Microplastics in Ovarian Follicular Fluid: What the Research Means for Fertility (Episode 585)

Full Transcript: Episode 585

Lisa Hendrickson-Jack:

This is the Fertility Friday Podcast, episode number 585.

In today’s episode, we are diving into some interesting new research. I’m sharing a very recent study and it is the first study of its kind to be examining microplastics in female ovarian follicular fluid. The title of the study is “First Evidence of Microplastics in Human Ovarian Follicular Fluid: An Emerging Threat to Female Fertility.” So we are going to be diving into that study, talking about the implications and really kind of looking at what this potentially means for you and I and for clients who are concerned about supporting their fertility. So without further ado, let’s go ahead and jump in.

So as I mentioned, this, according to the researchers in the study, this is the first time that microplastics have been officially discovered in ovarian follicular fluid. And this could be a result of just improving the techniques of detection, those types of things. So that makes this study in many ways a bit novel. And I think a good place to start is to actually define what microplastics are. So microplastics are simply tiny plastic particles that are very small, smaller than 5 mm. And so think about the size of a sesame seed or less. And they come from the breakdown of larger plastic items. And so when we are drinking water out of plastic bottles or when we are eating food from plastic containers or even using certain makeups or if you just think about where plastic is, those microplastics, we could be ingesting them. We can be inhaling them. Those are some of the most common ways that we would be exposed to them.

And so this study, like I said, is interesting and novel because it’s the first time that they’re specifically identifying it in the follicular fluid of women. And so essentially what the researchers did is they studied 18 women who were undergoing assisted reproductive treatment. So they were getting in vitro fertilization, IVF, and they then examined the follicular fluid. And out of the 18 women, they found microplastics in 14 out of the 18 samples. That in and of itself is a very significant finding because it is showing us, kind of confirming, that yes, they are everywhere and they’re kind of making their way through our body at various levels to the point that they are even found in our follicular fluid.

And what’s interesting about follicular fluid is that it does play an important role in supporting egg quality. I mean, if you think about what that means, within the ovary, that’s where our follicles are contained. And so within the follicle is the egg itself. So that fluid is what the egg itself is being bathed in. And according to the researchers, the follicle is the basic structural unit of the ovary, which can be divided into the pre-antral follicles and antral follicles. During the growth of the oocyte, the follicle is filled with follicular fluid, which plays a crucial role in the maturation and development of the oocyte.

One of the things that Lily and I talked about in Real Food for Fertility was the connection between the quality of nutrition that you’re consuming and how it can even impact ovarian follicular fluid, and studies that show the connection between the nutritional inputs that we’re putting in the body and of course the quality of the ovarian follicle, the quality of the egg that results.

So of course the implications then — the question is, is this actually affecting fertility? And I would say that that’s one thing that this study wasn’t conclusively able to do. And I think it’s because it’s a preliminary study, sample sizes are very small. And of course, this population in the study is specifically women who were already struggling with conception, making that statement because they were all seeking IVF treatment. And so I suppose what would be interesting would be more of a larger study, right, on a larger scale of women who had no challenges with fertility, women who did have challenges with fertility, women of various ages. And to see if we can add more complexity, more diversity to this sample size or the participants in the study — then that would give potentially the opportunity to have a better understanding of whether or not this is impacting fertility.

But what the researchers do in this study is they go through the research that has been done in this area. So although we don’t have a lot of research on how this specific issue — microplastics in human follicular fluid — could affect fertility for women, they do have a wide range of animal studies that they review within this study to kind of go through what the implications are from what we’ve seen in animal studies. And when we look at what they’ve provided, which are a lot of different studies, particularly done on rats, it doesn’t look good. And I mean, if you think logically, if we had a high level of microplastics throughout our bodies and in our follicular fluid, you wouldn’t naturally assume that that would be a positive thing. You wouldn’t naturally assume that this would be good for us. We know that microplastics are not a nutrient. We know that they’re not necessarily helpful. We know that they’re not supposed to be there. These are synthetic products that are created that are just not healthy.

So I think intuitively we know that this isn’t great, but I suppose then the question becomes, well, how bad is it? And what are the potential downsides here? So what the researchers say is that although there is currently a lack of evidence of reproductive effects in humans, several studies on animals demonstrate significant alterations in male reproduction. And so when they look at the studies on male animals, whether it’s mice or rats, they’re seeing effects such as reduced sperm motility, an increase in abnormal sperm — so sperm that are not of normal morphology — and also a decrease in testosterone levels. When they look at studies on female mice, they’re looking at reduced oocyte maturation, decreased capacity for fertilization, and alterations in the development of the embryos.

So they’re looking at the impacts that it’s having, and what they’re finding in these animal studies is that it is impairing reproduction. It is impairing the capacity for fertilization, normal oocyte development, and of course normal hormone production. So they’re looking at an increase in oxidative stress. When we talk about oxidative stress, I always think of peeling a banana and letting it sit on the counter — it turns brown. So there’s damage due to oxygen. And research tells us that when we have oxidative stress, that increases the risk of DNA damage, which of course is significant when we’re looking at reproduction. The quality of eggs and sperm are largely related to the percent to which the DNA is intact. And as we see higher levels of DNA damage, particularly in the sperm and the egg, we do see an increased number of potential complications and other issues.

The researchers go on to say that in recent years, the negative effects of microplastics on fertility have been extensively investigated in animal models, revealing significant impacts on the female reproductive system. Studies on rats have shown that microplastics accumulate in the ovaries and granulosa cells, which can impair follicular growth and disturb the hormonal balance. Specifically, exposure to microplastics leads to a decrease in levels of AMH and estradiol while increasing the levels of FSH, resulting in irregular cycles and disruptions in folliculogenesis.

So what the researchers are saying and what they go through in the study is the growing body of research in animal models showing that microplastics are having a significant negative impact on fertility — whether we’re looking at the effect on ovarian function, hormone production, or the impact on sperm production, testicular function, and hormone production in male animals. They’re showing an increase in inflammation. They’re showing an increase in oxidative stress. They are showing a variety of very specific effects that microplastics can have on fertility.

So in this study, they’re acknowledging the limitation. Their main role was just to verify if microplastics were present or not, which they did. So in their words, they say the main purpose of this preliminary study was therefore to verify the presence of microplastics in the follicular fluid of 18 women undergoing assisted reproduction according to their protocol. So now they have a way to actually test the fluid. Obviously microplastics are very tiny, so they need to have specialized ways to gather this information and test the fluid to conclusively determine if they’re there. But I suppose the question that remains now that they found them there is — we’ve seen this in animal models, so what is the actual impact in human beings?

And I guess the question for us, as we kind of take this all in stride, is what does this mean for us? There’s a variety of different toxins that we need to be aware of. And in Real Food for Fertility, for example, we have a whole chapter on toxins where we go through some of the most common toxins that we’re exposed to. The issue of toxicity in general is something that we should be aware of, and the question always remains: to what extent is this affecting our fertility, our hormones, our menstrual health, and what can we actually do about it?

So I think because this is more of an emerging field, the information around it is still being developed. And the primary approach when looking at this issue of microplastics is likely avoidance — to minimize our exposure as much as possible, while also acknowledging that it is ubiquitous. And if we look at different types of toxins, whether it’s phthalate exposure, whether it’s parabens or BPAs, when you look at the studies, the women that have the highest levels are the women that have the highest exposures. And there are some studies that would indicate that just by stopping using certain products, your exposure goes down significantly.

So what are some of the ways that we can reduce our exposure to microplastics? I think one of the most obvious ones is to look at our water consumption. I think for many of us, drinking water from plastic water bottles is likely one of the greatest exposures potentially to microplastics, as well as heating food in plastic containers or storing food in plastic containers.

I think the first step is just to become aware of it and to get curious about it. When you first start to look at it, it’s pretty scary. Everything is in plastic. Whether it’s lotions, makeup, drinking water, food — and then there’s also the ways that these foods are processed. So I think the first step is to become aware of it and to start thinking about it. And then the second step is, now that we are a little bit more aware, we can gradually start to shift our practices.

I don’t think it’s reasonable to say that I’m never going to use anything out of a plastic bottle again. But certainly we can start thinking about what are some ways that we can minimize. We can look at our food products and how many of those are in plastic containers, and are there alternatives in glass bottles? Is there a way for me to ensure that I’m drinking water out of a non-plastic container? How do I store my food at home? Are there ways for me to avoid plastic when possible?

And even switching from more processed foods that are typically packaged — moving to more whole foods, real foods that have less packaging. It really is about reduction, not about trying to achieve perfection, because microplastics are ubiquitous. They’re found in our water. They’re found in animals in nature. Some of the exposure may come from inhalation. One of the ways to reduce our exposure is to reduce the dust in our house — to actually make sure that we’re dusting and cleaning — because a lot of these toxins and tiny microplastics can kind of settle in the dust in our homes.

So my thought on it is awareness, education. First of all, we need to know it’s a problem. Then we need to look around and think, where are my exposures? And then we can think, how can I reduce that? And hopefully within the coming years, we’ll have a better idea of whether there’s anything we can do to help the body remove these. If we’re finding these microplastics in ovarian follicular fluid, is there a way to reduce that? Is there a way to clear that? And if we do reduce our exposure, does it have a meaningful difference on the follicles that are developing in each menstrual cycle?

From this study, I could come up with 10 to 15 to 50 additional studies that would be so interesting to look at so we can get a better sense of what the potential effects could be on female and male fertility. But I think for now, this study gives us just a little bit of insight.

Based on the study, it looks like they have also identified microplastics in seminal fluid. And of course, it’s concerning because we are seeing this trend of male fertility declining, especially if we look at the research over the past 70 plus years. This is just yet another potential insult, another potential toxin that we are aware of, and then we have to look at what the implications are.

In conclusion, this particular study has not identified any specific negative impacts that the presence of microplastics in ovarian follicular fluid have. That was not the purpose of the study, and so there’s not enough information to conclusively say, this is having this effect. But what they do in the study is present the body of research around the potential for negative impacts of microplastics on fertility based on animal models, and then they leave that question there for further research.

Hopefully this has given you a little bit of insight. It’s part of an ongoing conversation. We live in a toxic world. There are thousands of new chemicals developed every year. There are chemicals sprayed on our food, chemicals in our clothing — and that’s another potential source of exposure to microplastics, because a lot of our clothes are made from synthetic fibers that are basically plastic. There are toxins in our air, toxins in our water, toxins in our beauty products. It really is ubiquitous.

So along these lines, if you are interested in this particular topic — the topic of toxicity and its potential effect on our reproductive function and fertility — then I think you will appreciate next week’s episode. I’m sharing my interview with Lara Adler, and she is an expert in this area of toxin research and exposure. We get into a really interesting conversation not only about the sources of toxins and the potential ways to reduce our exposure, but also about the broader perspective — where there is a certain amount of our exposure that we have control over, and by no means do we have control over what chemicals are put in our public water system or what chemical exposures we have in the air. There has to be an acknowledgement that some of our exposures are not 100% within our control. And so that kind of lends itself to broader questions around legislation.

So with that said, if you enjoyed today’s episode, please share with a friend. The share link for today’s episode is fertilityfriday.com/585. I hope you have a wonderful weekend whenever you tune in to the show. And of course, as always, until next time, be well and happy charting.