Sharara F I, Seifer D B, Flaws J A
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore 21201-1703, USA.
Fertil Steril. 1998 Oct;70(4):613-22. doi: 10.1016/s0015-0282(98)00253-2.
To review current knowledge on the potential effects of environmental toxicants on female reproduction in laboratory animals, wildlife, and humans.
Published literature about the effects of endocrine disruptors, heavy metals, solvents, pesticides, plastics, industrial chemicals, and cigarette smoke on female reproduction.
RESULT(S): Published data indicate that chemical exposures may cause alterations in reproductive behavior and contribute to subfecundity, infertility, pregnancy loss, growth retardation, intrauterine fetal demise, birth defect, and ovarian failure in laboratory animals and wildlife. Data on the association of chemical exposures and adverse reproductive outcomes in humans are equivocal and often controversial. Some studies indicate that chemical exposures are associated with infertility, spontaneous abortion, or reproductive cancer in women. In contrast, other studies indicate that there is no association between chemical exposures and adverse reproductive outcomes. The reasons for ambiguous findings in human studies are unknown but likely include the fact that many studies are limited by multiple confounders, inadequate methodology, inappropriate endpoints, and small sample size. The mechanism by which chemicals alter reproductive function in all species is complex and may involve hormonal and/or immune disruption, DNA adduct formation, altered cellular proliferation, or inappropriate cellular death.
CONCLUSION(S): Studies are needed to clarify which toxicants affect human reproduction and by which mechanisms of action. Furthermore, methods should be developed to minimize exposure to known reproductive toxicants such as dioxins and cigarette smoke.
综述有关环境毒物对实验动物、野生动物及人类雌性生殖潜在影响的现有知识。
已发表的关于内分泌干扰物、重金属、溶剂、农药、塑料、工业化学品及香烟烟雾对雌性生殖影响的文献。
已发表的数据表明,化学物质暴露可能导致生殖行为改变,并导致实验动物和野生动物出现生育力低下、不孕、妊娠丢失、生长发育迟缓、宫内胎儿死亡、出生缺陷及卵巢功能衰竭。关于化学物质暴露与人类不良生殖结局之间关联的数据并不明确,且常常存在争议。一些研究表明,化学物质暴露与女性不孕、自然流产或生殖系统癌症有关。相比之下,其他研究则表明化学物质暴露与不良生殖结局之间并无关联。人类研究结果不明确的原因尚不清楚,但可能包括以下事实:许多研究受到多种混杂因素、方法不当、终点不合适及样本量小的限制。化学物质改变所有物种生殖功能的机制很复杂,可能涉及激素和/或免疫干扰、DNA加合物形成、细胞增殖改变或细胞异常死亡。
需要开展研究以阐明哪些毒物会影响人类生殖以及通过何种作用机制。此外,应开发方法以尽量减少接触已知的生殖毒物,如二噁英和香烟烟雾。