Disorders of reproduction.

Human reproduction is an exceedingly complex process susceptible to insult at many stages. The targets of reproductive injury include the male and female worker as well as the conceptus. Because research into the reproductive and developmental effects of occupational exposures is relatively new, there are significant gaps in our knowledge of specific agents, their mechanisms of action, and their adverse effects. At the same time, workers increasingly are turning to their primary health care providers with concerns about potential reproductive hazards. Evaluation of patients includes identifying occupational agents with suspected reproductive or developmental effects, defining exposure parameters, and making estimates of risk based on the best available data. Management includes patient counseling and intervention to decrease hazardous exposures through workplace controls or temporary job transfers and leaves. By taking an occupational history, identifying possible work-related problems, and making appropriate referrals, primary care physicians can have an important role in the diagnosis, treatment, and prevention of adverse reproductive outcomes.