TY - CHAP M1 - Book, Section TI - Genitourinary Principles A1 - Chu, Jason A2 - Nelson, Lewis S. A2 - Howland, Mary Ann A2 - Lewin, Neal A. A2 - Smith, Silas W. A2 - Goldfrank, Lewis R. A2 - Hoffman, Robert S. PY - 2019 T2 - Goldfrank's Toxicologic Emergencies, 11e AB - The genitourinary system encompasses 2 major organ systems, the reproductive and the urinary systems. Successful reproduction requires interaction between 2 sexually mature individuals. Xenobiotic exposures to either individual can have an adverse impact on fertility, which is the successful production of children, and fecundity, which is an individual’s or a couple’s capacity to produce children. The role of occupational and environmental exposures in the development of infertility is difficult to define.12,42,88 Well-designed and conclusive epidemiologic studies are lacking because of the following factors: laboratory tests used to evaluate fertility are relatively unreliable, clinical endpoints are unclear, xenobiotic exposure is difficult to monitor, and indicators of biologic effects are imprecise. Although the negative impact of xenobiotics on fertility is often ignored, infertility evaluations are incomplete without a thorough xenobiotic exposure and occupational history. Differences in the toxicity of xenobiotics in individuals are sex related, age related, or both. Xenobiotic-related, primary infertility is the result of effects on the hypothalamic–pituitary–gonadal axis or a direct toxic effect on the gonads.76 Fertility is also affected by exposures that cause abnormal sexual performance. Table 19–1 lists xenobiotics associated with infertility. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1163008355 ER -