International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals.

Exposure to toxic environmental chemicals during pregnancy and breastfeeding is ubiquitous and is a threat to healthy human reproduction. There are tens of thousands of chemicals in global commerce, and even small exposures to toxic chemicals during pregnancy can trigger adverse health consequences. Exposure to toxic environmental chemicals and related health outcomes are inequitably distributed within and between countries; universally, the consequences of exposure are disproportionately borne by people with low incomes. Discrimination, other social factors, economic factors, and occupation impact risk of exposure and harm. Documented links between prenatal exposure to environmental chemicals and adverse health outcomes span the life course and include impacts on fertility and pregnancy, neurodevelopment, and cancer. The global health and economic burden related to toxic environmental chemicals is in excess of millions of deaths and billions of dollars every year. On the basis of accumulating robust evidence of exposures and adverse health impacts related to toxic environmental chemicals, the International Federation of Gynecology and Obstetrics (FIGO) joins other leading reproductive health professional societies in calling for timely action to prevent harm. FIGO recommends that reproductive and other health professionals advocate for policies to prevent exposure to toxic environmental chemicals, work to ensure a healthy food system for all, make environmental health part of health care, and champion environmental justice.

Historical walk: the HRP Special Programme and infertility.

BACKGROUND/AIMS: The HRP Special Programme (HRP) began addressing 'reproduction' problems (infertility) at the same time as 'fertility regulation' (contraception). METHODS: This report is based upon data collected from official HRP Scientific and Technical Reports. RESULTS: In the 1970s, HRP supported research on human and nonhuman primate models to address the basic biology of reproduction. Importantly, however, it was the multicountry clinical research studies sponsored by HRP during the 1970s and 1980s which led to the identification of not only the large burden of disease but also global patterns of causation of infertility. The next decade saw the development of WHO guidelines and manuals for diagnosis, management, and treatment of infertile women and men, with HRP-sponsored operations research focused on adaptation within primary health care settings. Consensus consultations held during 2001 through 2011 resulted in recommendations to stakeholders, as well as the identification of barriers and inequities in access to infertility care services. CONCLUSION: With renewed focus on infertility through the current development of revised guidelines and manuals, and the desire to support critical clinical research protocols, including adaptation and implementation research for management and monitoring tools being developed through international partners, HRP will continue to support future success stories in family, maternal, child, and reproductive health.