US EPA

1599696 

Journal Article 

Testicular Dysgenesis Syndrome (TDS) And Environment: A Possible Role Of Endocrine Disruptors 

Skakkebaek, NE 

2005 

Yes 

Biology of Reproduction
ISSN: 0006-3363
EISSN: 1529-7268 

DART/TER/5002439 

Special Issue 

English 

Male infertility has become a major health problem in many Western countries. In Denmark more than 6% of all children are now born after assisted reproduction. Unfortunately the causes are not known in most cases, although spermatogenic failure can be due to Y microdeletions and other rare genetic causes. In addition, testicular cancer, which is a disease of young adults, is becoming more common in industrialized countries. We propose that male infertility, undescended testis, hypospadias and testicular cancer may all be symptoms of one underlying entity, the testicular dysgenesis syndrome (TDS). The most severe form of the syndrome is gonadal dysgenesis in intersex patients and the less severe phenotype may present itself as subfertility due to decreased sperm count. We assume that not only genetic abnormalities cause maldevelopment of the male gonad, but also environmental factors may contribute to an increasing occurrence of TDS. In fact, it has been repeatedly shown that TDS-like symptoms can be produced in rats exposed to phthalates in utero. Our preliminary data from an ongoing study suggests that phthalate exposure via breast milk may lead to decreased Leydig cell function in newborn boys. However, current research raises more questions than answers: Is there a biologically significant chemical exposure of the unborn child through placenta and breast milk. May it affect reproductive function during puberty and adult life? Are we, in the industrialized world, currently witnessing a process, where human fecundity is declining due to adverse environmental exposures?