Headlines - Human Reproductive Disorders and Endocrine Disruptors: What Monitoring Strategies for the Future?

On December 5 and 6, 2013, the InVS launched a collaborative effort involving epidemiologists and specialists in reproductive and environmental health to identify common indicators of male and female reproductive health with the aim of establishing an international surveillance system. According to the WHO, reproductive health includes fertility, as well as reproductive processes, functions, and systems at all stages of life. It thus encompasses pathologies of the reproductive organs, including cancers and urogenital malformations, biological characteristics (levels of reproductive hormones), and transgenerational reproductive effects. Research by Scandinavian teams led to the development in 2001 of the hypothesis of testicular dysgenesis syndrome (TDS), a developmental disorder believed to be caused by fetal exposure to endocrine disruptors. TDS is associated with urogenital malformations and, in adulthood, poor sperm quality and an increased risk of testicular cancer. More recently, the same hypothesis has been proposed for women, with ovarian dysgenesis syndrome (ODS), which could be responsible for various reproductive health issues throughout life (malformations, ovarian insufficiency, fibroids, endometriosis, cancers, etc.). Furthermore, recent studies by the InVS using existing databases (the Fivnat database and hospital data) have highlighted a decline in male reproductive health in France: a decline in sperm quality between 1989 and 2005 and, over the 1998–2008 period, an increase in the incidence of testicular cancer, cryptorchidism, and hypospadias.This workshop led to the creation of a network called HURGENT (HUman Reproductive health and General Environment NeTwork), which aims to increase cooperation and the exchange of experience regarding knowledge of reproductive health and surveillance related to the general environment. The work will be organized around four themes identified as priorities for establishing a common foundation for international surveillance: hormonal indicators, fertility indicators, hospital data, and cancers and malformations of the reproductive system.