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Making Baby Series - Part 19 : Avoid Toxins



Tens of thousands of chemicals are used in this country every day, with about a thousand more debuting each year, almost all of which were unknown as recently as fifty years ago.
The vast majority have never been studied for their effects on our reproductive systems. According to the Environmental Protection Agency (EPA), at least fifty of the most commonly used chemicals do have an impact on our reproductive systems, but only four are regulated because of it.




These toxic substances contaminate our air, soil, and water—and from there potentially just about anything we come into contact with. Sometimes we breathe them in. Sometimes they are in our food. Sometimes they just soak in through our skin. And when they do, they can cause all kinds of health problems. Cancer is perhaps the most publicly recognized threat from toxins in our environment, but they also have a detrimental effect on fertility.

The average sperm count for an American man has plummeted over the past few decades—so much so that doctors have had to redefine “normal”—and environmental toxins are among the prime suspects. The quality of sperm has dropped, too, while abnormalities have increased. Women’s bodies are also affected, although those changes are more complex to track than sperm count and so have been less comprehensively researched.

Case Study: George and Eleanor
 George and his wife, Eleanor, came to see me (Sami) because Eleanor had been unable to get pregnant. I couldn’t find anything in Eleanor’s medical history and physical that explained the holdup, so I suggested that George have his sperm count tested. He told me he’d had it done a year before (for unrelated reasons), and it had been normal. Still, with no other explanation available, he agreed to have it done again. The results showed that his sperm count had plummeted. So now it was clear why Eleanor wasn’t getting pregnant, but what had happened to George’s sperm production? I asked him what was new in his life, and he said only good things: he and Eleanor had bought a vacation home, and he was enjoying the country life there very much. None of my questions unearthed anything further, so we returned to the topic of the vacation home. 

When George mentioned that it had well water, I advised him to have the water tested. It turned out that his new retreat was also the source of his new trouble: the water was high in heavy metals and mercury. He’d been slowly poisoning his sperm. George switched to bottled water while he figured out how to clean up the well. He also went to see a specialist to discuss treatment with chelating agents to remove the heavy metals from his system. Months later, his sperm count was back up to normal, and I had full confidence that a pregnancy would soon follow.

In cases of unexplained infertility or repeated miscarriages, both men and women need to be evaluated for environmental toxin exposure. Even in the case of miscarriages, it’s not just the woman’s body that may be responsible. To take just one example, the wives of Vietnam veterans exposed to Agent Orange were found to have increased rates of miscarriage and infertility.
Common toxins—including pesticides; lead, mercury, and other heavy metals; bromodichloromethane (a ubiquitous by-product of the addition of chlorine to our drinking water); cadmium; cigarette smoke; and PCBs—have been linked to a wide range of fertility problems in both men and women, including low sperm count, poor sperm motility, increased sperm abnormalities, higher levels of DNA-damaged sperm, reduced semen quality, impotence, increased miscarriage, higher rates of endometriosis, failure in IVF, and some cases of otherwise unexplained infertility. These are just a few well-studied examples from a very long list.

Detailing the effects of all the chemicals that have been studied could fill a whole book, so here we focus on just two: dioxins and xenoestrogens. We chose these in part because they are among the most pervasive toxins and the most damaging to fertility. But they also are largely avoidable. You are in control of how much exposure you have—once you know where to look for them.

Case Study: Wanda 
Wanda was in her mid-30s and had been trying to get pregnant for a year when she came to see me (Sami). After doing a medical history and physical, I determined that she wasn’t ovulating and that fertility drugs could easily solve her problem. One thing from her history stood out, however: Wanda reported that she loved swordfish and ate it about three times a week. This gave me pause, given the reports of high mercury levels in swordfish, so I had Wanda’s blood tested. Her results for mercury came back so high—seven times the normal level (which is 10)—that I had to report them to the health department. I told her I wouldn’t give her any fertility drugs until her mercury level came back down. In fact, I advised her to ask her husband to use a condom until then, just to be sure she didn’t get pregnant. I feared for the health of any embryo conceived in such a toxic environment. 

Fortunately, the solution was simple: Wanda gave up swordfish. Her mercury level returned to normal over the next couple of months, and I started her on fertility drugs to help her ovulate. Ovulate she did, and within a couple of months, she was pregnant.

Dioxins
Dioxins are toxic chemicals created as by-products in a huge range of industrial processes, from bleaching paper to manufacturing herbicides to incinerating medical waste. Dioxins interfere with the body’s hormonal system. Exposure can alter the menstrual cycle and has been linked to an increased risk of endometriosis. It also has been implicated in the inability to maintain pregnancies. In men, high blood levels of dioxins are associated with lower testosterone levels, impaired sexual performance, lower-quality semen, and decreased sperm production and motility. Decreased testosterone, in turn, can mean less muscle mass (less strength), less bone density, more fatigue, and more depression to go along with the sexual dysfunction and infertility. Dioxins are also associated with a range of other harmful effects. (We’re focusing on just the most relevant to the subject at hand.)

Now for the good news: you are in control of how much dioxin you are exposed to. The biggest source of dioxins in humans is beef, milk, and other dairy products, followed by poultry and other meat and eggs. You can inhale dioxins (and do whenever you get a whiff of cigarette smoke, for example), but mostly you get contaminated by what you eat. That’s because dioxins are attracted to, and concentrated and stored in, fat—as in the fat in any animal product you eat and in the fat reserves in your body. This is another good reason to keep your own body fat down—a leaner you makes it harder for the dioxins to stick around.


What You Can Do About It
Our advice is to limit your intake of animal products and to switch to organic meats and low-fat and lean varieties when you do eat them. You don’t want to exclude fats in general from your diet, but animal fats—which provide saturated fats as well as dioxins—shouldn’t be your main source.


Xenoestrogens
Xenoestrogens are chemicals that mimic estrogen in the body, wreaking havoc with the proper performance of real estrogen. Male as well as female bodies produce estrogen, although women make much more of course. Estrogen is crucial to the workings of our reproductive systems, but it also plays an important role in bone development, growth, circulation, metabolism, and more. Estrogen serves as a kind of messenger, and pretty much every cell in the body has an estrogen receptor—sort of a docking station for estrogen molecules to plug into to convey their information.

Xenoestrogens are close enough structurally to estrogen to attach to these same receptors and block the real estrogen from doing its work. In this way, xenoestrogens are a prime cause of hormone imbalance—including estrogen dominance—and the infertility that can result from it. They are also testicular toxins. Exposure to xenoestrogens has been linked to declining sperm count, decreased semen quality, increased DNA-damaged sperm, low sperm motility, and otherwise unexplained infertility in men. It has been linked to increased risk of recurrent miscarriages, endometriosis, ectopic pregnancy, and polycystic ovarian syndrome (PCOS) in women. And it can reduce libido.


What You Can Do About It
Xenoestrogens are released into our environment and our bodies mainly from pesticides and plastics, although they can also be found in a wide range of everyday products, from paints to toiletries to spermicides. So the best ways to protect yourself are to buy organic and to be careful about how you use plastics, especially when it comes to food. Do not micro-wave food in plastic containers or covered with plastic wrap, and don’t place hot food in plastic. The heat will allow some plastic molecules to make their way into your food.


The molecules that can leach out of plastic and into food are “plasticizers” known as phthalates. Phthalates are versatile chemicals used in a wide array of products. They are ubiquitous in plastics, and they are also used in many cosmetics and personal care products. Phthalates are used most commonly in fragrances, including scented lotions, shampoos, and soaps. One kind of phthalate can be found in nail polishes that promise to prevent chipping and breaking, as well as in other plastic products that need to be strong, such as tool handles. At the risk of an imperfect manicure, you can protect yourself and your reproductive tract from phthalates by reading labels carefully—some are now proclaiming the absence of phthalates—or simply by choosing unscented products.
While you are reading those labels on personal care products, look out for parabens as well. Parabens are commonly used as preservatives in cosmetics. They are absorbed into the body through the skin, so you don’t want them in your facial cleanser, lipstick, or hair conditioner.

A final line of defense against powerful unnatural estrogens is to include phytoestrogens—plant estrogens—in your diet. Phytoestrogens also mimic estrogen in the body, but in a beneficial way: when they bind to estrogen receptors, more powerful xenoestrogens cannot. Flaxseeds and soy are the best sources of phytoestrogens. Nuts, sesame seeds, and legumes are good sources as well. Small amounts are found in many grains and some fruits, vegetables, and herbs, another argument for including a variety of whole foods in your diet.

We don’t see infertility due to environmental toxins all that often. Or rather, we may see the effects, as in low sperm count, but never trace the origins all the way back to the root cause. But doctors should be considering these toxins as part of the whole picture when trying to decode fertility problems. Particularly if you are dealing with unexplained infertility or miscarriage, toxicology screenings for lead, mercury, cadmium, and the like should be part of your workup.
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