Endocrine disruptor & nutritional effects of heavy metals in ovarian hyperstimulation.

PURPOSE: There is increasing concern that environmental chemicals have a direct effect on fertility. Heavy metals such as mercury have been shown to affect various organ systems in humans including nervous system and skin, however they could also act as endocrine disrupting chemicals adversely affecting fertility. Metals such as zinc and selenium are essential micronutrients with diverse functions that may be important for reproductive outcomes. We measured mercury, zinc and selenium levels in the hair, a reliable reflection of long term environmental exposure and dietary status, to correlate with the outcome of ovarian hyperstimulation for in vitro fertilisation (IVF) treatment. METHODS: We analysed the hair of 30 subfertile women for mercury, zinc and selenium using inductively coupled mass spectrometry. Each woman underwent one cycle of IVF treatment. Correlation between the levels of these trace metals and treatment outcomes was investigated. RESULTS: Thirty women were recruited with mean (±SD) age of 32.7(4.4) years and BMI of 25.4(5.0)kg/m(2). Hair mercury concentration showed a negative correlation with oocyte yield (p < 0.05,ßcoefficient 0.38) and follicle number (p = 0.03,ß coefficient0.19) after ovarian stimulation. Zinc and selenium levels in hair correlated positively with oocyte yield after ovarian stimulation (p < 0.05,ß coefficient0.15) and (p = 0.03,ß coefficient0.21) respectively. Selenium levels in hair correlated significantly with follicle number following stimulation (p = 0.04, ßcoefficient0.22). There was no correlation between mercury, zinc and selenium in hair and their corresponding serum levels. CONCLUSION: These data suggest that mercury had a deleterious effect whilst there was a positive effect for zinc and selenium in the ovarian response to gonadotrophin therapy for IVF. Hair analysis offers a novel method of investigating the impact of long-term exposure to endocrine disruptors and nutritional status on reproductive outcomes.

Infantile hemangiomas: a look back and future directions.

Over the past 10 years, there have been significant advancements in our understanding of the biology and natural history of infantile hemangiomas (IH). Research into their pathogenesis has led to many new discoveries including the first mouse model recapitulating hemangioma growth and genes such as the vascular Endothelial Growth Factor Receptor (VEGFR) which may be intimately involved in their proliferation. Large prospective studies have born out important data on the natural history, complications and structural associations of these fascinating vascular tumors. In addition, new therapies have emerged which appear to be very effective. In the following article, a summary of major contributions over the past decade is outlined.