In the United States alone, more than five million people of reproductive age experience infertility issues. When considering this reality, identifying the cause of conception struggles becomes all the more imperative.
The relationship between lead and fertility has been a subject of study for years. Dreaming of Baby speaks with Dr. Vasiliki Moragianni from the Colorado Center for Reproductive Medicine in Northern Virginia about the effects lead has on health and fertility specifically.
Daniela: We have with us today Dr. Vasiliki Moragianni, a board-certified reproductive endocrinologist from the Colorado Center for Reproductive Medicine in Northern Virginia and with whom we shall be discussing the effects of lead on fertility. To better inform our readers, it would be great if you could introduce yourself as well as give us an overview of your experience working in this field.
Dr. Vasiliki Moragianni: Hello, this is Dr. Moragianni and I am thrilled to be here today! I am a board-certified fertility specialist at CCRM Northern Virginia, a national leader in fertility care. I take care of patients dealing with infertility and I am happy to share my experience with you today.
What is lead and am I being exposed to it?
Daniela: Thank you for that informative overview Dr. Moragianni, it’s a pleasure to welcome you on Dreaming of Baby. Before we address the subject specifically, we would love to start by placing a background to the subject we will be discussing today: What is lead and to what extent are we exposed to it?
Dr. Vasiliki Moragianni: Lead is a heavy metal that humans are exposed to through contaminated air or food. Potential sources include inhalation of fossil fuel combustion products, drinking water contaminated by lead pipes, and ingestion or inhalation of flakes of lead-based paints.
Daniela: If I understand well then, lead is absorbed through the body through inhalation or ingestion? Is it easy for the body to get rid of it once absorbed?
Dr. Vasiliki Moragianni: Lead is very slowly cleared from the body. Initially, its half-life, or clearance rate, is in the order of days. But later on, it slows down to months and even years.
Daniela: Thank you for clarifying that; how do people mostly come in contact with lead?
Dr. Vasiliki Moragianni: Children are mostly exposed to lead through lead-based paint and lead-contaminated dust. Adults can have occupational exposures, depending on their job. Risk factors for exposure include recent immigration from countries with high lead contamination, living or working near a source of lead or someone who works with lead, using lead glaze/paint (used in ceramic pottery), or eating non-food substances, a condition known as pica sometimes seen in pregnant women.
What are the symptoms of lead exposure?
Daniela: That is very interesting to know. In such cases then, would there be a visible impact on the body or symptoms because of this exposure?
Dr. Vasiliki Moragianni: In general, lead attacks the nervous system and its effects depend on the level of exposure. The spectrum of symptoms ranges from loss of appetite and energy, weight loss, fatigue, muscle aches to tremors, headaches, hypertension, impaired heart and/or kidney function. Highly toxic lead levels can result in seizures, coma, or even death.
Dr. Vasiliki Moragianni: Children can exhibit more neurodevelopmental symptoms and anemia. In pregnant women, lead exposure has been associated with several pregnancy complications.
How does lead affect fertility?
Daniela: Proceeding to the relationship between lead and fertility: how does lead affect female fertility?
Dr. Vasiliki Moragianni: In humans, there are limited studies examining an association between lead and fertility, both male and female. Most data is derived from animal studies. The evidence that we do have seems to point to a link between lead exposure and negative effects on reproductive hormone levels, ovarian function, egg quality, fertility, and pregnancy outcomes.
Daniela: In terms of the evidence that lead exposure affects ovarian function and egg quality, is there any insight as to the extent to which – and how – these are affected?
Dr. Vasiliki Moragianni: Heavy metal exposure leads to smaller ovaries, lower number of follicles (potential eggs), and increased rate of follicle death. The magnitude of the effect is likely related to the extent of lead exposure and resulting blood levels, but, again, the data in humans is limited.
Daniela: Taking an example, let’s say a woman will be undergoing IVF soon, will she be given specific instructions on how to limit lead exposure or this is not normally emphasized/looked into?
Dr. Vasiliki Moragianni: As part of the infertility evaluation she will be asked about potential exposures and risk factors. If she reports any she will be counseled appropriately and testing for lead levels may be included in the evaluation.
Daniela: Thank you for this insight. In terms of reproductive hormone levels; how would lead affect these?
Dr. Vasiliki Moragianni: Some evidence shows that lead exposure may lower levels of LH, FSH, testosterone, and TSH, thus negatively affecting the reproductive potential of both men and women.
DR. VASILIKI MORAGIANNI: “SOME EVIDENCE SHOWS THAT LEAD EXPOSURE MAY LOWER LEVELS OF LH, FSH, TESTOSTERONE, AND TSH, THUS NEGATIVELY AFFECTING THE REPRODUCTIVE POTENTIAL OF BOTH MEN AND WOMEN.”
Daniela: Moving on now to the male factor – what are the effects of lead exposure on male fertility?
Dr. Vasiliki Moragianni: Lead exposure has been linked to decreased semen parameters (such as semen volume, sperm concentration, and motility), sperm immaturity, and decreased ability to fertilize eggs, which ultimately leads to lower pregnancy rates.
Daniela: When dealing with male infertility, is lead levels testing carried out routinely or only in specific cases?
Dr. Vasiliki Moragianni: Similar to female infertility, a thorough evaluation of male partners includes the assessment of risk factors. If such factors are identified then blood lead levels can be measured.
Daniela: Thank you. As a final question, and to better inform our readers, are there any lifestyle changes which can be undertaken through which to limit lead exposure and hence limiting its possible effects on fertility?
Dr. Vasiliki Moragianni: Educating yourself about lead is the key to lowering your chances of exposure. Some simple steps include washing your hands, remove shoes before entering your home, keeping your home clean, dust-free, addressing water damage, paint deterioration, and debris on outlet screens or faucet aerators. Also, make sure you and your family consume a healthy, balanced diet.
Daniela: Thank you for this insight, Dr. Moragianni. The information you have shared with us today will surely be helpful to our readers in their journey to baby as well as in their everyday lives. Thank you for your time!
Dr. Vasiliki Moragianni: Thank you!