Environment and women's reproductive health.
BACKGROUND
There is significant evidence that continuous and prolonged exposure to several endocrine disrupting chemicals (EDC) is a risk factor for reduced fertility and fecundity in women. There is also evidence that ED exposure has trans-generational effects. In this systematic review, we evaluate the evidence for an association between EDC exposure and women's reproductive health.


METHODS
Studies were found by searching the PubMed database for articles published up to 2010. Associations between ED exposure and women's reproductive health reported in the PubMed database are summarized and classified as fertility and fecundity, pregnancy outcomes, transgenerational exposure and effects.


RESULTS
Epidemiological studies on EDCs are not always consistent, in part due to limitations imposed by practical constraints. In order to make progress in this field, we recommend taking advantage of biomonitoring and biobanks, including the development of appropriate biomarkers, and taking into greater consideration modulating factors such as genetic polymorphisms and dietary habits. Further human studies are warranted with particular focus on impaired fertility/fecundity associated with currently widespread ED (e.g. bisphenol A, phthalates and polybrominated flame retardants).


CONCLUSIONS
A detailed appraisal of compounds specifically related to adverse reproductive outcomes is very important for prevention and risk-communication strategies. Besides research needs, the current evidence is sufficient to prompt precautionary actions to protect women's reproductive health.
Institute of Gynecology, Perinatology and Child Health, Sant'Andrea Hospital, University of Rome Sapienza, Via di Grottarossa 1035, 00189 Rome, Italy. donatella.caserta@uniroma1.it
D
D
Caserta
A
A
Mantovani
R
R
Marci
A
A
Fazi
F
F
Ciardo
C
C
La Rocca
F
F
Maranghi
M
M
Moscarini
D052244:Endocrine Disruptors / Q000633:toxicity*; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced* / Q000453:epidemiology; D018811:Maternal Exposure; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors
D052244:Endocrine Disruptors