PFAS are found in follicular fluid

PFAS are in follicular fluid. Yesterday I had dinner with a neighbor who is a retired astro-physicist. We started to talk about how PFAS are harmful to reproductive health. PFAS is the abbreviation of polyfluoroalkyl substances. These substances are resistant to biodegradation and thus have substances have long half-lives. Teflon, for instance is a PFAS, which was first discovered in 1938 and then trade- marked in 1945. My neighbor wanted to know how a large molecule which is not very reactive can harm health. PFAS are found in many products, such as firefighting foam, water repellent fabrics, non-stick cookware and food packaging. Teflon, for instance is a PFAS. Its chemical name is polytetrafluoroethylene. The public are exposes to these substances through drinking water, air, and contaminates food. They accumulate blood, liver and reproductive tissues. Public health concerns have succeeded in a phase out of the use of many of the PFAS that were first used by the military and then found there way to the general public in the form of non-stick cookware in the 1960s. Teflon was banned in the US in 2014. However, other PFAS were used instead and were thought to be less toxic. However, papers published in the scientific literature have found these to be problematic as well. Numerous studies have shown that PFAS are found in the follicular fluid surrounding the oocyte in the ovary. Results suggest that PFAS are associated with infertility and some reproductive diseases such as polycystic ovary syndrome, delayed puberty, irregular menstrual periods and early menopause. Studies were conducted outside the US, but a just published paper reports finding PFAS in women in North Carolina. Fifty-two individuals seen in a fertility center were evaluated. There were two groups studied. One group was infertile, average age 35.1. The other group members were fertile, average age was 34.1. This latter group were being seen by physicians in the center because they elected to preserve fertility, were oocyte donors, were undergoing IVF for male factor infertility or were concerned about genetic issues such as aneuploidy due to advanced reproductive age. The cumulative load of various PFAS were detected by ultra-high performance liquid chromatography -tandem mass spectrometry (UPLC-MS/MS). This cumulative load was varied but PFAS were detected in follicular fluid. Interestingly, there were no differences between the two groups in terms of PFAS present. The groups had similar body weight and BMI. In North Carolina, in the Cape Fear River basin has a number of fluorochemical manufacturing plants. These plants have released both PFAS that are the so- called legacy PFAS (manufactured early 1960s and onward) and the newer PFAS known as GenX which were considered less toxic.

To answer my neighbor’s question: PFAS have two mechanisms of action on humans. One is that they act as endocrine disruptors. In the body they mimic hormones. Endocrine disruptors can bind to active hormone receptors and block the hormones produced by the body; they can alter hormone production by either stimulating or inhibiting this production; they can affect hormone transportation to the cells and affect metabolism of the hormone; and they can alter cell function and affect cell processes such as proliferation and migration. The second mechanism is oxidative stress. Free radicals are formed normally in the mitochondria when they use oxygen to make energy. Oxidative stress means that there is an imbalance of the production of reactive oxygen species (free radicals) and the body’s ability to neutralize their formation. The excess free radicals attack lipids. Proteins and DNA and damage them. Free radicals steal electrons from stable molecules and trigger an chain reaction that causes the cell damage. Then the free radicals overwhelm the body’s functions.

The PFAS can seriously harm reproductive health. Further studies are needed to understand how to mitigate their harm.