial chemicals of all kinds that we get exposed through the food we eat, the water we drink and the air we breathe. These toxins accumulate in our body and contribute to the total toxic load that can cause a variety of health problems.

Nutrients that can support detoxification pathways include n-acetyl-cysteine, glutathione, calcium D-glucarate, milk thistle, and sulforaphane.

Just like traditional doctors use a complete blood count (CBC) and a comprehensive metabolic panel (CMP) as general screening tools to help rule out health problems in their patients, Dr. Jurgelewicz assesses the functional need for specific nutrients, diet modification, antioxidant protection, detoxification through organic acid testing. This identifies imbalances before any abnormal findings on a CBC or an CMP.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Nobles CJ, Mendola R, et al. Preconception Phthalate Exposure and Women’s Reproductive Health: Pregnancy, Pregnancy Loss, and Underlying Mechanisms. Environ Health Perspect. 2023 Dec;131(12):127013.

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