Before the beginning: environmental exposures and reproductive and obstetrical outcomes

Current evidence strongly implicates preconception environmental exposures having an adverse effect on fertility and obstetrical and neonatal outcomes.

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Volume 112, Issue 4, Pages 613–621


Thalia R. Segal, M.D., Linda C. Giudice, M.D., Ph.D.


There is growing consensus that preconception exposure to environmental toxins can adversely affect fertility, pregnancy, and fetal development, which may persist into the neonatal and adult periods and potentially have multigenerational effects. Here we review current data on preconception and prenatal exposure to several chemicals, including heavy metals, endocrine-disrupting chemicals, pesticides, and air pollution, and their associated obstetrical and reproductive health effects. Reproductive endocrinologists and affiliated health care providers have a unique opportunity to counsel patients before they get pregnant to minimize exposure to hazardous chemicals with the goal to improve reproductive outcomes and assure a healthy lifestyle overall. We provide practical tools and some publicly available resources for reproductive health professionals to assess a patient's risks and ways to reduce chemical and air pollution exposures during the critical preconception and prenatal periods.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.