Increasing toxins in the environment is one of the reasons for the disruption of hormones, leading to higher incidence of infertility in both men and women. 10 to 15 percent of men and women in India are infertile. In urban India, the figure touches 20 per cent due to lifestyle factors such as late marriage, delayed child birth, obesity and sedentary lifestyle, says Dr Ratna Durvasula, senior fertility specialist, Rainbow Hospitals. She provides answers to some common doubts:

Q Which are the identified hormone disrupting chemicals found to cause fertility issues? How does the human body come in contact with them?
Many chemicals, both natural and man-made interfere with hormones. These are called endocrine disrupting chemicals. They can be found in many of the everyday products such as plastic containers, food cans, detergents, toys, cosmetics and pesticides. For example, Bisphenol A which is used in manufacture of plastics and Phthalates which are used in plastics and food packaging.





Q What toxins affect the body due to occupational factors? Like for engineers working in gas companies and energy plants. Or, for women working in radiotherapy or chemical labs and industrial plants?
Constant exposure to high temperatures in chemical and gas companies can have a negative impact on sperm production. Radiotherapists can be exposed to ionic radiations for radioactive isotopes but they are usually protected by lead shields. Also, dosimeters are worn to monitor exposure. Perfluorinated chemicals are widely used in food packaging industry, non stick cookware, water and grease repellents. Exposure to Perfluorinated Chemical Acids (PFCA) can reduce female fertility and sperm production.

Q What is the role of phthalates and how do they cause harm? It is said that this chemical is found in plastics and affects sperm count and also the eggs
Phthalates are typical examples of endocrine disrupting hormones. They are found in plastic containers and personal care products. They can mimic the effect of natural hormones and interfere with their normal functions..

Q Why is it that some people are affected and others are not? What factors make some people more susceptible?
The genetic makeup of individuals and lifestyle decide the susceptibility. Some individuals can withstand toxic exposure as their bodies have better coping mechanism to process toxins.

Q How can fertility be preserved in both men and women?
A healthy lifestyle and diet, adequate intake of fruits, vegetables and water are great habits. It is advisable to eat organic foods and whole grains. It is also advisable to conceive before the age of 30.

Q Do IVF and other fertility treatments become a challenge in such patients? Do they have to opt for surrogacy?
In these patients, fertility can be enhanced by avoiding exposure to endocrine-disrupting chemicals, adopting healthy lifestyle and reducing stress levels. If these don’t work fertility treatments like IUI and ovulation induction can be effected. This involves making the egg grow and introducing sperm into the uterus at the time of ovulation. IVF can be used when three to four attempts at IUI don’t work out.

Q What is it in the environment that is reducing the sperm count and also concentration of sperms in men?
Increasing use of pesticides and fertilisers and personal care products are exposing men to endocrine disruptors, which are causing imbalance of hormones. Also obesity, sedentary lifestyle, stress, alcohol and smoking lead to low sperm count. These are found to be the major reasons in men whose sperm count and sperm motility is decreasing.

Q Do delayed marriages in women also reduce their quality of eggs?
Quality of eggs in women are stated to be the best between ’20s to ’30s. At a later stage there is an effect. But other factors like lifestyle and diet also matter. Women who are fit do not have problems while others need to come for treatment early after 30’s so that the best eggs can help in reproduction. Often in women we find that stress levels are very high. Once this factor is done away with, normal pregnancy is also observed.