RT Book, Section
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.
SR Print(0)
ID 1163008355
T1 Genitourinary Principles
T2 Goldfrank's Toxicologic Emergencies, 11e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259859618
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1163008355
RD 2024/04/18
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.