Nouiakh Nadia, Sunyach Claire, Jos Sarah-Lyne, Sari-Minodier Irène, Metzler-Guillemain Catherine, Courbiere Blandine, Bretelle Florence, Perrin Jeanne
Centre Clinico-Biologique d'AMP-CECOS, AP-HM La Conception University Hospital, 147 bd Baille, 13005, Marseille, France.
Plateforme CREER, AP-HM La Conception University Hospital, 147 bd Baille, 13005, Marseille, France.
Basic Clin Androl. 2022 Jul 5;32(1):11. doi: 10.1186/s12610-022-00161-z.
Exposure of men and women to environmental reprotoxic agents is associated with impaired fertility and pregnancy rates after assisted reproductive treatment (ART). Nevertheless, such exposures are generally not systematically assessed in current practice before ART and subfertile men are generally less explored than women. Our objective was to study subfertile men and women's level of knowledge about reprotoxic agents, their perception of their own risk factors and the correlation between perceived and identified circumstances of exposure.
In our public university hospital, 390 subfertile patients (185 men and 185 women) requiring assisted reproduction technique (ART) treatment, completed a self-report questionnaire before consultation, in order to assess patients' knowledge of reprotoxic exposures, sources of information about them and perception of their own circumstances of exposure. Then a standardized questionnaire was used by the physician during the consultation to estimate domestic, environmental and occupational risk factors of reprotoxic exposures (RFRE). We compared the patients' perception of exposure with the estimated RFRE. The reprotoxic agents knowledge score of patients was 61%. Their main sources of information were the media (40%), the internet (22%) and gynecologists (15%). The standardized questionnaire identified RFRE in 265/390 patients (68%); risk factor was statistically more frequent in men (77%) than in women (59%) (p < 0.05). In total, 141 of the 265 patients with identified RFRE (53%) were aware of their risk factor of reprotoxic exposure.
We identified risk factors of reprotoxic exposures in the majority of subfertile patients, more frequently in men than in women, and half of patients were not aware of their exposures. Patients' main sources of information were extra medical. Efforts should be made to inform patients, especially men, about potential reprotoxic exposure and to enhance medical training about reprotoxic agents, as recommended by international guidelines. The detection and correction of environmental exposures in subfertile men could improve their fecundity, but also their general health, which has been shown to be poorer than health of fertile men.
男性和女性接触环境生殖毒性物质与辅助生殖治疗（ART）后的生育能力受损和妊娠率降低有关。然而，在当前的ART实践中，此类接触情况通常并未得到系统评估，而且与女性相比，对不育男性的研究通常较少。我们的目的是研究不育男性和女性对生殖毒性物质的了解程度、他们对自身风险因素的认知以及感知到的和已确定的接触情况之间的相关性。
在我们的公立大学医院，390名需要辅助生殖技术（ART）治疗的不育患者（185名男性和185名女性）在咨询前完成了一份自我报告问卷，以评估患者对生殖毒性接触的了解、相关信息来源以及对自身接触情况的认知。然后，医生在咨询过程中使用标准化问卷来评估生殖毒性接触的家庭、环境和职业风险因素（RFRE）。我们将患者对接触情况的认知与估计的RFRE进行了比较。患者对生殖毒性物质的了解得分是61%。他们的主要信息来源是媒体（40%）、互联网（22%）和妇科医生（15%）。标准化问卷在265/390名患者（68%）中确定了RFRE；男性的风险因素在统计学上比女性更常见（77%对59%）（p < 0.05）。在265名已确定RFRE的患者中，共有141名（53%）意识到自己存在生殖毒性接触的风险因素。
我们在大多数不育患者中确定了生殖毒性接触的风险因素，男性比女性更常见，并且一半的患者没有意识到自己的接触情况。患者的主要信息来源是非医学渠道。应按照国际指南的建议，努力让患者，尤其是男性，了解潜在的生殖毒性接触情况，并加强关于生殖毒性物质的医学培训。检测和纠正不育男性的环境接触情况不仅可以提高他们的生育能力，还可以改善他们的总体健康状况，因为已证明不育男性的健康状况比有生育能力的男性差。
