Infertility etiology

The idea of reduced adrenal capacity as a possible model for PTSD has also been recently raised by Heim et ah, who concluded that low cortisol may not be a unique feature of PTSD, but may represent a more universal phenomenon related to bodily disorders, having an etiology related to chronic stress (Heim et al. 2000). There are numerous stress-related disorders such as chronic fatigue syndrome, fibromyalgia, rheumatoid arthritis, chronic pain syndromes, and other disorders that are characterized by hypocortisolism. In one study, Heim et al. showed decreased cortisol responses to low-dose DEX, but failed to observe blunted ACTH responses to CRF in women with chronic pelvic pain, some of whom had PTSD, compared to women with infertility (Heim et al. 1998). Since the data were not analyzed on the basis of the subgroup with and without trauma and/or PTSD, it is not possible to directly compare results of that study to other reports examining PTSD directly. 

Dubin, L. and Amelar, R.D. 1971. Etiologic factors in 1294 consecutive cases of male infertility. Fertil. Steril. 22, 469-474. 

Radiation can also cause male infertility, impoten-cy, decreases in sperm fertilizing ability, and damage to the process of sperm formation. These disorders have been observed in victims of the Chernobyl accident as well as in patients treated with radiotherapy. In laboratory rats, the damage to sperm formation can be alleviated by treatment with testosterone and estrogen, indicating an etiology of sex hormone imbalance. 

Our inability to defend ourselves against new chemicals and mixtures often results in epidemics of disease. For example, asthma, autism, infertility, and many cancers affect different parts of the body and seemingly have different etiologies. All, however, can be related to a combination of genetic predisposition and environmental exposure to chemicals. All are less prevalent where chemical exposures are lower, for example, in rural areas. All have known single chemical exposure causes and they can all be related to low level exposure to chemical mixtures. The toxic effects of chemical mixtures are explored in the chapters that follow. 

Baker HWG, Burger HG, DeKretser DM, Hudson B. Relative incidence of etiologic disorders in male infertility. In Santen RJ, Swerdloff RS, eds. Male reproductive dysfunction. New York Marcel Dekker Inc, 1986 341-78. 

Scientists at the John Duckett Center for Pediatric Urology, a research arm of the Children s Hospital of Philadelphia, are studying cryptorchidism (undescended testicles) from three angles analysis of data collected from patients in whom this condition was surgically corrected, analysis of seminal parameters found in these patients, and gene analysis related to the etiology of cryptorchidism and the related potential infertility. 

The maintenance of normal fertility in mammals is thus a complex of processes subject at almost every step to a balanced sequence of hormonal regulation. Infertility may arise because of a fault in any single step in this complex, but its etiology may be complicated either by the multiple effects... 

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