RT Book, Section A1 Chu, Jason A2 Hoffman, Robert S. A2 Howland, Mary Ann A2 Lewin, Neal A. A2 Nelson, Lewis S. A2 Goldfrank, Lewis R. SR Print(0) ID 1108426062 T1 Genitourinary Principles T2 Goldfrank's Toxicologic Emergencies, 10e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071801843 LK accesspharmacy.mhmedical.com/content.aspx?aid=1108426062 RD 2024/03/28 AB The genitourinary system encompasses two major organ systems, the reproductive and the urinary systems. Successful reproduction requires interaction between two 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.14,41,95,99 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 and occupational history. Differences in the toxicity of xenobiotics in individuals may be sex or age related (or both). Xenobiotic-related, primary infertility may be the result of effects on the hypothalamic–pituitary–gonadal axis or a direct toxic effect on the gonads.82 Fertility is also affected by exposures that cause abnormal sexual performance. Table 21–1 lists xenobiotics associated with infertility.