Kilcoyne Karen R, Mitchell Rod T
MRC Centre for Reproductive Health, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, UK.
Department of Diabetes and Endocrinology, Royal Hospital for Sick Children, Edinburgh, UK.
Arch Dis Child. 2017 Dec;102(12):1169-1175. doi: 10.1136/archdischild-2016-311374. Epub 2017 Jun 6.
Human male reproductive disorders (cryptorchidism, hypospadias, testicular cancer and low sperm counts) are common and some may be increasing in incidence worldwide. These associated disorders can arise from subnormal testosterone production during fetal life. This has resulted in a focus on in-utero environmental influences that may result in reproductive effects on the offspring in later life. Over recent years, there has been a dramatic increase in the scientific literature describing associations between in-utero environmental exposures (eg, industrial chemicals and pharmaceuticals) and subsequent reproductive outcomes in male offspring. This includes studies investigating a potential role for in-utero analgesic exposure(s) on the fetal testis; however, providing definitive evidence of such effects presents numerous challenges. In this review, we describe an approach to assessing the potential clinical relevance of in-utero (and postnatal) environmental exposures on subsequent male reproductive function using exposure to the analgesic paracetamol as an example.
人类男性生殖系统疾病（隐睾症、尿道下裂、睾丸癌和精子数量少）很常见，而且在全球范围内，有些疾病的发病率可能还在上升。这些相关疾病可能源于胎儿期睾酮分泌不足。这使得人们将重点放在子宫内环境影响上，这些影响可能会对后代成年后的生殖功能产生影响。近年来，描述子宫内环境暴露（如工业化学品和药物）与雄性后代后续生殖结果之间关联的科学文献急剧增加。这包括研究子宫内接触镇痛药对胎儿睾丸的潜在作用；然而，要提供此类影响的确凿证据面临诸多挑战。在本综述中，我们以接触镇痛药对乙酰氨基酚为例，描述一种评估子宫内（及出生后）环境暴露对后续男性生殖功能潜在临床相关性的方法。
