scientific program • symposia - American Society for Reproductive ...

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS
Tuesday, October 18, 2011 1:15 pm – 2:15 pm
Interactive Session
NEONATAL EXPOSURES TO REPRODUCTIVE TOXICANTS AND
ADVERSE REPRODUCTIVE OUTCOMES
Presented by the Environment and Reproduction Special Interest Group
Susan H. Benoff, Ph.D. (Chair)
The Feinstein Institute for Medical Research
Kevin G. Osteen, Ph.D.
Vanderbilt University School of Medicine
Needs Assessment and Description
While the effects of in utero exposure to endocrinedisrupting
chemicals have been well studied in numerous
mammalian species and the adverse adult reproductive
outcomes of such exposures have been identified, only
fragmentary human data exist supporting a relationship
between neonatal exposures to environmental chemical
contaminants and adult reproductive problems (e.g.,
polycystic ovary syndrome (PCOS), premature birth,
Leydig cell dysfunction). Nonetheless, recent evidence for
causality has been obtained from animal studies, which
also help to identify the underlying mechanisms and
transgenerational effects (e.g., altered estrogen signaling,
epigenetic modification of gene expression). Animal studies
also indicate that neonatal exposures can exacerbate
the effects of in utero and adult exposures (e.g., prostate
cancer). Recent studies provide preliminary evidence that
nutritional intervention and anti-inflammatory therapies may
be effective in countering the effects of neonatal exposures
and provide a starting basis for patient counseling. Given
the potential human benefit, there remains a need for
targeted research both in terms of markers for exposure
and for identification of additional interventional therapies.
Changes in public policy to minimize toxicant exposures
would likely also prove beneficial.
Room 224 G/H
91
Learning Objectives
At the conclusion of this session, participants should be able
to:
1. Evaluate existing human data on the adverse effects of
neonatal exposure to reproductive toxicants.
2. Demonstrate the utility of animal models in the
identification of underlying mechanisms of action.
3. Summarize existing animal and human data in order to
develop a rational basis for patient counseling.
4. Assess the potential benefits of existing interventional
strategies for improving reproductive outcomes.
ACGME COMPETENCY
Medical Knowledge
Patient Care
TEST QUESTION:
After participating in this session, at a preconception
counseling session in my practice, I will do the following:
A. Not consider a workup of the male partner necessary if
he had previously fathered a child.
B. Generally not consider the occupational history of a
couple’s parents and grandparents as being relevant to
the potential for infertility or adverse pregnancy
outcome.
C. In addition to prenatal vitamins, recommend to the
couple considering pregnancy that they each consider
dietary changes prior to conception in order to reduce
the potential impact of environmental toxicants on the
health of their future children.
D. Recommend that the female partner receive genetic
counseling if she has concerns regarding her
occupational exposures prior to conception.
E. Not applicable to my area of practice.