Exposure to non-persistent chemicals in consumer products and fecundability: a systematic review

program collaborators for Environmental influences on Child Health Outcomes, Alison E. Hipwell, Linda G. Kahn, Pam Factor-Litvak, Christina Porucznik, Eva L. Siegel, Raina N. Fichorova, Richard F. Hamman, Michele Klein-Fedyshin, Kim G. Harley

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Exposure to non-persistent chemicals in consumer products is ubiquitous and associated with endocrine-disrupting effects. These effects have been linked to infertility and adverse pregnancy outcomes in some studies and could affect couple fecundability, i.e. the capacity to conceive a pregnancy, quantified as time to pregnancy (TTP). OBJECTIVE AND RATIONALE: Few epidemiologic studies have examined the impact of non-persistent chemicals specifically on TTP, and the results of these studies have not been synthesized. We undertook a systematic review to summarize the strength of evidence for associations of common non-persistent chemicals with couple fecundability and to identify gaps and limitations in the literature, with the aim of informing policy decisions and future research. SEARCH METHODS: We performed an electronic search of English language literature published between 1 January 2007 and 25 August 2017 in MEDLINE, EMBASE.com, Global Health, DART/TOXLINE, POPLINE and DESTAF. We included human retrospective and prospective cohort, cross-sectional and case-control studies that examined phthalates, bisphenol A, triclosan, triclocarban, benzophenones, parabens and glycol ethers in consumer products, and considered TTP or fecundability as an outcome among women, men and couples conceiving without medical assistance. We excluded editorials, opinion pieces, introductions to special sections, articles that described only lifestyle (e.g. caffeine, stress) or clinical factors (e.g. semen parameters, IVF success). Standardized forms for screening, data extraction and study quality were developed using DistillerSR software and completed in duplicate. We used the Newcastle-Ottawa Scale to assess risk of bias and devised additional quality metrics based on specific methodological features of fecundability studies. OUTCOMES: The search returned 3456 articles. There were 15 papers from 12 studies which met inclusion criteria, of which eight included biomarkers of chemical exposure. Studies varied widely in terms of exposure characterization, precluding a meta-analytic approach. Among the studies that measured exposure using biospecimens, results were equivocal for associations between either male or female phthalate exposure and TTP. There was preliminary support for associations of female exposure to some parabens and glycol ethers and of male exposure to benzophenone with longer TTP, but further research and replication of these results are needed. The results provided little to no indication that bisphenol A, triclocarban or triclosan exposure was associated with TTP. WIDER IMPLICATIONS: Despite a growing literature on couple exposure to non-persistent endocrine-disrupting chemicals and fecundability, evidence for associations between biologically measured exposures and TTP is limited. Equivocal results with different non-persistent chemical compounds and metabolites complicate the interpretation of our findings with respect to TTP, but do not preclude action, given the documented endocrine disrupting effects on other reproductive outcomes as well as fetal development. We therefore advocate for common-sense lifestyle changes in which both females and males seeking to conceive minimize their exposure to non-persistent chemicals. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42018084304.

LanguageEnglish (US)
Pages51-71
Number of pages21
JournalHuman reproduction update
Volume25
Issue number1
DOIs
StatePublished - Jan 1 2019

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Time-to-Pregnancy
Fertility
Parabens
Triclosan
Glycols
Ethers
Life Style
Benzophenones
Medical Assistance
Endocrine Disruptors
Pregnancy Outcome
Fetal Development
Caffeine
Semen
MEDLINE
Infertility
Case-Control Studies
Epidemiologic Studies
Language
Software

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Exposure to non-persistent chemicals in consumer products and fecundability : a systematic review. / program collaborators for Environmental influences on Child Health Outcomes.

In: Human reproduction update, Vol. 25, No. 1, 01.01.2019, p. 51-71.

Research output: Contribution to journalArticle

program collaborators for Environmental influences on Child Health Outcomes 2019, 'Exposure to non-persistent chemicals in consumer products and fecundability: a systematic review', Human reproduction update, vol. 25, no. 1, pp. 51-71. https://doi.org/10.1093/humupd/dmy032
program collaborators for Environmental influences on Child Health Outcomes. / Exposure to non-persistent chemicals in consumer products and fecundability : a systematic review. In: Human reproduction update. 2019 ; Vol. 25, No. 1. pp. 51-71.
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