The determinants of the various endpoints of male reproductive health and dysfunction — including infertility, sexual dysfunction, sperm characteristics, adverse pregnancy outcomes, and reproductive system anomalies and cancers — are poorly understood. There is limited information about the mechanisms and the impact on male reproductive function of specific environmental and occupational exposures.39 It is therefore important to identify the following: the exposures with the highest priority for study, the appropriate biomarkers of exposure and effect, and the effective means of preventing or controlling exposures to reproductive toxicants.37 There is growing evidence that the male reproductive system can be influenced by exposure to hazardous substances during development; therefore, biomarkers that reflect exposures during pre-conception periods should be considered in human and in vivo experimental animal studies.140 It is important that researchers consider the added value of integrating some of the biomarkers outlined in this paper, including tests of sperm function and genetic damage, into future epidemiologic studies of the impact of environmental and occupational exposures on male reproductive health.

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