Lifetime infertility and environmental, chemical, and hazardous exposures among female and male US veterans

Background: Veterans experience many potentially hazardous exposures during their service, but little is known about the possible effect of these exposures on reproductive health.

Objective: This study aimed to assess the association between infertility and environmental, chemical, or hazardous material exposures among US veterans.

Study design: This study examined self-reported cross-sectional data from a national sample of female and male US veterans aged 20 to 45 years separated from service for ≤10 years. Data were obtained via a computer-assisted telephone interview lasting an average of 1 hour and 27 minutes that assessed demographics, general and reproductive health, and lifetime and military exposures. Logistic regression models were used to evaluate associations between exposures to environmental, chemical, and hazardous materials and infertility as defined by 2 different definitions: unprotected intercourse for ≥12 months without conception and trying to conceive for ≥12 months without conception.

Results: Of the veterans included in this study, 592 of 1194 women (49.6%) and 727 of 1407 men (51.7%) met the unprotected intercourse definition for infertility, and 314 of 781 women (40.2%) and 270 of 775 men (34.8%) met the trying to conceive definition for infertility. Multiple individual exposure rates were found to be higher in women and men veterans with self-reported infertility, including petrochemicals and polychlorinated biphenyls, which were higher in both the men and women groups reporting infertility by either definition. Importantly, there was no queried exposure self-reported at higher rates in the noninfertile groups. Moreover, veterans reporting infertility reported a higher number of total exposures with a mean±standard deviation of 7.61±3.87 exposures for the women with infertility vs 7.13±3.67 for the noninfertile group (P=.030) and 13.17±4.19 for veteran men with infertility vs 12.54±4.10 for the noninfertile group (P=.005) using the unprotected intercourse definition and 7.69±3.79 for the women with infertility vs 7.02±3.57 for the noninfertile group (P=.013) and 13.77±4.17 for the veteran men with infertility vs 12.89±4.08 for the noninfertile group (P=.005) using the trying to conceive definition.

Conclusion: The data identified an association between infertility and environmental, chemical, and hazardous materials that the veterans were exposed to during military service. Although this study was limited by the self-reported and unblinded data collection from a survey, and causation between exposures and infertility cannot be proven, it does show that veterans encounter many exposures during their service and calls for further research into the possible link between veteran exposures and reproductive health.